IFT vs 911 Pay

[Acetone]

Hey everyone,

I am in the middle of an emt course and the topic of ift vs 911 pay discrepancies have come up many times. I am located in LA county, and the word out of my instructors is that IFT pays much better than 911. From what I'm gathering from the instructors, they say that 911 = excitement, crappy hours, crappy pay. IFT = flexible hours (especially for part time), good pay, kind of boring. Is this accurate? Does IFT pay like 1.5 times what 911 would?

-Tones

 

[Sasha]

kind of boring.

Don't know about pay in your area, but it's only "Kind of boring" if you're too interested in the flashly lights and loud sirens to take a minute and learn from the patients you're transporting. A lot of them have fascinating stories (Like my psych who killed his wife, or the lady who'se accelerator stuck and she had a choice of running into a group of people, or into a brick wall with no airbags... Personally I'd have chosen the people.) and they're even more interesting on a medical level. You're exposed to treatments, tests, procedures and illnesses you'd never even think about on 911.

It gives you the chance to see what happens to the people 911 brings in, long term. It gives you a chance to be exposed to diseases in all different stages. Like early dementia vs. ES alzheimers.

911 certainly has it's merits, and I believe everyone should get experience in both, but I certainly wouldn't call IFT boring.

 

[MusicMedic]

in La County IFT Companies generally pay more depending on the company
911's usually pay around Minimum Wage.. IFT's pay anywhere from 9.50 to 12.00/hr

IFT's are a good place to get patient exposure in a slower(for the most part) paced enviorment.. you get good practice taking vitals/patient assesments...
as well as learn about disease processes
They also tend to work with your schedule more often than not
IFT's can get pretty monotonous.. especially when majority of the calls consist of dialysis/hospital discharges

i do agree with sasha though Psych calls are really fun and tend to be unpredictable.. ive picked up a few crazy patients from Jails/Private Residences/Pysch Facilities... they all have their own stories..(there are some that will spill their guts, some that wont talk to you, and some that'll wrestle/fight with you!!)

Beware of IFT companies in LA County/LA City as there are a MILLION of them and alot of them tend to be sheisty.. so research their reputation before applying

Try to get on with a company that does both IFT's and 911 such as CARE, Gerber, AMR or Bowers(they do mainly IFT's, but have a contract or two for 911)

hope that helps, feel free to reply here or PM more for more questions

 

[terrible one]

911 certainly has it's merits, and I believe everyone should get experience in both, but I certainly wouldn't call IFT boring.

Have to disagree, IFT is crazy boring! Sure you can learn a lot from the transfers you mentioned, however, IFTs in LA are mainly dialysis and SNF discharges, a lot of pts that could have done with out an ED to begin with. You can only learn so much from Mr. Smith with ESRD who you see every M, W, F.
While I recommend doing IFTs to begin just to get basic gurney ops, driving, and hospital roles down eventually I'd move on.
As fas as pay I make $22/hr as an IFT medic. Job isn't fun but I have learned a lot and it's nice to take a break while I'm in school and have other things going on. But come end of next semester I'll take less pay to play with lights and sirens

 

[Journey]

Have to disagree, IFT is crazy boring! Sure you can learn a lot from the transfers you mentioned, however, IFTs in LA are mainly dialysis and SNF discharges, a lot of pts that could have done with out an ED to begin with. You can only learn so much from Mr. Smith with ESRD who you see every M, W, F.

Dialysis patients are not boring in any way. In fact these patients amaze me each time one comes into the ED or hospital. ESRD is the end diagnosis and there is a long list of initial and inbetween diagnoses that present differently depending on which system wants attention at any given time. It is amazing how some of these patients can even make it to their next dialysis visit if you look at their labs. There are some patients who dread the weekends since that means they must make it to Monday. I can not imagine what these patients must endure if your life depends on a 4 hour visit to a dialysis center 3x a week.

Next time you transport a dialysis patient, see what the initial cause of their renal failure was. You might be surprised to find out they may have been "a save" from EMS from either an MI or a trauma. They may also had one of those fevers or UTIs that some take as a joke from SNFs which turns into sepsis requiring serious antibiotic therapy. Tracking from initial to recovery and the end results as well as everything inbetween might just change your mind about boring.

Some of the things that can be learned from these patient include various venous access devices, how to take BPs around shunts and contractures, and where you might establish IV access if you needed it. You will also find many SNF and some dialysis patients with different types of G and J tubes. Some don't realize there is a peg present when they tighten the stretcher straps causing discomfort or pain. These patients also provide great examples for heart and lung sounds. Rarely will two dialysis patients present the same or with the same underlying disease processes besides the obvious ESRD.

The van drivers who take these patients to dialysis are definitely under paid and probably catch more emergencies than some EMTs because they get to know the patients on their routes. EMTs do have a lot of responsibility transporting SNF and dialysis patients and should be compensated well provided they do an adequate assessment and care during transport.

 

[terrible one]

While that may be true seeing the same ones over and over and over and over is boring. I agree it is a ver interesting disease process and such,however, you can only read the chart of Mr. Smith so long before you've memorized it and it becomes montaneous boring transports

 

[Acetone]

Just wanted to thank everyone for the insightful responses.

 

[looker]

Beware of IFT companies in LA County/LA City as there are a MILLION of them and alot of them tend to be sheisty.. so research their reputation before applying

Try to get on with a company that does both IFT's and 911 such as CARE, Gerber, AMR or Bowers(they do mainly IFT's, but have a contract or two for 911)

There are million of ambulance company(s) in la? Dam, I didn't realized it was that many If by "sheisty" you mean they are in business to make money you're correct. What is the point of having your own business, taking all of the liability if you're not going to make significant profit as result of it.

 

[JPINFV]

If by "sheisty" you mean they are in business to make money you're correct. What is the point of having your own business, taking all of the liability if you're not going to make significant profit as result of it.

Oh, please. There are good companies and bad companies and it comes down to more than making a profit. Yes, everyone has to make a profit, however some companies treat their employees better than others. It's the In-N-Out vs McDonalds comparison. Sure, both are in it for a profit and to make money, but the wages at In-n-Out are a lot higher than anyone else. Even from a profit maximization point of view, there's value in reducing employee turnover in terms of higher efficiency (knowing the ropes so to speak) and a decrease in initial training costs. Similarly, there's value in keeping employee morale high. High morale decreases turnover and increases customer service (if I'm in a good mood, I'm more likely to go that extra mile), and morale goes beyond just pay. Unfortunately, some companies can't seem to look past the end of the day total and not taking into account other expenses.

Similarly, too many employers and supervisors fail to realize that the people who do the most harm are the front line employees (EMT and paramedics in EMS). It's much easier to prevent bad customer experiences by hiring and keeping good, happy employees, than it is for a manager to swoop in after something has happened and fix it. After all, how much profit is there if no one will hire you (generic "you") because your employees are scraped off of the bottom of the barrel due to poor wages and poor management techniques and they end up providing poor service?

 

[MusicMedic]

Oh, please. There are good companies and bad companies and it comes down to more than making a profit. Yes, everyone has to make a profit, however some companies treat their employees better than others. It's the In-N-Out vs McDonalds comparison. Sure, both are in it for a profit and to make money, but the wages at In-n-Out are a lot higher than anyone else. Even from a profit maximization point of view, there's value in reducing employee turnover in terms of higher efficiency (knowing the ropes so to speak) and a decrease in initial training costs. Similarly, there's value in keeping employee morale high. High morale decreases turnover and increases customer service (if I'm in a good mood, I'm more likely to go that extra mile), and morale goes beyond just pay. Unfortunately, some companies can't seem to look past the end of the day total and not taking into account other expenses.

Similarly, too many employers and supervisors fail to realize that the people who do the most harm are the front line employees (EMT and paramedics in EMS). It's much easier to prevent bad customer experiences by hiring and keeping good, happy employees, than it is for a manager to swoop in after something has happened and fix it. After all, how much profit is there if no one will hire you (generic "you") because your employees are scraped off of the bottom of the barrel due to poor wages and poor management techniques and they end up providing poor service?

+1 to everything you said...

Ive worked for two IFT companies, One was awesome, and the other one sucked...

Wanna know what the difference was between those two companies?
the better one didnt focus just on profit margin, they focused on QA/QI, Employee Morale(bbq's,parties,gift cards), Better wage compensation... as a result everyone went the extra mile, didnt complain much about their jobs...


The crappy company, focused on mainly on making a quick buck.. they didnt care much for their employees.. nor QI/QA... Employees were disgruntled... No one seemed to care.. PCR's were half-assed.. constant call off's... Employees not looking professional..

The point im trying to make is: If you dont care for the Employees they wont care for you.. (and why should they?)

another point: if your employees are disgruntled.. they will be looking to jump ship the first opportunity they get.. thus higher turnover and more costs to the bottom line (as JPINV stated)

To the OP: Try asking the employees of a company (the emts/medics) and see what they have to say... (sure there might be one or two or a few disgruntled employees so try to ask a few)

 

[firecoins]

Dialysis patients are not boring in any way. .

I am sorry but that is a matter of opinion. As mentioned you study the same person's disease process 3 dialysis sessions a week. After 1 month of 6 transports a week, you will have their disease process memorized.

 

[Journey]

I am sorry but that is a matter of opinion. As mentioned you study the same person's disease process 3 dialysis sessions a week. After 1 month of 6 transports a week, you will have their disease process memorized.

Dialysis patients can have more than one disease process. ESRD is usually the end result of one of those diseases but that does not mean the others go away. Even for someone what has a history of being born with kidney disease, it does not mean that patient has not developed many other diseases along the way as a direct result or from other system failures. Once the patient get labeled with one disease does not mean you stop monitoring it or doing as assessment just because you have memorized all the names.

 

[NomadicMedic]

I've learned more working as an IFT medic than I did as an IFT EMT. Transporting criticaly ill or injured patients from one facility to another can be a nerve racking experience, but one that never fails to educate. A vented patient on multiple meds on a 2 hour transport is a LOT different than dealing with a Chest Pain and having a 10 minute transport time. Luckily, the company I work IFT at is sending selected medics to a CCEMTP program. Hopefully, I'll be one that's picked.

I love running 911 calls, but it's importnat to not discount the IFT experience.

And to keep this post on topic, I make almost double what I take home as a full time 911 medic when I work as a part time/per diem IFT medic. Silly, isn't it?

 

[firecoins]

Dialysis patients can have more than one disease process. ESRD is usually the end result of one of those diseases but that does not mean the others go away. Even for someone what has a history of being born with kidney disease, it does not mean that patient has not developed many other diseases along the way as a direct result or from other system failures. Once the patient get labeled with one disease does not mean you stop monitoring it or doing as assessment just because you have memorized all the names.

Of course diaysis patients have more than one disease process going on. If you find it exciting to read about high blood pressure, morbid obeisity, diabetes, cardiac hx or cancer, thats great. I read the hx, learned from it for about 2 or 3 months. There is only so many times I can read about pt x's multiple disease processes.

I don't discount the IFT experience. its important. SNF emergencies are a great experience. I can't tell you how many times I ran into a train wreck both BLS and ALS. Nurses never seem to know much.

I would even go as far to say that most 911 calls are boring. The "exciting" calls are few and far between. The calls I found exciting 2 years ago are run of the mill now.

 

[Journey]

Of course diaysis patients have more than one disease process going on. If you find it exciting to read about high blood pressure, morbid obeisity, diabetes, cardiac hx or cancer, thats great. I read the hx, learned from it for about 2 or 3 months. There is only so many times I can read about pt x's multiple disease processes.

I don't discount the IFT experience. its important. SNF emergencies are a great experience. I can't tell you how many times I ran into a train wreck both BLS and ALS. Nurses never seem to know much.

I would even go as far to say that most 911 calls are boring. The "exciting" calls are few and far between. The calls I found exciting 2 years ago are run of the mill now.

Dialysis patients can change quickly. It is more than just reading the face sheet or the brief summary of diagnoses. You have to actually assess the patient and talk to them. Find out if anything is different since their last visit. Several EMTs have rolled into the ED with a critically ill dialysis patient without any recent information including the BP because they figured that was also the same as the previous trip. They didn't bother to ask how the patient had been feeling after their last dialysis or they might have learned things like their glucose was up and down or they felt weaker or felt like they had a chest cold coming on.

If you are not doing an assessment, I would say you and your company are being paid too much.

All of things you mentioned (high blood pressure, morbid obeisity, diabetes, cardiac hx or cancer) should play a role in your assessment and should not be discounted. But, you also need to do an assessment for the present.

I see you want to make an attack on nurses. But, they did call for an ambulance so they must have known something. Patients in SNFs are very fragile and can deteriorate in minutes even before the nurse is off the telephone from calling an ambulance. One nurse may also have 30 patients to care for in one shift in a nursing home or SNF. Some of those patient with fevers and UTIs you may have considered to be boring calls may have died within a few hours at the hospital. That is how rapidly some deteriorate. Unless you have worked alongside these patients for a greater length of time than just the drive to the hospital, you may not be aware of this. I can not fault you if this was not in your education. Geriatrics and chronic patients have medical concerns that an EMT and Paramedic must put forth a little extra effort to learn more about beyond their EMT or Paramedic courses. I could also add pediatrics to that list.

 

[Shishkabob]

As firecoins said... IFT experience is useful... to a point. Then it just becomes a detriment if it's all you do.


Doing IFT for 8 months hurt my assessment skills. It hurt my ability to critically think. It hurt my manual skills. It hurt my ability to deal with acute situations. It hurt my ability to control a scene. It hurt my ability to interact with other agencies.


Yes, you still have to do an assessment, and yes you do learn the long term disease process, and there are still times where something can go drastically wrong that you have to correct, but even compared to 911, it's rather small.

There truly is only so much you can do on a BLS transfer. ALS transfer are a much better learning experience for medics, but true ALS transfers (beyond "They have a liter of saline going TKO") are rare.



The best thing would be to do an agency that does 911 AND IFT, best of both worlds. If you do just one, you could suffer atrophy in something.

 

[Journey]

There truly is only so much you can do on a BLS transfer. ALS transfer are a much better learning experience for medics, but true ALS transfers (beyond "They have a liter of saline going TKO") are rare.

What we find on the hospital side is that many of the patients EMS labels as BLS actually require many advanced life support measures but just not the type you in EMS can detect or have to offer on your ambulance regardless of whether it is ALS or BLS. But, again that is just due to the limitations of EMS and probably it should not be your fault nor can you be held accountable for something you do not know or have been trained for. You do not have access to diagnostic equipment or lab values so you may not be able to detect bilateral pneumonia, sepsis or any of the many medical conditions that land these patients in the ICU. So it is not because these patients are not sick, it is that you do not have to ability to know just how sick they are until they present with emergent symptoms and by that time, it will probably be too late for the patient and surviving this trip to the hospital will probably not be likely. It also isn't about how many drips the patient has but the condition that requires closer monitoring. If you are judging a patient only by the meds, you may be missing the bigger picture. But again that goes back to the EMS education where the focus is very narrow for just the emergent and the more skills you can do on one call is how you rate the patient.

Doing IFT for 8 months hurt my assessment skills. It hurt my ability to critically think. It hurt my manual skills. It hurt my ability to deal with acute situations. It hurt my ability to control a scene. It hurt my ability to interact with other agencies.

That comment explains alot about the reports we get from IFT EMTs and Paramedics. It seems they just provided ride and little more. Even for the amount of fluids or meds given during transport is rarely relayed. That would also account for the interaction with other agencies. Thank you for giving me some insight on these problems. I think we do need more RN based CCTs through the hospital and I don't mean that as an insult to you but the RN would have to ability to maintain these skills with hospital experience and more patients.

 

[Shishkabob]

What we find on the hospital side is that many of the patients EMS labels as BLS actually require many advanced life support measures but just not the type you in EMS can detect or have to offer on your ambulance regardless of whether it is ALS or BLS. But, again that is just due to the limitations of EMS and probably it should not be your fault nor can you be held accountable for something you do not know or have been trained for. You do not have access to diagnostic equipment or lab values so you may not be able to detect bilateral pneumonia, sepsis or any of the many medical conditions that land these patients in the ICU. So it is not because these patients are not sick, it is that you do not have to ability to know just how sick they are until they present with emergent symptoms and by that time, it will probably be too late for the patient and surviving this trip to the hospital will probably not be likely. It also isn't about how many drips the patient has but the condition that requires closer monitoring. If you are judging a patient only by the meds, you may be missing the bigger picture. But again that goes back to the EMS education where the focus is very narrow for just the emergent and the more skills you can do on one call is how you rate the patient.

I'm sorry, but taking granny HOME after he UTI treatment is neither a good use of taxpayer money, nor EMS resources.

There is no "hidden need" there.

That comment explains alot about the reports we get from IFT EMTs and Paramedics. It seems they just provided ride and little more. Even for the amount of fluids or meds given during transport is rarely relayed. That would also account for the interaction with other agencies. Thank you for giving me some insight on these problems. I think we do need more RN based CCTs through the hospital and I don't mean that as an insult to you but the RN would have to ability to maintain these skills with hospital experience.

When you provide little more than a taxi ride for the lazy, or for the family of the lazy, that is what it is: A useless, expensive taxi ride.

This is not including legit ALS transfers. This is not including psych transfers. This is not including CCT transfers. This is not including movement to higher-level of care transfers. This is only including the waste that Medicare / insurance companies / taxpayers are expected to pay for, that have no legit medical need.

THAT is what I was commenting on.




Quit placing the blame on education when the matter at hand has nothing to do with such. Not every complaint from an EMS provider stems from us not knowing what we're talking about, thank you.

 

[looker]

Oh, please. There are good companies and bad companies and it comes down to more than making a profit. Yes, everyone has to make a profit, however some companies treat their employees better than others. It's the In-N-Out vs McDonalds comparison. Sure, both are in it for a profit and to make money, but the wages at In-n-Out are a lot higher than anyone else. Even from a profit maximization point of view, there's value in reducing employee turnover in terms of higher efficiency (knowing the ropes so to speak) and a decrease in initial training costs. Similarly, there's value in keeping employee morale high. High morale decreases turnover and increases customer service (if I'm in a good mood, I'm more likely to go that extra mile), and morale goes beyond just pay. Unfortunately, some companies can't seem to look past the end of the day total and not taking into account other expenses.

Similarly, too many employers and supervisors fail to realize that the people who do the most harm are the front line employees (EMT and paramedics in EMS). It's much easier to prevent bad customer experiences by hiring and keeping good, happy employees, than it is for a manager to swoop in after something has happened and fix it. After all, how much profit is there if no one will hire you (generic "you") because your employees are scraped off of the bottom of the barrel due to poor wages and poor management techniques and they end up providing poor service?

Lets go with McDonalds vs In-n-out comparison. McDonalds is probably 100 or 1000 times bigger compare to in-n-out. They are present all over usa and the world, In-n-out is in California and couple of other states. In this economy as emt you're lucky to have a job, period. Even experience emt is replaceable very quickly. Unless you're in right to work state, it is advisable to do good work and keep management happy as you will be replaced quickly if you half *** job on transport and/or paperwork.

 

[looker]

I'm sorry, but taking granny HOME after he UTI treatment is neither a good use of taxpayer money, nor EMS resources.

There is no "hidden need" there.

So what would you like Hospital to do, call a taxi?