Rant about how much volunteers are hurting our profession

[Medic]

Lets say you have 15 calls par day per ambulance in your area in a single 12 hour shift, you have 5 ambulances on call in that shift.

All ambulances can be on a call at any given time and you then start getting a back log of calls.

There could be a few P1's(most critical pt) not sure what you call it in the states, in that back log with lets say a blocked air way and unconscious, or a huge trauma and needs help asap.

you might have to ask other services to help out which is not all ways a option.

This is where a "weekend warrior" can respond in his personal vehicle or how ever to stabilize a pt until a rig is free to come and transport a pt to a hospital. This can save lives I know where I live it can.

I dont see an issue with having a vollie on call for those emergencies a paid rig can get to. A full time vollie on a rig is a totally different story.

Thats my view on the situation.

 

[Seaglass]

This is where a "weekend warrior" can respond in his personal vehicle or how ever to stabilize a pt until a rig is free to come and transport a pt to a hospital. This can save lives I know where I live it can.

I dont see an issue with having a vollie on call for those emergencies a paid rig can get to. A full time vollie on a rig is a totally different story.

Thats my view on the situation.

How do those vollies get enough experience and practice to know what they're doing?

 

[Level1pedstech]

How do those vollies get enough experience and practice to know what they're doing?

Where do most people get experience and practice? For most of us paid or not its by running calls and attending drills,obtaining CE's and furthering our level of knowledge by searching out every opportunity to better our level of education. I do believe that most providers want to improve their education regardless of what the pointy headed, book throwing, everyone needs a degree to provide BLS, anti volunteer brigade seems to think. What percentage of the nations Fire/EMS personnel work in systems where they run hard all through their shift. I guess if you work in a slow system your just not as qualified and lack the training and hands on patient contact. If you work off that theory your not getting the big picture. I worked at a combination paid volunteer department that provided service to a small municipality and the surrounding rural communities,we sometimes would go a whole 24 hour shift without a call. During the day we always had some type of drill or class and were ready for whatever came our way. Does a situation like that where we did not actually run a call make us any less qualified and to be honest it happened quite often. Its a double edge sword, at my all volunteer department if we had the call volume we could justify staffing paid personnel. It has been stated before that most volunteer agencies take classes and test at the same level as their paid counterparts. Most states have oversight of certified medical responders (FR,EMT's) so if members don't keep up with CE's and skills maintenance they are unable to apply for recertification. I don't know of any departments that have no oversight or training plan in place and just let untrained people respond on calls. Most agencies paid or not train for the worst possible scenarios that their crews may be involved in.

I still think people are missing the whole concept of the basic in EMT-B. I realize the above mentioned pointy headed brigade just hates the way EMT-B's are shuffled through the mills ( for the record my WA state basic class was 156 hours with 24 hours of ER time) but they are fighting a long uphill battle. I just wish I could get a straight answer from the brigade on the need for all the college level courses when you will never use the material at least not until you advance to medic school. Once again to respond to a call then safely and effectively follow the ABC's(at the basic provider level),package and prepare for or transport that patient to the appropriate facility for advanced care does not require advanced college level knowledge of A+P or biology. I have said before any thing above a basic and I am with you 100% but come on give me some situations where any of this would play into the daily routine of your average basic. I know that there may be a time when that advanced knowledge would be of use but that's not the norm and you know it, so no oddball once in a lifetime trick medical scenarios please. I'm thinking about your average IFT or BLS basic that works with a system that has average protocols and expects their basics to be basics.

 

[Medic]

Volunteer on a on going bases if you vollie every weekend with a paid crew or who ever,, if the vollie is all ready a Emt of any sort,they will gain experience quite fast.. A vollie with a bit of experience who is certified is better than a first aider or no one at all.

There is good in this whole argument. You just finding or looking for the bad.

Maybe a person has a job and cant quit but really wants to help out and the only way is to vollie, this is not a train smash. Grow with change you cant fight it.

Take what i say with a pinch of salt. It's my opinion.

 

[Seaglass]

Volunteer on a on going bases if you vollie every weekend with a paid crew or who ever,, if the vollie is all ready a Emt of any sort,they will gain experience quite fast.. A vollie with a bit of experience who is certified is better than a first aider or no one at all.

There is good in this whole argument. You just finding or looking for the bad.

No... I'm just curious because I know nothing about how the South African system works. From what you said originally, it seemed to me like the vollies were only responding when paid crews weren't available, which sounded rare, not also volunteering with paid crews.

I'm a big fan of drills and CE. But I think patient contact is essential, because it's a lot more stressful when everything's for real. A lot of people who are great at drills and textbooks stumble in the field because they aren't used to handling the chaos and adrenaline rush. If call volume is limited, I can't blame the provider for not getting experience on calls. But if systems are designed to keep some providers from getting frequent patient contact, whether by calls or some other method, I suspect that errors are going to go up when those EMT's wind up alone on scene.

As for college courses, I don't think they're essential for basics. Instead, they're part of going above and beyond, which is something to be encouraged. But I think the "brigade's" argument is more that everyone should train up to medic.

 

[Achromatic]

Volunteers hurt EMS because they will always be the lowest common deominator that standards are watered down to please.

Always? Great stereotype. Our county does its BLS training in-house. Whether you are volunteer or career, you a) have to compete for the same spots in the EMT-B course (our last intake had 45+ applicants from the paid and volunteer staff for 30 spots in the course, and intake was determined based on practical and written exam from the AHA CPR curriculum), and b) are held to the same standards in regards to ongoing education, discipline, and functionality.

But hey, just continue to belie we're a bunch of clowns that need our hands held to get through any training.

 

[JPINFV]

I have said before any thing above a basic and I am with you 100% but come on give me some situations where any of this would play into the daily routine of your average basic. I know that there may be a time when that advanced knowledge would be of use but that's not the norm and you know it, so no oddball once in a lifetime trick medical scenarios please. I'm thinking about your average IFT or BLS basic that works with a system that has average protocols and expects their basics to be basics.

Any time the basic is deciding whether the patient needs paramedics or not.

Any time that the complaint involves a patient on dialysis or with abnormal labs.

There's two right there.

 

[Ridryder911]

Always? Great stereotype. Our county does its BLS training in-house. Whether you are volunteer or career, you a) have to compete for the same spots in the EMT-B course (our last intake had 45+ applicants from the paid and volunteer staff for 30 spots in the course, and intake was determined based on practical and written exam from the AHA CPR curriculum), and b) are held to the same standards in regards to ongoing education, discipline, and functionality.

But hey, just continue to belie we're a bunch of clowns that need our hands held to get through any training.

You will have to do better than referring to such courses as anything relevant for a screening process.

I believe that I and others doubt that anyone is against the Basic or now called EMT level. It is rather that I feel that it is no longer acceptable as an entry point and YES it is just above the first aid level. (prove me wrong - hint...compare the curriculum with that of ARC Advanced First Aid... I have).

It is an excellent program for the first responder/ first response but not qualified to actually assess and perform medical procedures that is needed in todays health care. A 120-150 clock hour course is not sufficient enough to meet the demands to be the sole care-giver provider on the EMS unit.

WARNING: Anyone that spouts off protocols is in danger of looking like a fool. Remember, we should be treating patients individually not as a protocol! Protocols are and should be only used as guidelines ! Truthfully, what is it the EMT level would need a protocol for (other than oxygen and epi-pen (activated charcol has been removed in the new standards)?

R/r 911

 

[Achromatic]

You will have to do better than referring to such courses as anything relevant for a screening process.

I believe that I and others doubt that anyone is against the Basic or now called EMT level. It is rather that I feel that it is no longer acceptable as an entry point and YES it is just above the first aid level. (prove me wrong - hint...compare the curriculum with that of ARC Advanced First Aid... I have).

It is an excellent program for the first responder/ first response but not qualified to actually assess and perform medical procedures that is needed in todays health care. A 120-150 clock hour course is not sufficient enough to meet the demands to be the sole care-giver provider on the EMS unit.

WARNING: Anyone that spouts off protocols is in danger of looking like a fool. Remember, we should be treating patients individually not as a protocol! Protocols are and should be only used as guidelines ! Truthfully, what is it the EMT level would need a protocol for (other than oxygen and epi-pen (activated charcol has been removed in the new standards)?

R/r 911

Oh, definitely - don't mistake me as thinking that an EMT-B is anything beyond that acronym of the rig they are in - 'basic. life. support.'

"Know what you know. And know enough to know what you don't."

For me, my plan is to be a paramedic within the next three years, with at least an AAS.

The reference to the AHA courses etc was more to draw a contrasting opinion to the person who claimed that "volunteers bring us all down because standards will have to be lowered and watered down for them" when point in fact in our county at least is that there is zero differentiation in training (though not in what is unabashedly extremely valuable, experience, by virtue of hours clocked) between a paid EMT-B and a volunteer. We are assigned shifts, are expected to be at station, in uniform, etc, and respond to all calls - actually, one thing this thread has shown me is that it seems at least from my perspective that I'm in probably one of the better areas in the country in terms of the 'volly experience' - I've not once heard people discussing what lights they want to run on their POV, and if a crew on shift was to even attempt to avoid a 'boring' call, the med. director and county would rain a sh*tstorm down on them.

And you, Mr Rider, I wish to thank - reading these forums over the last couple of weeks has given me a lot of insight into this change in my profession (although I started in college studying biomedical science, I got sidetracked by healthcare IT, and now at the age of 31 am looking to get back into 'practical medicine' - with all caveats acknowledged, that I realize EMT-B is not a medical practitioner certification!) - though blunt at times, I respect that you have a lot of beliefs and opinions that have been formed through a lot of experience - even on a more general level, being willing to "know what I don't know" and take those on-board, even if I disagree, is one of the keys to becoming a better medic. That, and "the patient's best interest should always be the #1 priority".

 

[Level1pedstech]

Any time the basic is deciding whether the patient needs paramedics or not.

Any time that the complaint involves a patient on dialysis or with abnormal labs.

There's two right there.

On deciding whether to continue ALS your joking right?

With regards to a patient on dialysis or with abnormal labs, I must be missing something can you offer a little more for me to work with in regards to the basics responsibilities and how college level courses fit into the treatment plan at the basic level. Maybe we should consider your first statement and at least consult with a higher level provider.

 

[JPINFV]

...because, you know... every situation is completely cut and dry. There's no gray area at all when dealing with patients.

Also, who said anything about 'continuing.' Not every patient is going to get an initial paramedic response for a variety of reasons.

 

[Medic]

In SA a BLS medic gets paid pea nuts. They can barley live on there salary, it sickens me an its no different in our police or fire. they have to work extra shifts and jobs to pay for a house and food putting aside school fees.

In my eyes thats what scares people from working in our amazing ems system. I'm sure in the states you wont get 15-20 calls per 12 hour shift on a average day not even talking about a busy day thats experience in a nut shell.

Thats why people will vollie on weekends or some weeknights and keep there 8-5 job. Both to help out the services and do what they love. I belive SA needs a hell of a wake up call because we losing our medics to over seas where there better paying jobs. Who will replace all these leaving medics in the mean time vollies are helping quite a bit, and vollies willing to give up time are few and far between but play a roll. Full time medics on the road vollie on choppers or sea rescue or mountain rescue.

Im not degrading any SA medic leaving or any service its just we have a world cup around the corner and we have to import medics for the event, what message is that leaving you?

So you complaining bout a vollie stealing your call well if that happened here it would snow and it does not snow here. We need staff here.

 

[8jimi8]

Before I answer this questions i must ask my own.
Is the only reason that you don't like volunteers because of how easy it is to become a basic?

I'm all for raising the bar on education to be an EMT. I have never argued against that. Yah its easy to be an EMT. I took mine online during while it was in school full time for nursing. Requiring that type of education as a baseline to get into practice will not stop me from volunteering. It may hugely cull the ranks of incoming basics and stop a great many people from volunteering. The only other problem that I foresee with raising the bar to entry level is that everyone who actually takes those courses will eventually continue on, or possibly immediately start paramedic education. You aren't gonna have any people at just the basic level after a while.

So why not just eliminate basics altogether. Maybe make the baseline of entry EMT-A. No more bls units? Is that all i have to say to get you to agree that volunteering is not the reason that EMS is held back from other allied healthcare? Do you REALLY think its the volunteers faults? Seems most of the employed people on this site are negative towards volunteering, is that really an accurate depiction of EMS as a whole, across the nation? Does everyone REALLY hate volunteers?

I have never been one to downplay the education hoop jumping. When i get my red patch, i will probably get the one with gold letters. Not sure if i want to... cause it really just costs more money to re-cert. I will probably not ever be a paid paramedic on an ambulance, not in the area where I live. No one pays enough. Eventually I will be trying to fly either as a nurse or a medic, and i'm sure that i will always volunteer. Nothing feels better than helping someone who needs it.

So yah, up the education, just don't blame volunteers because you in your professional wisdom and experience (that somehow makes me inferior) haven't done it yet.

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.

 

[EMTinNEPA]

Volunteers lobby to keep the educational standards low. Volunteers are also the reason that professionals usually need one and a half jobs to get by. Educational standards are low and people are willing to do it for free... hmm, why should we pay you a livable wage?

 

[46Young]

Volunteers lobby to keep the educational standards low. Volunteers are also the reason that professionals usually need one and a half jobs to get by. Educational standards are low and people are willing to do it for free... hmm, why should we pay you a livable wage?

Lack of political organization by EMS workers is by far the major reason why EMS professionals need one and a half jobs (or more) to get by. This has been addressed previously at the EMS and unions thread.

So, you get your way and vollies disappear. Now, you go hunting, skiing, camping, or whatever up in the mountains. Your car goes off the side of the road. The nearest paid EMS is greater than 30 minutes away, on a good day, as the tax base can't support full time medics. your golden hour comes and goes, and now you're taking a dirt nap. Or the elderly gentleman with an MI who needs an interventional cath lab. Pt contact and txp is delayed by 30 minutes or more due to lack pf resources, and he expires. Additionally, in both cases, air txp is not an option due to weather.

 

[EMTinNEPA]

Lack of political organization by EMS workers is by far the major reason why EMS professionals need one and a half jobs (or more) to get by. This has been addressed previously at the EMS and unions thread.

So, you get your way and vollies disappear. Now, you go hunting, skiing, camping, or whatever up in the mountains. Your car goes off the side of the road. The nearest paid EMS is greater than 30 minutes away, on a good day, as the tax base can't support full time medics. your golden hour comes and goes, and now you're taking a dirt nap. Or the elderly gentleman with an MI who needs an interventional cath lab. Pt contact and txp is delayed by 30 minutes or more due to lack pf resources, and he expires. Additionally, in both cases, air txp is not an option due to weather.

I'd say "Welcome to Pennsylvania" because you're looking at that situation anyway once three separate vollie BLS companies fail to crew, which happens quite often. If these services were paid (which they aren't largely due to tradition) we wouldn't have that problem now.

 

[ffemt8978]

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.

Actually, some areas and programs do make it a prerequisite to have at least one year of experience before you can even apply for the paramedic program. Just because it's that way where you are does not mean it's that way everywhere.

 

[ffemt8978]

Volunteers lobby to keep the educational standards low

About as much as fire departments in Florida...

Volunteers are also the reason that professionals usually need one and a half jobs to get by. Educational standards are low and people are willing to do it for free... hmm, why should we pay you a livable wage?

Care to offer proof for that one?

 

[EMTinNEPA]

Care to offer proof for that one?

Average salary for a paramedic in this area fresh out of school: $29,120
Cost of living: $50,000
Number of paid services in this county: 2
Number of volunteer services in this county: 6

How many volunteers are there in PA? Tens of thousands of people... doing my job for free.

Why do nurses make more? They have more education.

 

[ffemt8978]

Average salary for a paramedic in this area fresh out of school: $29,120
Cost of living: $50,000
Number of paid services in this county: 2
Number of volunteer services in this county: 6

How many volunteers are there in PA? Tens of thousands of people... doing my job for free.

Why do nurses make more? They have more education.

That doesn't mean you would be paid more if there were fewer volunteer agencies. You might think it would, but voters can be unpredictable when it comes to raising their taxes to pay for something that they may or may not use, or even understand.

Look at it from this perspective...If the vollies were done away with in your county, that would mean that more personnel would have to be hired to provide the same coverage. That means more money spent on CE's, equipment, training, retirement, insurance, unemployment insurance, facilities, etc... Do those 6 communities have the tax base to support the increase in costs, or would the burden be shared throughout the county?