Rant about how much volunteers are hurting our profession

[Sasha]

I have seen the anti volunteer brigade suggest that if you force agencies to go paid that people will have no choice but to go along or risk losing service. Sounds to me like no pay no play or unless were paid we dont show up.

Links please.

 

[PotatoMedic]

Since everyone wants data here is my two cents:

Until someone provides me with DATA and STUDIES with information stating that volunteers hurt an organization, I will always support volunteers and career personnel. As long as they meet or exceed the standards that they are required to meet. (EMS, FIRE, POLICE, RED CROSS, SAR, etc.)

 

[andydrumm05]

Don't know if this point was already made.

I'm a volunteer. We sit through the same classes. The same number of hours. Are held to the same standards as far as obtaining our certification. We have to pass basically the same test. We learn the same skills. We all have to get CEU's in order to renew our certifications. It doesn't make any sense. an EMT is an EMT, no if's and or buts. Just because it could take vollys longer to respond to a call because we don't man a station 24/7, doesn't mean that we are bringing the profession down. The same thing happens with paid crews as well. What if all their crews are out and receive a call? What will they do then? Same thing with Volly crews. Would I like to get paid to do this? I wouldn't turn down the offer, but that's not why I went into EMS. I like helping people, and what better way to help people than helping them in a time of need. I know of basics on paid crews with private ambulances, and they are nothing more than a glorified driver. Their medical director drastically limits what a basic can do. They also volunteer, and if they didn't volunteer, they wouldn't be able to keep current on their skills. And yes, there is a lot of ego within these smaller volly departments, but at least with the case of my department, we do hold our members responsible for what runs they go on and what they did to help the patient, and did they follow their scope of practice? I do see some of the points from the other side. There are a lot that can be done to improve volunteer departments, but there are also a lot that can be done to improve some of the paid departments as well, at least those paid crews in my area. But I go back to my first statement, we are all EMT's. We all go through the same training. And as someone else had mentioned earlier, the only difference between a paid EMT and a volunteer is if you ask them. That's it. Plain and simple. I worked hard to get my license and will continue to work hard to keep it. And I know a lot of volunteers who are the exact same way. I know in my area, I feel safe with the volunteer crews we have.

 

[medic_texas]

First of all, you have a certification not a license.

Secondly, someone who performs as a EMT(any level) on a fulltime basis tend to be more experienced, competent, and educated (most EMS services require education on top of their CEU's that are required for recert) than a volunteer.

I like helping people too, that's why I'm in health care but I don't do it for free.

 

[Ridryder911]

Since everyone wants data here is my two cents:

Until someone provides me with DATA and STUDIES with information stating that volunteers hurt an organization, I will always support volunteers and career personnel. As long as they meet or exceed the standards that they are required to meet. (EMS, FIRE, POLICE, RED CROSS, SAR, etc.)

I offerred data and referrences. What more do you want?

R/r 911

 

[EMTinNEPA]

Finally someone stands up and makes a clear no BS statement against this continued bashing and outright disrespect aimed at this country's volunteers.

Why is it that the only people who consider the statements in this thread to be infantile, disrespectful bashing are the ones being directly criticised?

My volunteer crew will run circles around your paid crew and that's a fact.

As Sasha mentioned, it is an opinion. And an unfounded opinion, since you have no idea what kind of additional training our paid services require.

Thank you catskills and if this thread goes the way I think it might Ive got your back my brother (or sister).

Catskills is NOT your brother of sister just because they're also a volunteer. This "brotherhood" nonsense is a remnant of the fire service and has no place in EMS.

I am an equal opportunity provider and help all who are in need whether you can pay your bill or not.

What a coincidence... so is my for-profit service.

Should you require paid assistance it will be on scene in around 30 minutes so maybe you could begin your own treatment(because your so superior to me) and hope for the best.

Actually, if I required treatment I could count on the paid service to be there within a few minutes. The only time I would have an extended wait time for them would be when I'm in a volunteer BLS company's coverage area and they fail to crew (as they do very often).

Are you really going to have all this bias at that point in time and refuse treatment from what you all consider as your less than equal counterpart.

For the vast majority of them... yes, I would.

 

[EMTinNEPA]

Wow this forum has some real stuck up paid EMS employees. I made a list of those who think because they get paid they walk on water and because volunteers don't get paid they provide inferior patient care. Let me very clear about what I am about to say.

If you think just because your paid you are better than a volunteer, then I do NOT want you providing me or anyone in my family medical assistance. You got that. I am very serious abut that statement. Read it again and then go take a hard look in the mirror. It may be time for you to get off your high horse and find another profession.

How immature. You would deny medical care for yourself or a family member because somebody has the audacity to collect a paycheck? And you're telling me to find another profession because I want my profession to be a profession? Think about it...

 

[JPINFV]

I'm a volunteer. We sit through the same classes. The same number of hours. Are held to the same standards as far as obtaining our certification. We have to pass basically the same test. We learn the same skills.

I made the comment before, but since this response keeps poping up, I'll post it again.

How many volunteers would you have if the EMT-B education required college level anatomy, physiology, chemistry, and physics (minimum of mechanics)? Why do you think that the 1994 EMT-B curriculum was set at 110 hours?


Yea, EMT-B training is EMT-B training regardless of professional vs volunteer. The problem is that it's because of the volunteers that the training is so pathetically low and simplistic.

 

[PotatoMedic]

I offerred data and referrences. What more do you want?

R/r 911

I must have missed them. I'll go back and try to find them. Thank you.

 

[Ridryder911]

Don't know if this point was already made.

I'm a volunteer. We sit through the same classes. The same number of hours. Are held to the same standards as far as obtaining our certification.

Doubtful. Did I see you in my chemistry or anatomy cadaver lab? I must have missed you at the Pediatric Burn Unit or while I was scrubbed in OR doing intubations or maybe during the psychiatric lock up clinical we must have missed each other? Where you getting coffee while they were awarding the degree after three and a half years of studies?

So, please don't compare yourself or your "training" versus my education, unless you really want to go toe to toe.

How many patient contact do you make a day? Five, ten, fifteen more? How much studies do you actually perform in improving yourself a day, a week, a month? When was the last time you read the New England Journal of Medicine, JAMA or Trauma? Do you know your percentages of correctly diagnosing/clinical impressions? Would you like to compare the results? When was the last time you discussed the emperical data findings of STEMI AMI with a cardiologist or how to decrease ICP in the first few minutes of a TBI in a major trauma patient with a neurosurgeon?

You see, I am a professional. This is not a hobby or a community need I fulfill.

I am a health clinician, educator, professor and EMS promoter. I take my profession very damned serious. Just alike the physician or practitioner you see when your ill, I have focused my life work around mastering and what I and others do.

So please, don't even try to compare your charity work which maybe admirable but may not always be in the best interest for everyone if you really don't know the facts.

Just because someone shows up with a patch does not mean that person is the best qualified or is better than nothing. Filling a space that is there does not mean the problem has been resolved. In fact, placing a band-aid on spurting wound is much more dangerous as the wound is still bleeding but is hidden.

The cause and affect that volunteers is tremendous. Much more than some realize. Large lobbying groups has set us back decades in moving forward in EMS. Again, look at the studies and programs that was developed all for saving volunteers.

Why do you think that EMS programs continue to be watered down or the number of hours have been fought against? The largest protest against increasing EMS education have and continually is from the volunteer sector. Lobbying organizations protesting that it is already difficult to obtain and maintain their membership.

So patients must continue to suffer because the system is broke? All of the system must then lower national standards because some communities cannot get their act together?

Amazing, in all other areas of medicine they are treated equal. A physician in the reservation of Arizona recieved the same degree and minimal education level as those working in downtown Chicago. No emphasis or curtailing of curricula was made because of where that person might practice. The same is true for professional RN or Respiratory Therapist, Laboratory Technologist. Something, we cannot say within our profession.

So those that want to compare themselves with professionals. You would not mind then to be required to obtain your degree within EMS to continue your volunteerism if mandated?

If your state described within three years, you have to had to complete an accredited academically program, would you do so? If not, then really who and what are you in this for?

R/r 911

 

[daedalus]

I made the comment before, but since this response keeps poping up, I'll post it again.

How many volunteers would you have if the EMT-B education required college level anatomy, physiology, chemistry, and physics (minimum of mechanics)? Why do you think that the 1994 EMT-B curriculum was set at 110 hours?


Yea, EMT-B training is EMT-B training regardless of professional vs volunteer. The problem is that it's because of the volunteers that the training is so pathetically low and simplistic.

I second JP's challenge. Can the volunteer advocates on here please answer our question? How many volunteer EMTs would there be if getting your EMT meant taking chemistry, biology, anatomy and physiology, microbiology, and physics all at a college? Providing medicine means taking these classes before starting to learn pathology and its treatment.

A volunteer advocate here mentioned he/she would not let a paid EMS provider touch his family. I put forth that EMS is a division of medicine and public health, and every other part of that machine collects a paycheck here in the United States.

By the way, and as Rid/Ryder will tell you, we are moving on without you guys. I speak of the people who insist that EMTs are effective volunteer medical providers. We have changed what will be taught in future EMT and Paramedic classes, a small step to be sure, but one in a positive direction. I plan on continuing to raise the bar until it will be impossible to become a prehospital provider just by taking a semester long night school class.

 

[daedalus]

I used to get upset in regards to vollies. Not any more. The bar has been raised and will continue to do so. Vollies do have their place, as I have always stated. That being in very rural America and first response units only.

I chuckle when reading most posts here. Most of the posters will ever get involved in EMS is the chili cook off or a CPR class given. Responding to more than 15 emergency calls a day (even while in a rural area) would cause a mind struck; never mind discussing adult education and methodologies of teaching EMS. Requiring states to update and mandate additional education, as insurance (Medicare, BC/BS) will require states to offer more and more aggressive treatment.

It still saddens me though to read so called medics describing to treat protocols rather than have an educated hypothesis and treat the clinical problems. In other words the patient and not the protocol. Sorry, I don't treat protocols or do I make them fit within a protocol to be able to treat.

The remainder of the medical community is getting tired of EMS lame excuses. Patient care is more and more initiated by what is determined in the field setting. Good accurate thorough examination provided by those that have a formal education (yes, degree) along with several hundreds of clinical hours and preceptorship.

Most involved in this site is very lacking of what is really occurring within the profession of EMS. Lack of interest past responding with l/s or simple training does not mean anything to them. Very few are participants within National, State or Local development of the system itself other than being stretcher fetchers.

I and many others have always provided and encouraged others to participate if they were truly interested within the profession. It appears some have listened, as there are some major changes on the way.

I do doubt that most of those that volunteer will find time to return back to school for the gap or bridge course, that will be required. Doubt that many will want to take college academic level courses such as anatomy/physiology and statistics to be in a Paramedic program. Clinical arrangements have to be made with on site preceptors to verify not just numbers but actual patient contacts and procedures performed (gone are the coffee clinicals). This will not just affect vollies but those that just want to "skate by".

One of the major focus now, is requiring degree entry level. The profession as a whole is asking for it for multiple purposes, many do not understand or lack to have an interest to.
So podt. voice and yell, describe tradition and how things ought to be..... time and progress will resolve it.

R/r 911

Post of the year. Rid, I can't wait until our colleagues are all medical professionals with degrees.

 

[PapaBear434]

Is this a part paid service? I love volly services personally but, sometimes we confuse paid and volly. If there is compensation beyond a tiny stipens which might cover fuel costs, it's a part paid department. My husband for example, worked volly for years. He was given a quarterly stipens of very little (maybe 200 bucks) for his service along with all of the time he donated to all other responsibilities involved. He did everything from train rookies, to being an officer, to respond to servicing their trucks.

Kind of. As I said, the city employs 40-50 paid medics to make sure there is always ALS available. But the rest of us are volunteers.

They don't give us any pay or stipend to cover fuel, as our own personal vehicles are never used for a response. It's not like a lot of rural systems where a call comes in, everyone gets a call at home, rushes to the station and mans up the truck and goes to the site.

We actually put on a uniform, go to the station, and we are there for an entire 12 hour shift (thought it ends up more like 13-16 some days). We have a lounge to sit, play on the computers, BS and watch TV. We have a bunk room with about eight beds to rack out when we need to. But the call comes in over the PA and we just walk the 200' to our truck bay and we're off.

As far as compensation, the city pays for any schooling related to EMS in exchange for your service. So as long as you are going with the goal of medic, they'll pay for the classes and books involved so long as you maintain a "B" average. So far, I have a 4.0, so here's hoping THAT keeps up.

It's a sweetheart deal for the city, because it costs less than having to train AND pay people, only to have them leave for a better job later. The individual stations pay for everything equipment wise, right down to our trucks and other apparatuses, and all the city pays is for fuel, insurance, and repairs. As an independent station, we qualify for a lot more federal and state grants as well, so we end up better funded than the city would be able to provide too.

The other kicker that as far as our resume goes, we are listed as city employees, not "volunteer" status. That means that as far as any future employer is concerned, you were a city employed EMT/Medic for X amount of years in a high population, high call volume, diverse population tourist town like Virginia Beach. And that looks pretty good wherever you go.

 

[JB42]

I second JP's challenge. Can the volunteer advocates on here please answer our question? How many volunteer EMTs would there be if getting your EMT meant taking chemistry, biology, anatomy and physiology, microbiology, and physics all at a college? Providing medicine means taking these classes before starting to learn pathology and its treatment.

Not as many, but I would still be there and volunteer along with many others at my service. Of course in a perfect world EMS would be compensated reasonably and I would be a paid full-time EMS professional instead of a cube jockey/EMS volunteer.

There are a lot of unfair generalizations being tossed around in this thread. I am well aware that some volunteers are not up to snuff and unwilling to help EMS move forward, but some of us are. No, I cannot possibly keep up with Rid and others in terms of medical education and continuing ed. The anti-volly group has that right, full-time paid EMS just has more time and opportunity for education. (Although that could be up for debate since in order to survive with EMS as a career it seems that you need to work two full time jobs.) That doesn't mean there isn't a place for volunteer providers, at least right now.

As the situation stands right now there is a need for volunteers in some areas of the country. There need to be other changes in EMS before volunteers are no longer necessary, changes that are not being held back solely because I volunteer in some small town in NH. Education standards need to increase, scope of practice for paramedics really needs to be increased to that of a true practitioner (this is secondary to higher education standards), pay needs to be reasonable, and burn out prevention really needs to be addressed. All of that can be done while working along side volunteers. As volunteers disappear due to lack of interest in keeping up with new requirements paid people will have to take their place. Then you can have what you are striving for.

 

[Level1pedstech]

For anything above an EMT-B I am with you on the education but I think you give a little to much credit to most basics. All I hear is what a joke the training is and how quick a person can go from being a lay person to a certified EMT-B. Did you ever think maybe its called a basic for a reason, I'm not expecting an ER doc or PA when I call 911. I want someone who can respond and safely and methodically work their way through the ABC's. Why must you keep fighting such a simple concept, one that sure was developed and refined over time with the lay person in mind. Do you really think most EMT-B's are practicing medicine? I think that's a bit of stretch and I will gladly put my ten years of service behind that statement. The material and the skills are BASIC so that people can offer BASIC life support. I know someone will offer what they think is a valid argument but please explain what you don't understand about basic life support provided by an emergency medical TECHNICIAN.

I think the theory to work with is lets have as many people as we can that provide care at the EMT-B level. CPR,ABC'S and BLS do not require advanced college level studies and fight as you may they never will. Whats next a two year community CPR class. In regards to anything above a basic I am with you 100%, I think change has already begun with more states making paramedicine a degree program with the same educational requirements as nursing school. I think this is a step in the direction you want to take pre hospital medicine.

I do agree it would be next to impossible to recruit my fellow community members if the education requirements were that high for a person wishing to provide aid at an entry level. So I ask again what is my family going to do when there is no one to respond? Keep in mind we have paid ALS that will respond but they are 30 minutes out on a good day. I have made this statement before but I guess it fell on deaf ears. Start with your local system and leave mine alone until you can provide adequate first response care for my family. You are really pushing hard and you may not like what results you get. So go back to your books and life on campus,become super educated and stand in line to change the world. Some of us who work close to 80 hours a week would love to be in your position but college is not always an option for the working man. Are you getting any of this!

Once again my system is not broke stop trying to fix it,you are messing with the health and well being of my family and many others who rely on the aid provided by first response EMTs paid or not. I have spent the last four years working part time in a level one trauma center that acts as a teaching hospital. I have had the opportunity to interact and be around on a regular basis some of the brightest and most promising students from EMT's to MD's and I can tell you there is no shortage of well educated people waiting to get out there and affect change. Lets give them a shot and stop trying to force your educational ideals on providers that for the most part are here to do one thing and that is help their fellow man. Remember its called BASIC for a reason.

 

[bunkie]

In reading this thread, it seems to me that in general people seem to be more against the B level of care as a whole, not necessarily if its a paid or volunteer member. I can understand the thought that patients need a higher level of care that comes from a higher level of education. But I know that in *my* area, you have to be a B for at least a year or be working for a FD or local EMT around the area before you can even get into their paramedic program. So where does that leave people, either at the paid EMTB level or volunteer because they have no choice but to gain those hours so they CAN get to that higher level of education. What is your thought on that then? Should the year experience and/or sponsorship from an agency be waved to get into paramedic school, or should they not have that stepping stone of education and experience before they get there? Not to mention, after a year of it, you tend to weed out who really wants to be there and who doesn't. Or why the hell else would people go through any of this?

 

[JPINFV]

Why must you keep fighting such a simple concept, one that sure was developed and refined over time with the lay person in mind. Do you really think most EMT-B's are practicing medicine? I think that's a bit of stretch and I will gladly put my ten years of service behind that statement. The material and the skills are BASIC so that people can offer BASIC life support. I know someone will offer what they think is a valid argument but please explain what you don't understand about basic life support provided by an emergency medical TECHNICIAN.

If a provider is making any sort of judgment based off of an assessment, then yes. They are practicing medicine. I don't care whether it's a question of back board or not, provide supplemental O2, and if so at which flow rate and by with device, whether or not to call paramedics, or any other judgment, then they are. Most systems do not have a single protocol for all patients, require basics to backboard every single trauma, and administer oxygen to every single patient and a lot of the systems that do probably don't rigorously enforce that strict of a protocol. EMS isn't cookbook medicine in most areas, even for basics.

Besides, lay people have no business responding to a medical emergency as the person in charge. I want someone who feels that they are a medical provider, not a lay rescuer playing weekend warrior.

I think the theory to work with is lets have as many people as we can that provide care at the EMT-B level. CPR,ABC'S and BLS do not require advanced college level studies and fight as you may they never will. Whats next a two year community CPR class. In regards to anything above a basic I am with you 100%, I think change has already begun with more states making paramedicine a degree program with the same educational requirements as nursing school. I think this is a step in the direction you want to take pre hospital medicine.

Then we need to take basics off ambulances and use them only as first responders.

I do agree it would be next to impossible to recruit my fellow community members if the education requirements were that high for a person wishing to provide aid at an entry level. So I ask again what is my family going to do when there is no one to respond? Keep in mind we have paid ALS that will respond but they are 30 minutes out on a good day. I have made this statement before but I guess it fell on deaf ears. Start with your local system and leave mine alone until you can provide adequate first response care for my family. You are really pushing hard and you may not like what results you get. So go back to your books and life on campus,become super educated and stand in line to change the world. Some of us who work close to 80 hours a week would love to be in your position but college is not always an option for the working man. Are you getting any of this!

All of your physicians, registered nurses, and midlevel medical providers all went to college, right? There aren't any physicians or PAs that are practicing from Billy Bob's Accelerated Night School of Medicine. Yet, somehow you have physicians in your area, right?

Once again my system is not broke stop trying to fix it,you are messing with the health and well being of my family and many others who rely on the aid provided by first response EMTs paid or not. I have spent the last four years working part time in a level one trauma center that acts as a teaching hospital. I have had the opportunity to interact and be around on a regular basis some of the brightest and most promising students from EMT's to MD's and I can tell you there is no shortage of well educated people waiting to get out there and affect change. Lets give them a shot and stop trying to force your educational ideals on providers that for the most part are here to do one thing and that is help their fellow man. Remember its called BASIC for a reason.

So it doesn't matter what the training requirements are as long as the soul is willing?

 

[TransportJockey]

In reading this thread, it seems to me that in general people seem to be more against the B level of care as a whole, not necessarily if its a paid or volunteer member. I can understand the thought that patients need a higher level of care that comes from a higher level of education. But I know that in *my* area, you have to be a B for at least a year or be working for a FD or local EMT around the area before you can even get into their paramedic program. So where does that leave people, either at the paid EMTB level or volunteer because they have no choice but to gain those hours so they CAN get to that higher level of education. What is your thought on that then? Should the year experience and/or sponsorship from an agency be waved to get into paramedic school, or should they not have that stepping stone of education and experience before they get there? Not to mention, after a year of it, you tend to weed out who really wants to be there and who doesn't. Or why the hell else would people go through any of this?

That requirement to spend at least a year as a basic is an old myth that you couldn't be a good medic unless you had street experience. It to should be done away with. No other profession makes people stop at each level on the way up.

And I've seen it work. My medic class' best student was someone who had never been on an ambulance a day until he started doing his internships. Hell, the only reason I spent some time working as a basic was cause the job paid better than what I was doing. I jumped straight into medic school as quick as I could get the pre-reqs done right after I finished my basic

 

[JPINFV]

What is your thought on that then? Should the year experience and/or sponsorship from an agency be waved to get into paramedic school, or should they not have that stepping stone of education and experience before they get there? Not to mention, after a year of it, you tend to weed out who really wants to be there and who doesn't. Or why the hell else would people go through any of this?

Physicians don't have to be PAs. RNs don't have to be CNAs (heck, there are entry to nursing MSN programs out there). If paramedic schools provided quality education, then there wouldn't be a need to 'require' people to work at a lower level first.

 

[medic417]

Then we need to take basics off ambulances and use them only as first responders.

+1
10charcrap