How to buff calls in NYC?

RedAirplane said:
Good volunteer services should have their own medical director, continuing education, QA/QI, etc. What else did you have in mind?
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Good volunteer services. As far as I can tell, none of these services possess any of this or the wherewithal to do so. The attitudes displayed here and in other venues do not make me think that these services wish to provide a quality EMS service. They want to get their rush or whatever with as little outside inconvience possible.

And that makes me unhappy. At all three of my jobs (different service models and locations), I work with consumate professionals who seek to better themselves and the profession. I am not going to get behind something that allows "providers" to do the opposite. That's not what this industry needs. There is a reason that no large urban areas rely on volunteers to provide primary 911 EMS services, and more and more areas that are not urban are also realizing that it is not sensible to rely on volunteers to provide what is an essential service.
 
Tigger said:
Good volunteer services. As far as I can tell, none of these services possess any of this or the wherewithal to do so. The attitudes displayed here and in other venues do not make me think that these services wish to provide a quality EMS service. They want to get their rush or whatever with as little outside inconvience possible.

And that makes me unhappy. At all three of my jobs (different service models and locations), I work with consumate professionals who seek to better themselves and the profession. I am not going to get behind something that allows "providers" to do the opposite. That's not what this industry needs. There is a reason that no large urban areas rely on volunteers to provide primary 911 EMS services, and more and more areas that are not urban are also realizing that it is not sensible to rely on volunteers to provide what is an essential service.
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I guess I am a big advocate of the professional volunteer service. I don't like services that respond in POVs, without uniform, etc. But it sounds like the volunteer ambulances in NYC are here to stay for better or for worse, so they should be integrated. I think the attitude you describe is more a byproduct of the system than the volunteers, but who knows.

I'm curious / I had imagined that each of these ambulances had proper equipment, training, QA/QI, oversight, etc. Perhaps someone knows more specifically?
 
They are not professional volunteer services, making their integration into the system a poor idea.

Most states have incredibly lax QA requirements and the medical director may be in name only.
 
Tigger said:
They are not professional volunteer services, making their integration into the system a poor idea.

Most states have incredibly lax QA requirements and the medical director may be in name only.
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I agree very much with Tigger on this. Having been involved with a Department of Emergency Medical Services audit of a volunteer EMS agency I can tell you that the medical director hadnt been involved for years and was surprised when called that his name was still listed as such. He swore he was no longer the MD but the volunteer agency said he was.
 
I think the volunteer thing is very dependent on where you are. Where I came from we had a full time county medical director who made 6 figures. A large portion of the providers also worked a paid gig but there were still quite a few weekend warriors but they were usually not by themselves.
 
ERDoc said:
I think the volunteer thing is very dependent on where you are. Where I came from we had a full time county medical director who made 6 figures. A large portion of the providers also worked a paid gig but there were still quite a few weekend warriors but they were usually not by themselves.
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Ah, you mean one of those...special...departments you find on the east coast. You know the ones I mean...the ones that scream and ***** and whine about how they are such a supercool superawesome supereffecient department and do just as good IF NOT BETTER than a professional, paid department and they do it ALL WITH VOLUNTEERS...except they forget to mention that they have a paid staff doing the bulk of the administration and running the department, and have fulltime paid personnel working (often 24/7) to "supplement" the volunteers...you know...the ones that do all the "real" work.

One of those places? Because places like that are just...so...precious...;)
 
triemal04 said:
Ah, you mean one of those...special...departments you find on the east coast. You know the ones I mean...the ones that scream and ***** and whine about how they are such a supercool superawesome supereffecient department and do just as good IF NOT BETTER than a professional, paid department and they do it ALL WITH VOLUNTEERS...except they forget to mention that they have a paid staff doing the bulk of the administration and running the department, and have fulltime paid personnel working (often 24/7) to "supplement" the volunteers...you know...the ones that do all the "real" work.

One of those places? Because places like that are just...so...precious...;)
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Maybe. :cool:
 
Tigger said:
They are not professional volunteer services, making their integration into the system a poor idea.
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Would integration be worse than the status quo of volunteers legally jumping 911 calls, thus having two (or more) units all scurrying to the scene of the same emergency?
 
No one gets paid at our volly
 
RedAirplane said:
Would integration be worse than the status quo of volunteers legally jumping 911 calls, thus having two (or more) units all scurrying to the scene of the same emergency?
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It is not legal to drive code three to calls you were not dispatched to. So the ideal solution would be to legally stop them from running unless they were specifically called.

There is not a way that you can convince me that allowing poor excuses for EMS organizations to participate in a major metropolitan EMS system is of benefit. It is certainly not a benefit to me or anyone who wishes to further EMS as a respected part of healthcare.
 
Tigger said:
It is not legal to drive code three to calls you were not dispatched to. So the ideal solution would be to legally stop them from running unless they were specifically called.

There is not a way that you can convince me that allowing poor excuses for EMS organizations to participate in a major metropolitan EMS system is of benefit. It is certainly not a benefit to me or anyone who wishes to further EMS as a respected part of healthcare.
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About the Code 3 bit, it seems New York is a bit special as it either does not have this law, or de facto doesn't have it.

The New Yorkers on here have already indicated that the volunteers aren't going anywhere because of their political power. While we may disagree on whether that is a good or a bad thing, it appears to be an invariant of the situation.

So, given that, how would you propose making things better? I think improving oversight (if needed) and integrating them is a lot better than pretending they don't run 911 calls.
 
RedAirplane said:
About the Code 3 bit, it seems New York is a bit special as it either does not have this law, or de facto doesn't have it.

The New Yorkers on here have already indicated that the volunteers aren't going anywhere because of their political power. While we may disagree on whether that is a good or a bad thing, it appears to be an invariant of the situation.

So, given that, how would you propose making things better? I think improving oversight (if needed) and integrating them is a lot better than pretending they don't run 911 calls.
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Operating an ambulance in an emergent mode while responding to a call you were not dispatched to is not operating the vehicle with due regard. They are not running 911 calls, they are listening to a scanner and jumping them. In this day and age of 911 education, I cannot imagine that their seven digit phone is being used much.

I also do not understand what sort of political power they actually have. Sure some neighborhoods may say they support their presence, but if FDNY just said stop, what would happen? Who know? I'd imagine that FDNY really just does not want to deal with the headache of getting them to stop, and lets be honest, FDNY EMS is not exactly known for its managerial prowess.

Improving oversight is not a free process. Where will the money come from to do this, especially since many of these places are already struggling to survive?
 
How to integrate: When we log in, give us jobs, spread em around.

How I see our role as NYC Vollies:

1) We often are local-based so we arrive to the scene first along with FD's CFRs, therefore getting pt's treated and txp faster.

2) We give overburdened 911 crews more breaks, as evidenced by their willingness to give up their patients, even if we are second on scene

3) We assist ALS when there's no BLS backup

4) We are officially called upon when 911 is backed up, such as severe weather conditions.

How I see the value of vollying for those fresh out of EMT school:

- It is the fastest route to doing patient care on street/911 jobs ie unconcious, ped struck, mvas, cardiac, diff breather, etc.

- The long hard way being: Work txp for 6-12 months, hope you land a job in hospital based EMS, or wait 1-2 years for FDNY EMS, or hope you get lucky getting flagged down while doing txp work.

Or one could commute epic distances to new jersey, long island, or upstate NY and get 911 dispatched, maybe even paid for vollying.
 
adamNYC said:
How I see the value of vollying for those fresh out of EMT school:

- It is the fastest route to doing patient care on street/911 jobs ie unconcious, ped struck, mvas, cardiac, diff breather, etc.

- The long hard way being: Work txp for 6-12 months, hope you land a job in hospital based EMS, or wait 1-2 years for FDNY EMS, or hope you get lucky getting flagged down while doing txp work.
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Been there very recently. The "fast" route happens to be the hard way for those who want to do well.
 
adamNYC said:
How to integrate: When we log in, give us jobs, spread em around.

How I see our role as NYC Vollies:

1) We often are local-based so we arrive to the scene first along with FD's CFRs, therefore getting pt's treated and txp faster.

2) We give overburdened 911 crews more breaks, as evidenced by their willingness to give up their patients, even if we are second on scene

3) We assist ALS when there's no BLS backup

4) We are officially called upon when 911 is backed up, such as severe weather conditions.

How I see the value of vollying for those fresh out of EMT school:

- It is the fastest route to doing patient care on street/911 jobs ie unconcious, ped struck, mvas, cardiac, diff breather, etc.

- The long hard way being: Work txp for 6-12 months, hope you land a job in hospital based EMS, or wait 1-2 years for FDNY EMS, or hope you get lucky getting flagged down while doing txp work.

Or one could commute epic distances to new jersey, long island, or upstate NY and get 911 dispatched, maybe even paid for vollying.
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I agree that the volunteer ambulances should be integrated in EMS. However, I am slightly concerned that you see volunteering as a shortcut than as a way to make the community better.

Others can say a lot more about the value of non emergent EMS but I'll share my two cents.

As I am learning, caring for the NOT SICK patients is important to be able to deal with the sick patients. What should I do if the patient's relative is screaming at me? What if they keep forgetting about the conversation and wandering off? What if they're dancing while you're trying to take a blood pressure?

I'm just beginning to feel the tip of this thing and there's a lot more to go. Even though I volunteer and have another full time career, I'm looking at per diem IFT roles for the BLS calls because I want to improve myself as a provider.

Did you do ride alongs as part of EMT class? If so, you probably saw that most 911 calls are not true emergencies. But those patients need your help.

Now here's a thought. What if the vollies took all the grandmas in their neighborhoods to doctors and dialysis, free of charge?
 
Flying said:
Then there would be no vollies, unfortunately.
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I like that response. A lot of what we do is getting people to places that they can't get to on their own in the IFT side. Not all of them truly need the ambulance, but sometimes you have to use what's available.
 
Flying said:
Then there would be no vollies, unfortunately.
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Yup. You have the OP talking about how volunteering is a "good" way to see the "good" calls. If suddenly they don't get to choose what calls they go on and have to do relatively benign IFT type calls, I don't imagine people motivated by adrenalin will last.
 
I do enough txp/IFT is my full time job I do 40-50 hours a work trying to make ends meet beleive me i have my IFT down the only thing that drives me to continue is that I'm months away from having a 1 year of experience, we also do get emergencies from SNFs, doc offices, assisted living, and txp for hatzolah when they don't have a bus available. I tell everyone the value of IFT work and the experience gained. Also getting flagged down happens too which is nice.

The crap IFT pay sucks though I'm looking into other things like driving uber and making 2-3x more. A good temp job till a hospital or FDNY calls me up. Vollying on weekends is all I need.
 
Since the hospital EMS "voluntarily" participate in the 911 system and are sent to calls, I think the best bet would be for volunteer agencies to demonstrate a high quality service and then ask to be extended the same courtesy.
 
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