Hospital based paramedic jobs in NYC

[Parameduck]

I see a lot of posts on FDNY EMS, it seems you make more money working the hospital based paramedic jobs at Long Island Jewish and New York Presbyterian. What are the Pros and Cons to working these systems. From what I have read they seem to be more protected than just a private service. Is getting hired on these departments extremely competitive? There is a possibility of me being relocated to the NY area, currently a paramedic in Oregon. I've looked into the FDNY EMS hiring process and that seems to be mostly a waiting game, with not great pay, currently I'm making more in Oregon with a much lower cost of living.

Thank You!

 

[Pond Life]

I can't speak for FDNY EMS and working in hospitals around NYC. I can reflect on my experiences working here in the UK as a paramedic in the ED.
I have never felt really comfortable / at home in the ED. Great when we interact as prehospital personnel working on a patient when we bring them in, but I find I am like a fish out of water if I work there on shifts.
Don't get me wrong - great people and all that but my working practice in the community has greater freedom and autonomy than in the ED. A patient with pneumonia with a CURB65 or 0-1 I would treat happily at home. With a score of 2 I would still treat at home but get the patients GP involved the following day. Take that scenario in hospital and there is an acceptance by all that the very same patient would have to be seen by a doctor and then probably admitted to a ward and the decision making process' are taken out of my hand.
I realise it's my problem and not that of the ED. They have policies and procedures and I have to adhere to the 'talk to a grown up' pathway. I don't find that challenging enough.
Other people may and probably do have very different experiences.

 

[SixEightWhiskey]

I can't speak for FDNY EMS and working in hospitals around NYC. I can reflect on my experiences working here in the UK as a paramedic in the ED.
I have never felt really comfortable / at home in the ED. Great when we interact as prehospital personnel working on a patient when we bring them in, but I find I am like a fish out of water if I work there on shifts.
Don't get me wrong - great people and all that but my working practice in the community has greater freedom and autonomy than in the ED. A patient with pneumonia with a CURB65 or 0-1 I would treat happily at home. With a score of 2 I would still treat at home but get the patients GP involved the following day. Take that scenario in hospital and there is an acceptance by all that the very same patient would have to be seen by a doctor and then probably admitted to a ward and the decision making process' are taken out of my hand.
I realise it's my problem and not that of the ED. They have policies and procedures and I have to adhere to the 'talk to a grown up' pathway. I don't find that challenging enough.
Other people may and probably do have very different experiences.

You may not be familiar with NYC, the hospital based paramedics there are actually in 911 ALS ambulances and respond as part of the NYC 911 system, along with FDNY EMS.

 

[Pond Life]

ah gotcha

 

[Parameduck]

Thank you for your replies. It appears that hospital based ems paramedics handle about 40 percent of nyc 's 911 calls. New Yorks ems system seems very confusing. Bls units running code 3, "buffing" calls. I was watching a documentary the other day on a hospital in nyc and a GSW was brought in with no lines started by a bls unit. Very different than the west coast.

That Being said, From My Research It Seems That the pay is better on the hospital based systems so I was wondering if it was as competitive as fdny ems? I know a lot of people are interested in testing out of fdny ems to the fire side, so I see the allure there but for those interested in ems it would appear that going for a system that pays twice as much would be better. I could be wrong. I appreciate all answers. Thank you!

 

[Grozler]

Thank you for your replies. It appears that hospital based ems paramedics handle about 40 percent of nyc 's 911 calls. New Yorks ems system seems very confusing. Bls units running code 3, "buffing" calls. I was watching a documentary the other day on a hospital in nyc and a GSW was brought in with no lines started by a bls unit. Very different than the west coast.

That Being said, From My Research It Seems That the pay is better on the hospital based systems so I was wondering if it was as competitive as fdny ems? I know a lot of people are interested in testing out of fdny ems to the fire side, so I see the allure there but for those interested in ems it would appear that going for a system that pays twice as much would be better. I could be wrong. I appreciate all answers. Thank you!

Speaking from personal experience in the Bronx (other boroughs most certainly will vary) but I don't think the voluntaries (what we called hospital based EMS) handle 40% of NYC's 911 call volume but I could be wrong. Trauma in NYC's 911 system is 99% BLS load and go (one exception being lower extremity injury in the elderly requiring pain management and therefore theoretically an ALS call from the get go). Traumas turn into ALS calls when the patient is unconscious (and then dispatched as an unconscious patient and not a trauma) or when extrication is required. Having started EMS in the state of Washington, yes I can vouch for the vast differences between east coast and west coast when it comes to the way traumas are dispatched.

When it comes to pay, it varies hospital to hospital. Most if not all the voluntaries in the Bronx are subcontracted through Transcare. Several people I went to the academy with were former Transcare NYC 911 system veterans (as opposed to the interfacility branch of the operation) and how I understand it the hourly rate is better but the benefits (ie out of pocket health insurance costs) are a huge bite out of your check versus little to none depending on your plan from the FDNY. Also you are looking at a 401k versus a pension. An academy buddy who left LIJ had similar things to say about that shop. There are some hospitals in other boroughs that still employ their own EMS personnel and yes the pay at those spots is pretty good as I understand it.

I'm fairly new to the department and if people with better info or have better insight than I do see this, chime in.

Finally, I learned this tidbit from a lieutenant very recently: there are roughly 3500 line FDNY EMTs and paramedics currently and out of the 12,000 or so FDNY firefighters, about 4000 are former FDNY EMS members. ¯\_(ツ)_/¯

 

[Parameduck]

Thank you for the great reply. I'll have to find where I saw that break down of 40% of the 911 system is handled by hospital based systems. That is quite different on Traumas out there. I guess a huge factor would be proxemities of hospitals. Still find it strange that a patient with a gsw can be brought in with no lines. I have read that some FDNY EMS make decent money with OT. Can you break 6 figures out there with OT after 5 or so years?

I know some of the hospital based systems are BLS volunteers, like St. Lukes and Columbia, do you still consider payed employees from LIJ and NYP vollies? Would there training be as intense as yours?

As far as the hiring process goes for FDNY it seems like its a waiting game. I looked at the application and at this time, if I had my NY State cert and Remac I would score an 85. Are they in need of paramedics in the city? Did you start some where else.

Thank you for all your feed back. Not sure if I will end up out there, really depends if my fiance gets a job out there or not. I'd be following her.

 

[Eddie263]

Thank you for your replies. It appears that hospital based ems paramedics handle about 40 percent of nyc 's 911 calls. New Yorks ems system seems very confusing. Bls units running code 3, "buffing" calls. I was watching a documentary the other day on a hospital in nyc and a GSW was brought in with no lines started by a bls unit. Very different than the west coast.

That Being said, From My Research It Seems That the pay is better on the hospital based systems so I was wondering if it was as competitive as fdny ems? I know a lot of people are interested in testing out of fdny ems to the fire side, so I see the allure there but for those interested in ems it would appear that going for a system that pays twice as much would be better. I could be wrong. I appreciate all answers. Thank you!

In the NYC 911 EMS system i can say as well 99% of trauma is dispatched as BLS reason being is that hospitals are minutes away. Out in the suburbs its very diffrent as hospitals are farther in distance. From my experience depending on the MOI ALS is right behind you. The 2 gsw I've had ALS arrived 2 min after me and took over. But if they don't get dispatched we do what we can and just transport.

As far as pay goes "in house" hospital based EMS providers make more money but have 401k as opposed to FDNY pension after 25 years. Benifits are out of pocket as opposed to FDNY low or no cost. On the BLS side from my experience hospitals like Presbyterian, St Lukes, St Lukes Roosvelt, NSLIJ start at $22-$26 an hour based on experience . Then you have the subcontracted hospital EMS that have Transcare run their 911 like Mt Sinai, Beth Israel, NYU, St Barnabas, Montefiore, Bronx Lebanon which start at $15 an hour.

NON-FDNY EMS are called Voluntary 911 EMS which refers to hospital based paid ambulance. This is because FDNY runs the NYC 911 system and these voluntaries are dispatched by FDNY. Volley EMS agencies like Park Slope, Corona, Central Park, Hatzolah, are composed of volunteers. Some of them are dispatched by FDNY. The trainig varies from agency to agency. Non-Paid Volleys usually require you to first become a dispatcher, then training and then get your shot at responding to calls. Transcare requires 1 week class and 1 week ride along. NSLIJ requires you to attend an academy, do IFT, then transfer to 911.

All in all there's always a need for medics. Wether its 911 or IFT.

 

[MOmedic]

Any idea what Paramedics start at or near?

 

[Michael Iacono]

Im intrested in this too...can a FDNY medic break 6 figures on the year?

 

[Chewy20]

Has anyone tried looking at the FDNY EMS website? Amazing that they have the answers you need!

$31,000 starting pay for EMT. $45,000 after 5 years.

$42,000 starting for a paramedic. $59,000 after 5 years.

Base salary does not include overtime, benefits or shift differentials.

Would be tough with that salary to live in a decent place in NYC that isn't 300sqft.

 

[DrParasite]

Im intrested in this too...can a FDNY medic break 6 figures on the year?

sure. just work 90 hour weeks, those 50 hour week of OT will help make 6 figures easily.

but without OT, even if you end up working there for years, and get promoted, the chances are very slim that you will break 6 figures

 

[Michael Iacono]

Idk man...i dont work for fdny ems but i did the math and ONE shift a week of OT at 59000 a year should put you in the 70's...two shifts which is really in 16 hours extra a week should have tou close to six figures.

Add shift differntial and meal money, is the job as bad as everyone really makes it out to be?!?

 

[Grozler]

Idk man...i dont work for fdny ems but i did the math and ONE shift a week of OT at 59000 a year should put you in the 70's...two shifts which is really in 16 hours extra a week should have tou close to six figures.

Add shift differntial and meal money, is the job as bad as everyone really makes it out to be?!?

For starters, meal money is a joke. Because of the way they pay us, we only get paid for 7.5 hours a day (please don't ask how it works but it has always been that way) and then get less than $5 a day for that meal money as compensation for not getting a meal break. Personally I feel like one seems to mention that if we got that extra 30 minutes of straight pay each day, that would be far more than the pitiful meal money we get. But that would throw off the way we are paid and which would then affect our work schedule.

On top off all the regular taxes that everyone pays (state and federal income, SS, etc), you pay a city tax as well so that's a nice little extra bonus I get for the honor of serving the public of NYC.

Also, OT is capped at 35% of your annual income. So you can work your tail off all you want but you will get capped in the fall. Now there are exceptions where they lift the cap (i.e. every December when all the OT hounds have been capped since September or October and cannot work so picks up the OT and therefore the cap is lifted to fill all the open shifts) or some sort of special occurrence (i.e. when Transcare went out of business and they added extra shifts but those shifts did not count towards your OT cap). I hope that makes sense.

Now to the crux of the matter: is the job as bad as everyone really makes it out to be? I'll be honest, right now it isn't great. I work in the Bronx, the fastest growing borough in the city population-wise. Until the recent additions of new tours and influx of new EMTs, I felt like Sisyphus going to work (as a medic). Clear the hospital and BANG another job. Hope you are a fast eater. Units that are deployed from other boroughs are very surprised with the call volume compared to where they normally work. Management will tell you to your face "It's not about numbers," then in the same breath quote you numbers that we need to improve upon. Everybody (officers included) is under pressure to do more faster. There are a litany of things I feel could be improved upon but only if were that easy...

Finally, do not kid yourself with that $59,000 number. Even if you add in longevity pay and meal money, I doubt its more than $65k a year (before OT). It is expensive as hell to live here and that top end salary is a complete joke compared to fire ($99k) and PD ($92k).

All that being said, I do enjoy working there. Good partners at my station, mostly good officers. If you don't try to scheme your way out of doing work, you will be fine. Co-workers have their opinions on our union but its better than anything in the privates (which in this area is either none or a complete joke). If you need assistance/supplies/PD, you'll get it. Not the case at my last private job in Westchester County (the unofficial motto there was "make it work with what you got"). You can build up leave very quickly and health insurance is pretty good and relatively inexpensive. And do not forget the golden goose of public service: the pension. Now I just have to get through the next 20+ years in one piece.

 

[Parameduck]

I believe north Shore lij starts it's medics at 72k a year after 6 months of probation.