Rant about how much volunteers are hurting our profession

[46Young]

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.

Funny that you should bring that up. I don't know if this has been addressed before, as this thread is quite long winded - I've observed that volunteer FD's and ambulance squads on Long Island NY have been 100% volunteer there, with the exception of Nassau County PD EMS. NCPD staffs their EMS division with consideration to the availability of vollie EMS. Suffolk County had no prior fire based or PD based professional EMS.

Over the past decade or more, the vollies have had increasing difficulty in staffing their EMS units, particularly in the daytime, since members need to work a job or two to stay afloat nowadays. The volunteer FD's have been adding paid medic fly cars, and the Town of Rockville Centre has a contracted out a 24/7 dedicated 911 ALS unit with the North shore LIJ CEMS. The town guarantees the CEMS a certain amount of revenue. Any shortcomings in billing will be offset by the town. Any revenue over the agreed upon amount goes to the town. Not a bad deal, something for some areas to consider. I'm not sure if any other vollie FD's have any paid rigs, but it will come to that sooner or later.

My dept was 100% volunteer at one point. Now it's like 1%. Other surrounding counties started out the same way, but have been progressively shifting from vollie to paid by varying degrees. I know that our systems are fire based, but I'm sure that similar scenarios are in progress with vollie single role EMS.

So, it appears that these vollie organizations are actually providing paid positions in a progressive fashion. Dur to financial constraints, the community will typically staff only what's needed with paid personnel.

This increasing shift towards paid personnel is likely the norm across the country. so, vollies aren't stealing anyone's job. declining participation in many areas will ultimately result in replacement by paid personnel.

Stop whining about vollies stealing your jobs. these individuals are willing to help their communities basically for free, and ask little in return.

 

[Foxbat]

That doesn't mean you would be paid more if there were fewer volunteer agencies.

I do not have data for percentage of career vs. volunteer EMS service by state, but I do have such data for fire departments.
I put this data into Excel and here's what I got.
Each datapoint represents a state. X axis is percentage of all-volunteer FDs in this state. Y axis is average yearly wage of career firefighters in this state.
Graphically, I do not see how one is dependent on another. If anyone would like to analyze it numerically, I can send you the entire spreadsheet.

 

[TransportJockey]

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.

I never said it doesn't exist, I just said it should be done away with. I said it's a myth, which tends to be perpetuated in 'tradition' bound depts

 

[catskills]

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?

I hear your pain. I am all for people earning a wage they can live on. Its obvious EMT-B is not a job one can live on.

That said, I don't think forcing the volunteers EMT-Bs to be paid EMT-B is going to solve the problem of low pay for EMT-B profession. If anything all those volunteer EMT-Bs will be forced to find part time EMT-B jobs where they get paid. As noted here there are 100s of 1000s of volunteer EMT-Bs that would be looking for a paid EMT-B job if they could not volunteer. I personally don't think this scenario is going to help the EMT-B low salary problem.

Also note that myself and many volunteer EMT-Bs that I volunteer with have taken many college level chemistry and biology classes. I have a BS degree in Electrical Engineering. I volunteer with a Math professor, Mechanical Engineer, Dentist, and RNs. These highly educated people enjoy doing part time EMT-B work. If these professionals start looking for part time EMT-B paid jobs, they may end up taking away existing full time paid EMT-B jobs that have less education. :sad:

 

[medic417]

I hear your pain. I am all for people earning a wage they can live on. Its obvious EMT-B is not a job one can live on.

That said, I don't think forcing the volunteers EMT-Bs to be paid EMT-B is going to solve the problem of low pay for EMT-B profession. If anything all those volunteer EMT-Bs will be forced to find part time EMT-B jobs where they get paid. As noted here there are 100s of 1000s of volunteer EMT-Bs that would be looking for a paid EMT-B job if they could not volunteer. I personally don't think this scenario is going to help the EMT-B low salary problem.

Also note that myself and many volunteer EMT-Bs that I volunteer with have taken many college level chemistry and biology classes. I have a BS degree in Electrical Engineering. I volunteer with a Math professor, Mechanical Engineer, Dentist, and RNs. These highly educated people enjoy doing part time EMT-B work. If these professionals start looking for part time EMT-B paid jobs, they may end up taking away existing full time paid EMT-B jobs that have less education. :sad:

If they quit volunteering the places they volunteer at would go paid. Thus more jobs would be created. Thus the pay grade would be higher. At this point when a city/county works to make a pay decision they include what each service in the region pays. Every volly organization shows up as zero. Then the city/county leaders take that low average and say what are you complaining for you are paid higher than the average emt or Paramedic.

 

[Ridryder911]

In my area it is a rarity to see EMS as a volunteer although there is more volunteer Fire Departments, as well very few true EMS that are associated with the fire service as well. As being a state that not only that population is less than rural rather considered frontier (look those stats up) I can say bullish on describing EMS cannot be done with professionals.

I have never said that volunteers should be done away with. I am all in favor of first response first responders; however in the majority.. (not all) a professional EMS with Paramedics could rendezvous within minutes to a workable time.

What I do get angered with is communities that continue to utilize volunteer EMS that can afford professional care. Any community that will be utilizing Paramedics that obtain their "training" from a sub par trade school with very minimal clinical exposures (albeit paid or volunteer). Cook book medicine from any service where patients are regarded as protocols and one only knows treatment regime as step by step from set guided algorithms. For some reason, many communities still assume that they have to have their own EMS instead of regional or interacting vollie intercepting with professional EMS.

Sorry, if I had my choice of knowing that my person has the possibility of being monitored and being fired for any problems, I would chose the later. As well as the physician that performs a procedure every week to one that performs one a year, that would be closely monitored and had proven academically that they are educated and demonstrate expertise in clinical performance I would want those in EMS to have the same foundation.

Again, I don't think anyone is ignorant or naive to describe that volunteers will not be needed or should be used. It is that their role and methods that will be drastically changed. It is happening, it is not a "possibility" or "if" it is a fact. Within the next two to five years EMS will have a drastic over haul, even affecting those that are paid. We will see who will last and endure those changes as many will be filtered out.

I have just reviewed some new national changes that are coming out and very excited about the future. There are projects underway that will shape EMS in the near future. Unfortunately, I am not at liberty to go into detail at this time but I can describe that I am finally seeing EMS come around after 40 years. It's about time.

R/r 911

 

[emtjack02]

Once again so many good points brought up. I honestly don't know what it would cost to run a full time ambulance for our coverage area, or what a private full time would charge/bid to contract it. I encourage any of the business savey to come and get a pd service going. We currently tax about 10/hr.
The OP must be right, if I didn't volunteer they would have a pd department. Their education would be so much better. And their experience...wow..the call volume that they'd see would be...well not much at all.
While volunteers may be adrenaline junkies. Or not the most highly educated they are providing care in places that I believe could not afford a full time ALS ambulance.
We may be behind the times or caught with older equitment but that is not neccessarly the doing of the crew.
Should I still bring my questions here...or would you rather I not bring you down more.

 

[Ridryder911]

Once again so many good points brought up. I honestly don't know what it would cost to run a full time ambulance for our coverage area, or what a private full time would charge/bid to contract it. I encourage any of the business savey to come and get a pd service going. We currently tax about 10/hr.
The OP must be right, if I didn't volunteer they would have a pd department. Their education would be so much better. And their experience...wow..the call volume that they'd see would be...well not much at all.
While volunteers may be adrenaline junkies. Or not the most highly educated they are providing care in places that I believe could not afford a full time ALS ambulance.
We may be behind the times or caught with older equitment but that is not neccessarly the doing of the crew.
Should I still bring my questions here...or would you rather I not bring you down more.

Questions are always appreciated if one has attempted to already seek answers (we have found many attempt too many short cuts i.e. reading). One can learn many ways as the old saying of "skinning a cat" even may learn the cat does not be skinned...lol

As in EMS, I also believe in nursing, etc. it does not matter the size or location of where you provide care at. I have worked in a 1 bed ER and in one of the nations largest Level 1 trauma center and seen good and bad care at both. One of the best & most aggressive services I worked at was at a very rural area with < 6,000 people. We did RSI, central lines, thrombolytic & 9 lead (12 lead monitors for EMS was not invented yet) and this was in the mid 80's so it can be done if the desire and determination and of course good medical direction.

I believe it is more difficult to work in such areas. Sure, our call volume was only about 2 calls a day but our transport time was always > than a hour + and we bypassed the local ER due no real services available. So we carried numerous medications as we often seen patients either worsen or improve with treatment alike within a ER. As well due to the low volume we had to maintain our skill level to be sharp. So we instituted a high level of studies and clinical performance. This meant performing IV therapy at the hospital and quarterly intubations in OR and ECG reviews with the hospital visiting cardiologist. We made up special training such placing a KED on blind fold or who could place on a traction splint the fastest to prevent skill deterioration. Again our statement was because we were rural or small did not mean we were stupid or provided lower care.

This carried on at one of the ED's I managed was a rural 8 bed ED. We recognized our limitations for hospital services but I enforced that the patient could be packaged and stabilized the best we could do and provide before leaving hospital grounds. That means emphasizing early recognition of injuries and illnesses as soon as possible so no further delay can occur.

Again, it can be done. It is very hard work and the main emphasis is to think outside the norm. Look at systems such as Canada, South Africa and Australia that provides good quality medical care in many remote areas. Modifications and collaboration may have to occur; but that is okay as long as the patients best interest is always the key factor and main point.

R/r 911

 

[medic417]

Once again so many good points brought up. I honestly don't know what it would cost to run a full time ambulance for our coverage area, or what a private full time would charge/bid to contract it. I encourage any of the business savey to come and get a pd service going. We currently tax about 10/hr.
The OP must be right, if I didn't volunteer they would have a pd department. Their education would be so much better. And their experience...wow..the call volume that they'd see would be...well not much at all.
While volunteers may be adrenaline junkies. Or not the most highly educated they are providing care in places that I believe could not afford a full time ALS ambulance.
We may be behind the times or caught with older equitment but that is not neccessarly the doing of the crew.
Should I still bring my questions here...or would you rather I not bring you down more.

Lets see I am involved to some extent with several ambulance services, all in small remote poor areas. All are paid. One of them just hit 70 report numbers for the year, yet station is staffed 24/7. And that 70 is misleading as to number of calls as actually many of the calls involved multiple patients. Probably safe to say this station has only had about fifty 911 calls for the year.

How did this and other poor areas go paid? They got their priorities right. See the topic I started a few days ago on changing from volly to paid.

 

[Achromatic]

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?

I assume you have actual evidence for these assertions, rather than claims based on your perceptions...?

 

[emtjack02]

If I am taking your jobs..come get them. Don't expect me to try to change things so you can have a job. Thats up to you. I would love for our department to be full time but I know the trustees...they are old firemen that dont care about EMS.

 

[medic417]

If I am taking your jobs..come get them. Don't expect me to try to change things so you can have a job. Thats up to you. I would love for our department to be full time but I know the trustees...they are old firemen that dont care about EMS.

Then vote them out. EMS is not about tradition it is about what is best for the patients.

 

[PapaBear434]

If I am taking your jobs..come get them. Don't expect me to try to change things so you can have a job. Thats up to you. I would love for our department to be full time but I know the trustees...they are old firemen that dont care about EMS.

That kind of confrontational attitude isn't helping anything.

 

[emtjack02]

Telling us that we are bringing you down doesn't really help much either. And I would love to vote them out. One problem, I dont live in our district so I can't run or it or vote against them.

 

[Sparky79]

If I am taking your jobs..come get them. Don't expect me to try to change things so you can have a job. Thats up to you. I would love for our department to be full time but I know the trustees...they are old firemen that dont care about EMS.

I tend to agree with this statement. If you CHOOSE to make a career doing a job that thousands are willing to do for free, what do you expect? I would bet that even the oldest, most experienced medics that have been doing this for their entire career knew when they made the decision to get into EMS that there were thousands of volunteers doing this "job". Now these people complain that "volunteers are ruining this job". I have read on this forum in the past statements like "would you volunteer to pickup trash, pave streets, or other menial jobs"? No, nobody wants to do those jobs for free, so the town has to pay someone to do it. That argument is comparing apples and oranges. People will do EMS/firefighting for free. You knew that going in, so stop complaining and deal with it!

If you don't want to compete with volunteers, or are upset that volunteers are keeping wages down, you should have chosen a different career path, one people don't want to do for free. I'm an electrician. Nobody wants to do my job for free (aside from a DIY homeowner who will end up calling us anyway to fix their mistakes afterwards). Actually there are less people entering my field every year than people retiring, meaning eventually there will be an electrician shortage driving both prices and salaries higher. Most people don't want to do my job at all, which is fine by me. It's a dirty, physical job with no glory and very little respect, but it pays well and I can make as much money as I want by doing side jobs and such. I love it!

EMS/Fire/Police have a never ending line of applicants, all of whom will do anything to get the job including working for peanuts. As we all know there is a very high turnover at the lower levels of EMS, and an unlimited labor pool for employers to pick from to replace those leaving. This is due to the amount of education required to enter the field, it's a joke even at the paramedic level never mind the basic level. That is what is stopping the professional from progressing, not volunteers. Increase the education levels across the board and let the chips fall where they may.

I have read on this forum people questioning if there would still be volunteers if the educational standards were increased, probably, but I'm sure the number of volunteers would drastically decrease. I'll be honest, if the education requirements were a lot tougher I would probably not do this. I'm not a volunteer, we're paid oncall, but the money I make doing ambulance calls would definitely not convince me to make a whole lot more of an investment in education to continue. I have enough to do to maintain my electrical licenses both in license renewal fees and continuing education requirements (both of which are much more intensive than that required to maintain my EMT cert.).

Increasing the education requirements for all levels would not only affect the number of volunteers, but would also eliminate the number of "wannabees" who aren't really serious about a career in ems but get into it because it's "easy money".

To say that volunteers are bringing down the profession gives way to much credit to all of the lazy providers at every level, both paid and vollie, who do the absolute minimum to get by in this field. There are plenty of so called "professionals" who show up, do their shift, and get paid. They do no more than what is absolutely necessary to keep their job. They don't go on websites such as this to learn from others, they don't research topics to learn any new things, they don't take extra classes to better themselves. They show up for the paycheck, period.

So all of this volunteer vs. paid stuff is BS. If you want to better the profession - great! Increase initial education requirements, increase continuing education requirements, make the testing more difficult. There might be some volunteers who will still do this no matter what the requirements are, and so what? As long as the requirements are the same across the board for both paid and vollie that is all that should matter. Volunteers were doing this before you came, and will be doing it long after your gone. Deal with it!

 

[taporsnap44]

Increasing the education requirements for all levels would not only affect the number of volunteers, but would also eliminate the number of "wannabees" who aren't really serious about a career in ems but get into it because it's "easy money".

Hopefully this will be in full swing soon. With the new paramedic curriculum going into effect, and the possible updates to scope of practice requiring a bridge for existing paramedics. This is hopefully the first step in getting existing persons out of this profession that have no other reason then the "glory".

 

[EMTinNEPA]

I assume you have actual evidence for these assertions, rather than claims based on your perceptions...?

Read.
10 characters.

 

[Ridryder911]

I tend to agree with this statement. If you CHOOSE to make a career doing a job that thousands are willing to do for free, what do you expect? I would bet that even the oldest, most experienced medics that have been doing this for their entire career knew when they made the decision to get into EMS that there were thousands of volunteers doing this "job". Now these people complain that "volunteers are ruining this job". I have read on this forum in the past statements like "would you volunteer to pickup trash, pave streets, or other menial jobs"? No, nobody wants to do those jobs for free, so the town has to pay someone to do it. That argument is comparing apples and oranges. People will do EMS/firefighting for free. You knew that going in, so stop complaining and deal with it!

If you don't want to compete with volunteers, or are upset that volunteers are keeping wages down, you should have chosen a different career path, one people don't want to do for free. I'm an electrician. Nobody wants to do my job for free (aside from a DIY homeowner who will end up calling us anyway to fix their mistakes afterwards). Actually there are less people entering my field every year than people retiring, meaning eventually there will be an electrician shortage driving both prices and salaries higher. Most people don't want to do my job at all, which is fine by me. It's a dirty, physical job with no glory and very little respect, but it pays well and I can make as much money as I want by doing side jobs and such. I love it!

EMS/Fire/Police have a never ending line of applicants, all of whom will do anything to get the job including working for peanuts. As we all know there is a very high turnover at the lower levels of EMS, and an unlimited labor pool for employers to pick from to replace those leaving. This is due to the amount of education required to enter the field, it's a joke even at the paramedic level never mind the basic level. That is what is stopping the professional from progressing, not volunteers. Increase the education levels across the board and let the chips fall where they may.

I have read on this forum people questioning if there would still be volunteers if the educational standards were increased, probably, but I'm sure the number of volunteers would drastically decrease. I'll be honest, if the education requirements were a lot tougher I would probably not do this. I'm not a volunteer, we're paid oncall, but the money I make doing ambulance calls would definitely not convince me to make a whole lot more of an investment in education to continue. I have enough to do to maintain my electrical licenses both in license renewal fees and continuing education requirements (both of which are much more intensive than that required to maintain my EMT cert.).

Increasing the education requirements for all levels would not only affect the number of volunteers, but would also eliminate the number of "wannabees" who aren't really serious about a career in ems but get into it because it's "easy money".

To say that volunteers are bringing down the profession gives way to much credit to all of the lazy providers at every level, both paid and vollie, who do the absolute minimum to get by in this field. There are plenty of so called "professionals" who show up, do their shift, and get paid. They do no more than what is absolutely necessary to keep their job. They don't go on websites such as this to learn from others, they don't research topics to learn any new things, they don't take extra classes to better themselves. They show up for the paycheck, period.

So all of this volunteer vs. paid stuff is BS. If you want to better the profession - great! Increase initial education requirements, increase continuing education requirements, make the testing more difficult. There might be some volunteers who will still do this no matter what the requirements are, and so what? As long as the requirements are the same across the board for both paid and vollie that is all that should matter. Volunteers were doing this before you came, and will be doing it long after your gone. Deal with it!

Take away the badges, l/s on their POV's, and T-shirts/jackets with block letters on the back and see if there would not be a shortage alike electricians. Require real education with a formal degree before entering alike all other health care professionals and again then compare the line...

R/r 911

 

[medic_texas]

Don't take away my blinky things!!!

 

[scottyb]

Take away the badges, l/s on their POV's, and T-shirts/jackets with block letters on the back and see if there would not be a shortage alike electricians. Require real education with a formal degree before entering alike all other health care professionals and again then compare the line...

R/r 911

All Healthcare professionals do not require degrees. For example, CNA's. I understand, that there are mostly bathers, shavers, movers and wipers. But, they do work in the health care profession.

Making a case for greater education is great. But most of us volunteer's are basic's, at least in my area. A degree required for basics, come on. Paramedics, yes. I would tend to agree with you. Unless you feel all ambulances should be ALS, and there is no room for basics in health care. Can you really see Paramedics in a rural setting having to respond to band aid call after band aid call for the pay they would get when they can probably get paid a little more and have some calls where they can use that ALS education that they paid and worked for.