Maine....low wages, lot of volunteers, HUGE shortage, 25 years behind the times, limited protocols as compared to other states I have worked in, lot of rural towns to cover. Most Medics I know, work one full time job and then 2-3 per diem gigs. Outside of the established cities (which are few), there are tons of towns, and each town likes to maintain control as opposed to consolidating or sharing resources. Many fiefdoms where it has always been done this way and they do not want to give up control. The state just approved I think 25M to be released to EMS to help with falling revenues, loss of staff, and to prevent some of the towns from losing their services (you know the ones they would not lose if only they worked with another town).
Can have some very long transport times with no air support due to weather. My longest (5 hours from start to receiving facility) was a septic shock patient, lived way back in the sticks, took me 40 minutes to get to him, on scene was about 50 minutes due to house layout (home made elevator, big dude, paraplegic, and acuity), stairs, weather, then got stuck in the snow, waited on back up, then of course a fleet of volley FFs, nice dudes all with big trucks....they eventually made their way and then chained the ambo out of the snow bank, up an ice hill and then to main road where we could continue our journey. Meanwhile I am in back giving fluids after fluids, pressors, aggressive airway, had to do IO, it was a crap show.
I did work for one service which I would recommend for many reasons if interested. Its a non-profit that formed from 11 towns agreeing to consolidate.
Leadership is good, many "old" medics on department, meaning a ton of experience and wisdom to be shared. Recently went Union (teamsters) which I had a significant part in their negotiations. Wages and benefits are above average. They invest in equipment, do have decent protocols and are upgrading their fleet.
Only major challenges is everything of significance has to go before the board which is comprised of people from the various towns. Many of the board members are old school Mainers, sitting on a ton of wealth but counting every penny, and many of them are 65+ and completely out of touch with reality. This was evident during negotiations; however, I did get through to many of them by breaking it down. They are definitely confused as to what it costs to live.
Not long after negotiations were finalized, I moved on. Job done.
Only took a little over 14 months or so. And many aggressive meetings...I was the token bad guy, but was one who was informed, able to stand and present, and able to speak in their language. The department was being railroaded until I intervened and yes I am tooting my horn because I helped all existing and future staff there by laying down a darn good first union contract. Part of the problem is all the staff NEEDED their job so no one wanted to make waves. IDGAF, so I was the arsehole.
