Looks like I posted my last reply to soon.
THANK YOU ROCKETMEDIC. This is the info I have been searching for.
oh and i think I have 2 more post b4 I can PM you. I'll work on that and I'll use you for reference. cheers
Originally Posted by Rocketmedic40 View Post
1979 and future readers;
EMSA (the Emergency Medical Services Authority of Oklahoma City/Tulsa), is, at its core, a third-service EMS agency. EMSA is technically a nonprofit corporation that is overseen by a board of directors and survives with a water-bill subscription program called TotalCare and billing for services. EMSA covers something like 3 million people at any one time between Tulsa and Oklahoma City and is the primary 911 response agency for all medical calls within its service area (Oklahoma County, Eastern Canadian County, parts of Cleveland County, Tulsa County and other fringe areas up there). As the EMSA is government-funded, the trucks are all relatively new (the oldest ones down here are 2008) and the equipment is top-notch, albeit lacking some cool things like LUCAS. To serve its population base, EMSA practices system-status management with a variety of shifts between its Eastern and Western (Tulsa and OKC) divisions. As an EMSA medic, you are the medical- so Californians and R/M Colorado, we do not have to wait for, care about or listen to fire medics. These are our patients. OKC and Tulsa have identical protocols (PM me, I can forward a digital copy to you).
Operationally, you are an employee of Paramedics Plus, the paramedic-staffing arm of East Texas Medical Center in Tyler, TX. As a P+ employee, you can transfer within the company to a place of greater need. EMSA does not advertise this affiliation, but it's not denied either- most people assume we are government employees. Paramedics Plus and EMSA have a fairly close relationship. Tulsa has been a Paramedics Plus stronghold for nearly twenty years, OKC was acquired from AMR in the early 2000s. Functionally, this means that you can work on either end of the turnpike with no transition needed.
Our pay is about area-average, maybe area-average plus. As a Step 2 paramedic, I make $15.36/hour on a 48-hour schedule. Tulsa medics make more, but are on a sweet 42-hour rotating 3/4 schedule that keeps them at the same annual rates (a 15% raise across the board there). Western Division is unionized, Eastern is not. Western is currently still on a 48-hour 4-on 3-off schedule, but is negotiating with the union to implement the rotation here. Overtime is steadily available. Functionally, you can expect to make around $40-43k/year here. We also have bonuses for critical-need OT shifts, which means that some of your overtime could potentially be $30 or $40/hour.
American Medical Response and Paramedics Plus are in a bidding war for EMSA, with no clear winner to be announced until October. There is also a city buyout option a la MAST or REMSA. Field employees are safe.
What's it like to work for EMSA (in all honesty)? That's a great question. I left EMSA several weeks ago and came running back (just waiting on my drug test results to come back in so I can hop on a truck and go out), did a lot of self-inspection and growing up and gained a little outside perspective.
EMSA is a system moreso than a lot of other places and relies upon relatively strict assignments and structures to ensure smooth function and appropriate patient care. As a paramedic, you will tech everything in the EMSA system, your partner (although important) is primarily a driver. Dual-medic trucks do exist and are pleasant, but plan on attending every patient. We do a lot of post moves every night and average between 6 and 10 calls/night per crew in the Western Division, 90% 911. We do some IFT, primarily ER to ER, but that's rare. On most occasions, the system is able to send help if needed- so your thirty-patient calls are not rural nightmares, but ten or so ambulances will arrive rapidly. Medically, we are fairly aggressive and progressive in some areas, nearly retro in others. A few months ago, as a brand-new full-time medic, I got butthurt that I was being looked at for providing what I thought was appropriate care. In hindsight, I should have exercised more discretion in use of pain meds (that's not to say I was wrong, but I was probably a little overzealous). We are often accused of being protocol-driven, with some justification- we literally have a protocol for almost everything, including some things that you can realistically expect to see once or so a year. That accusation is actually the inverse of what I thought- my week at REACT showed me that we, as paramedics, are far more trusted in the EMSA system than we were in the REACT model in terms of actual patient care. EMSA's ideal is to make good medical care a matter of drill reinforced by thought, whereas other services tend to try and model thought into drill. I think both are valid approaches when the paramedic can remember both are needed. As opposed to a smaller service, we can actually stay on-scene and help patients when appropriate. I knew REACT wasn't for me when we did a diabetic wakeup in the truck 'because we can't take the time to wait on-scene with her, so we transport". At EMSA, we can be paramedics, not AEMT+.
Our service area and customer base is pretty diverse. OKC has a knife and gun club, every ethnicity (I ran a Cambodian patient a few months back), and plenty of hospitals, treatment options, crime and slums literally next to mansions. It is nothing like the nearly 100% homogenous groups I grew up with in California (out in the desert).
EMSA's medical director, Dr. Goodloe, does a lot of research and likes to publish, which means that we have a pretty wide scope of effective practice and a reasonable amount of freedom. BiPAP on trucks, mag sulfate for asthma, tourniquets, TXA...we are pretty high-speed in some areas, far moreso than the general area. Considering that one of my REACT co-workers told me that "tourniquets guarantee amputation" and wholeheartedly believed it, I'd rather live in EMSA's area should I need EMS. As far as pain management goes, it's pretty conservative, but I have learned to adjust my practice for that. We do not currently have true RSI, but we can facilitate intubations with etomidate and versed. We are also a fairly progressive service in that we don't crucify you for using supraglottics like the King LT, aids like bougies or even making small mistakes. The grass is definitely greener in the Oklahoma region at EMSA than other places IMO. EMSA may be the Borg, but better the Borg than some crappy Firefly rejects. Oklahoma (and everywhere else, I presume) is cursed with an abundance of pro-volunteer, Ricky Rescue, Hillbilly EMS-type providers. EMSA is trying to change that, and does legitimately hold itself to a higher standard than other places. Look at the cots- an EMSA crew generally lugs both bags and the monitor to the patient; REACT is lucky to take the monitor and generally leaves the bag in the truck. Yes, EMSA is some harder work, but it pays off. Ever have to mega-mover someone downstairs instead of a stairchair because "we need to get done with this one fast"? Not at EMSA.
We are a Physio LP-15/Impact 731 vent/IV pump (Tulsa)/Zoll Rescuenet/Ford F450 ambulance company. All trucks are identically-configured AEV ambulances. Broken equipment is immediately replaced.
All in all, I love being an EMSA Paramedic. The flaws in the system are the Iron Schedule and the posting- it's great to get out of the truck and relax, but we are honestly generally fairly busy. I can check out my truck, do my job and help people for eleven or twelve hours, drop it off to get restocked and deep-cleaned, and go home. I realistically expect to see 1-2 ALS patients a night. I don't have to be a firefighter's taxi service. After leaving the flock for a few days, I realized that what I thought were complaints were really just immature *****ing and that the best option I had was to return to EMSA and adapt to the company's way of doing things. I won't lie to you and claim that there isn't a game, Kool-Aid or some griping, but that's normal anywhere. I have learned that the secret to success here is to play the game with a smile on your face, lightly sip the Kool-Aid and don't worry about the little things, because it does most definitely get worse in other places. If you want to do this professionally, I am learning, that is the best advise possible no matter where you work. I don't yet know if EMSA will be a career place, but after my indiscretion in leaving, the grass is greenest locally here. It's going to take a drastically better-compensated offer to get me to move again, and that's years away.
Come on over from California, brother. It's a good place and I think you'll really like it. I know I do. Oklahoma's a bit...different, but not in a bad way. The Duck Dynasty lookalikes are not all we have, and even they have 4G, WiFi, college and such. If you're married, the job market here is pretty diverse and easy to get hired into pretty much anything. Taxes are lower, turnpikes are annoying and votes go Republican.
PM me if you have any questions. (Also, if you're thinking about EMSA, PM me- I want recruiter bonuses lol!)
Starcare drone monitor, if you happen upon this, this drone is functional and happy!
-Bumped
