I saw HGH EMS and felt I needed to reply to shed a little bit of light on our current situation. Long time lurker, first time poster and what follows is of course under the usual "These are my views and not those of my agency" disclaimer.
What
@NPO said is accurate, to a point. Currently, only two of the seven command staff that were here in November are still working for us and they are serving as the Interim Director and #2. I was in the new hire process when the leadership change happened back in November. The agency was very transparent and notified me that the changes had occurred almost as soon as they did. From speaking with some of the other medics, some of the changes were needed changes, but they just happened extremely suddenly and relatively unexpectedly. Right now we are "short" I think I heard 5 Paramedic positions, but we only have one shift line actually open, because two of the positions would be to staff a unit about 45 minutes north of town, but that hasn't been staffed since the change and isn't a "required" unit. The other two would be filling office positions, which are currently secondary duties of two of the Medics. We also have what are called "Casual Call" employees, which is essentially our verbiage for per diem positions, and we are almost always hiring for those.
I haven't noticed the morale actually feeling down, if anything I think the changes in leadership have strengthened the organization, because much of the workload has been shared between everyone, rather than one or two people as it historically was. It also feels like the initial shock has worn off since and we are just about back to operation as normal. If you are interested, I would absolutely apply, just knowing that the process may take some time.
The "cliff notes" version (in case it hasn't been updated) of the agency is that we run approximately 3000 calls a year between 911, IFT between two hospitals, vehicle extrication, Haz-Mat, and Rope rescue. We cover an area of approximately 10,000 square miles and roughly 20,000 people, currently with two full time crews and a supervisor, with most of the staff living in town with call back ability if needed. We have 3 primary 911 ambulances, a "Rescue Ambulance," a heavy rescue, and a dual stretcher transfer rig as well as 8 or 9 additional semi- or unstocked rigs we use for Burning Man or if we had a significant MCI.
We just switched to a 2 on, 5 off schedule (previously 1 on, 1 off, 1 on, 4 off) and are still feeling it out, since an average transfer is about a 6 to 7 hour round trip to Reno and seem to like to start around 9 pm. I came from Fire based systems in Colorado and REMSA previous to that and absolutely love it here. We have very open ended Clinical Guidelines, and usually do some type of training every day, with a lot of focus on airway and ventilator management. We do have RSI and TXA on standing orders, as well as vents, IV pumps, and KingVision VL on every truck. It is by far the most open scope I've had as a Paramedic, and we are encouraged to look beyond the 911 setting and actually about the long term patient outcome and course on each call. I actually feel supported by the leadership in all contexts of the job, and the channels of communication are very open between field crews and the Interim Director.
Hopefully this helps out a little bit. Feel free to PM me if you have some other questions.
