NJ EMS is Awful, and Here's Why

JPINFV

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I'm just wondering, since this thread has been revived, what exactly do EMT-Bs want to do extra that can be justified by a 110 hour training course?
 

MAC4NH

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I also work (and volunteer) in NJ and the problems here run deep. The paid services blame the First Aid Council. The volunteers blame the Department of Health. The politicians ignore the problems until a situation makes the news or until they find a way to personally gain from it (those of you from other parts of the country need to understand that this is NJ and the Sopranos was not a drama but a documentary). The public at large does not want to think about us at all (kind of like whistling past the graveyard).

I have a really radical suggestion. Why don't the paid groups join together with the First Aid Council? This is not as crazy as it sounds. The FAC's leadership at this time are the smartest, best educated and most open-minded group I have ever seen in the organization. The FAC does realize that the days of volunteers in this state are numbered (though they won't admit it openly). They do have a large organization that has access to the politicos in Trenton. An alliance between the professional and volunteer EMS systems might have enough clout to actually change something in Trenton. What has to happen first is communication because there is and will be a lot of mistrust from the rank and file of both groups. The main benefit to both groups is that they can then go to Trenton and tell the politicians the solution that we as providers think will work. Otherwise we will have a bunch of potentially crooked individuals who know nothing about EMS imposing on us a system worse than the one we have (and anyone who works in Jersey knows that it will be worse).
 

firecoins

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(those of you from other parts of the country need to understand that this is NJ and the Sopranos was not a drama but a documentary).
The mob does not exist.:glare:
 

Artttom

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I worked Essex Valley in 1988..

I saw your post about EMS in NJ and I was laughing. I worked Essex Valley in 1988 so I probably know the people who wrote those old call sheets you mentioned in your post about ems service being crappy. Even back then we were frustrated by poor funding and we would routinely borrow stiffneck collars and backboards from University and other places, just to have enough to complete a run. I remember so many crazy stories about working my first paid ems job after leaving the Marines, I still remember interviewing for the job. I only worked there for about six months and then went to UMDNJ for a few months until I moved to Los Angeles to become a cop. I went to Google maps to look for our old quarters but couldn't find it, it probably was torn down years ago, it was in an old fire house a few blocks from the hospital. If you get this fire me back a note it would be funny to hear from a current employee...assuming you're still there.
 

DrParasite

The fire extinguisher is not just for show
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wow, talk about bumping an old thread....

I'm a currently NJ EMT (probably working in the same area as you used to), and think that when you have crappy private EMS sevices (Essex Valley happens to be one of the crappiest), which isn't part of the government in any way, that's what happens: remember, if management can cut down on expenses, not do repairs to trucks, limit supplies, and pay their EMTs poorly, it means higher profits for them. Can you now see what they did it?

and the first aid council sucks and should be disbanded. worst thing to happen to NJ EMS ever.
 

Bullets

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Seriously, was this needed to be dragged up? We all know the NJSFAC is a mess, and the squads are realizing it. My volunteer squad has left the the NJSFAC after deciding we are tired of sending them money for nothing and their refusal to help advance the profession. Some squads, especially those with large life membership will remain until the current members can out vote them, but it is happening. If you look in the Gold Cross supplement 2-3 squads resign a month.

We have 4 squads in my town, 2 have left, 2 are still stuck in the past, their old members keeping them in it. There used to be a time when the NJSFAC was good, when they helped the volunteers, but that time has passed. The current president is a milquetoast who wont do whats right, only what the board and the most vocal members demand. If you go to the convention, it looks like a casualty clearing station, everyone is over 40, most over 80, and they look like fools.
 

medicsb

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When was the NJFAC ever for progress? Their opposition to anything progressive dates back to the 70s when they fiercely opposed the up-start of paramedic services, twice organizing massive protests in Trenton and Newark. Look at articles from the 70s and early 80s and compare them to what they were saying opposition to S818 - little has changed. They are a pox on the face of EMS everywhere.
 
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Bullets

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When was the NJFAC ever for progress? Their opposition to anything progressive dates back to the 70s when they fiercely opposed the up-start of paramedic services, twice organizing massive protests in Trenton and Newark. Look at articles from the 70s and early 80s and compare them to what they were saying opposition to S818 - little has changed. They are a pox on the face of EMS everywhere.
The District were functional, and i think in many cases they were able to bring together squads who otherwise didnt work with each other or had no relationships.
 

Pinksock

Forum Ride Along
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Hi, I'm not too sure how long the state recognized EMT-I and A's for. I do know that those levels were discontinued in 96. I was certified as an emt-b in 97 and had to take a separate course to be certified for defribrilation. For a short period of time I had to sign emt-d on my sheets and redo my patches with the emt Defib then revert back to the regular and patch about a yr later. I also remember way back when the oems started to run a l.m.a. pilot trial in rural counties like hunterdon and Sussex due to the er eta and based on the results the state was supposed to implement lma training for emts in both rural and urban settings. That fell by wayside. But yes all in all nj has some real good emts but the state and fac and other factors can't get past their egos and allow the smart emt s to advance and have the not so smart ones just drop off naturally.
 

RobertAlfanoNJEMT

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As I mention regularly, I'm a paid EMT working in East Orange, NJ. East Orange is a hard town with a high call volume but no money, so the proverbial belts tend to be drawn tight up here. Old vehicles that are falling to pieces, old equipment, crap pay, and long hours with the stong potential of no relief showing up are more than commonplace, they're almost hallowed traditions at this point. I was hired shortly after the new directors (or Chief and Assistant Chief, if you prefer) came on from NYC EMS and OEM. They've tried to fix things but it isn't easy, thanks again to the utter lack of funding.

I have two gripes about Jersey EMS; one is more of an amusing anecdote and the other will likely infuriate some people, but both relate back to the same issue.

New Jersey has a terrible tendency to believe that volunteer organizations can handle all fire and EMS, except in major urban areas where the call volume is simply to high to expect the FFs/EMTs to maintain "day jobs". This is rapidly proving to be an outmoded concept. Volunteerism, at least in EMS, was beginning to become obsolete in the late '90s, in my view. Fire departments in suburban and rural areas, while call volumes are increasing, are still usually receiving no more than 2 calls a day. EMS is wildly different, with call volume only growing as immigrant populations increase and the "indigenous" population ages. Many volunteer agencies have taken to hiring paid EMTs (usually) during the weekday, leaving nights and weekends to the volunteer corps. Some municipalities have opted to go fully paid, while others hire private companies, most notably MONOC, to cover their EMS 911. The state has no direct regulation over the agencies which remain volunteer, as they are under the jurisdiction of their municipality and that is usually only in a cursory role. Volunteer agencies, particularly in sparsely populated regions with few riding members, are well-known to allow non-certified individuals to ride and function in a BLS capacity. As these individuals aren't paid, there are no real repercusions for whatever action they may take, as it isn't a case of getting one's cert. revoked and losing their job. If they have a cert, losing it doesn't always guarantee that they will cease riding.

BLS scope of practice in NJ is laughable, which only compounds the problems raised by increasing volume and decreasing volunteerism. I've heard medics complain about those of us BLS folks as being totally dependent upon them, which is not by our choice. We function as either just a taxi service to the hospital or just as muscle for the medics. There is truly no middle ground. We are incapable of operating on our own in the simplest of emergencies; while other states allow BLS to provide baby aspirin, albuterol, nitroglycerin, activated charcoal, etc. etc., the state of NJ allows us to administer only one medication: oxygen. There is nothing between EMT-B and EMT-P in this state. It's all or nothing.

All of these problems, while not necessarily caused by, are certainly exacerbated by the First Aid Council, which is essentially a union/lobbying group for the volunteer corps. Whenever a new treatment has been brought up as a possibility for BLS to exercise, the FAC has blocked it, because it would have forced them to allow the state oversight on their agencies. Due to their ubiquitous nature, many municipalities consider paid EMS a pointless expenditure, having the concept of "why pay for something you can get for free?" This attitude is quickly showing itself to be foolish, totally without merit, as response times suffer and the quality of care plummets. However, the volunteer agencies and the local politicians are unwilling to give up their ground or admit defeat. The end result of all this is that those 911 agencies which do pay their EMTs are generally only in the most difficult areas to work (i.e. high-crime areas or areas with great distances between patients and the hospital) and get away with underpaying them for the trouble.

As for the aforementioned anecdote, my partner was nosing around in our dispatch room the other night and discovered a folder full of old run reports. From 1987. Just for a goof, we started leafing through these 20-year-old reports; I found myself getting depressed, and said so to my partner.
"These are making me kinda sad, bro."
"Why's that?"
"Nick, these are 20 years old, right?"
"Yeah?"
"We could be using the exact same paperwork right now, man. There's absolutely nothing on the brand-new sheets that isn't on these ancient ones. EMTs have had nothing new to do in Jersey for at least 20 effing years."
"Yep, Jersey sucks, man."
20 years with not a single advancement or improvement to the system. 20 years of training EMTs, not with caution or quality, but with speed, simply to put warm bodies on trucks. Thanks a lot, FAC.
I can feel the fists quenching if volunteers right now 😂😂 I don’t get why volunteers want to hold on to it so long why would you not want to be paid! Let it go! Sign all of you ambulances on to a county service or something! And this is coming from a volunteer..
 

DrParasite

The fire extinguisher is not just for show
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Why would the volutneers clench their fists? the OP is a paid EMT, working for a crappy hospital based EMS system in a crappy city. He's complaining about a system (And this was only 12 years ago). He's actually complaining about the system that pays his bills. He's not a paramedic, so all those limitations apply directly to him. He's not a volunteer (although it wouldn't surprise me if he used to be one) and a lot of what he's saying is, quite honestly, wrong, and based on inaccurate urban legends that have spread through paid EMS agencies for years.

The last time I was an EMS volunteer in NJ was 2007 or so, so while you are willing to work for free, I decided 8 years was enough for me. I started my paid EMS career in an urban city in 2005. Did we have some idiots on my squad, who refused to move the profession forward? yep. Did we have some idiots at my job that I couldn't figure out how they hadn't been fired due to gross incompetence? more than you would like to believe. And if you do work on the paid side of EMS, you see you have the same people who are also volunteers, but they are now getting paid an hourly wage to do the job.

Going paid is not the solution, because simply providing a salary for the people on the ambulance won't fix all the systemic problems. There are plenty of understaffed and underfunded career EMS agencies (including the one where the OP worked). County services sound like a great idea, until all of your ambulances are in other areas, and a resident in your town has to wait 20 minutes for an ambulance to show up. I have since left NJ for a state with cheaper taxes and nicer people, and live in an area that has a county wide service. extended response times are common, low availability of units is common, and other counties frequently rely on mutual aid because they don't have enough ambulances to handle the call volume. Units are frequently OOS due to no staffing. So a paid, county-wide system has not solved the problems caused by poor management.

Fix the funding problems, fix that staffing issues, raise the education standards.... and remember many paid EMTs only have a high school diploma, and their EMT certification. Many of those volunteer EMT have an EMT certification, a high school diploma, and associates degree, and bachelors degree (which is important, because there is a push for all paramedics to have degrees, well, many of your volunteers already have completed that requirement).

NJ EMS has plenty of issues; I have yet to find a state that has no issues with their EMS system.
 
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