"Hose jockeys defensive of their territory, what's new?" is a generalization, which includes everyone else in the fire service. This type of comment can alienate the fire based EMS providers on this forum. That's what sweetpete was getting at.
Seattle/King County Fire and EMS politics.
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"Hose jockeys defensive of their territory, what's new?" is a generalization, which includes everyone else in the fire service. This type of comment can alienate the fire based EMS providers on this forum. That's what sweetpete was getting at.
NYMedic828
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Hey now, don't exclude the bucket fairies...
And don't be jealous that the firemen have bigger hoses.
NomadicMedic
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It's not hose jockeys trying to defend their territory, it's much bigger than that. Kind of hard to explain if you haven't worked in the system. Let me just say there is a big disconnect between ALS and basic life support. There is a huge rift between fire department EMTs and private ambulance EMTs.
I understand it's a great place to work as a paramedic. The training is amazing. The pay is great. It is an absolutely horrific place to work as a BLS provider. Especially if you're on a private ambulance.
I understand it's a great place to work as a paramedic. The training is amazing. The pay is great. It is an absolutely horrific place to work as a BLS provider. Especially if you're on a private ambulance.
KingCountyMedic
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I have to disagree with this. I have spent 25+ years in Washington State EMS with over half of that time working Private EMS in Pierce, Thurston, and King. It is what you make it here. We have Tri-Med and AMR crews come to our stations for meals, especially around the Holidays. The majority of KCM1 Medics come from the private sector, many of our best people are former Tri Med and AMR guys & gals. In the last 10-15 years we have added more Medics and the culture has changed. Many of the old school "less than friendly" folks have retired. The majority of fire departments now have their training done by KCM1 Paramedics. Our Medical Directors are also getting very much involved in the BLS programs as well now. I'm not denying that you may have some horror stories and you may have experienced bad things when working here, I too can look back on stuff in King County from my Private days that was bad at times but all in all this place is not as bad as many people on here would make it out to be. Again, anyone can come ride with us any time, we welcome it.
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NomadicMedic
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You can disagree with whatever you choose. That's the nice thing about the Internet, we can all have opinions.
As I mentioned, working as a paramedic in King County is probably a great job. You have excellent training, outstanding oversight on the ALS medicine, you make great money… If I never worked BLS in King County, I wouldn't know any better and I probably would have applied for a job there.
However, after working BLS there, I was disgusted and decided that there was no way I would ever consider working for that system. So, perhaps it's based on perspective. And please, don't tell me that a ride along would get to see any of the dreck that occurs on a daily basis. Everyone would be on their very best behavior, hey… It happens here too. For a ride along to really experience the interaction between BLS fire, private ambulance and ALS, a paramedic candidate should probably put on a white EMT shirt and ride BLS with TriMed or AMR for a couple of weeks and then see if they want to put themselves in that position.
As I mentioned, working as a paramedic in King County is probably a great job. You have excellent training, outstanding oversight on the ALS medicine, you make great money… If I never worked BLS in King County, I wouldn't know any better and I probably would have applied for a job there.
However, after working BLS there, I was disgusted and decided that there was no way I would ever consider working for that system. So, perhaps it's based on perspective. And please, don't tell me that a ride along would get to see any of the dreck that occurs on a daily basis. Everyone would be on their very best behavior, hey… It happens here too. For a ride along to really experience the interaction between BLS fire, private ambulance and ALS, a paramedic candidate should probably put on a white EMT shirt and ride BLS with TriMed or AMR for a couple of weeks and then see if they want to put themselves in that position.
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The above poster has also been known to make broad, sweeping generalizations about how privates are "fake 911", run down their abilities compared to fire medics (which in this area is laughable depending on the department), call them "woodchucks", tell them to "get over my opinion, and many other derogatory comments. Glass houses and such...
Broad, generalizations are (as a broad generalization) stupid. Every place has their turds.
The fire-based hate is often hurled around in response to the arrogance that seems to go hand in hand with scoring higher on a high-school level civil service exam than everyone else.
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NomadicMedic
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Who, exactly, are you speaking of?
Sweetpete, a post history reveals some very pointed accusations towards private EMS.
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PotatoMedic
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I must say I do like your little star sheriff!
I don't know how long ago you worked here in King County, but it is not as bad as you make it sound. Sure, there are some engine crews that couldn't give a rats a** about us. That happens in every system. I have worked with almost every station in the city and can say that Seattle Fire and Medics have treated me with respect and been respectful of my company.
Ever think that maybe it was you that had the conflict? Some people don't fit in. I agree with KingCountyMedic. I have been invited to the stations for meals and to hang out. Both Seattle and King County Medics have BS'd with me at Harborview. In fact it is their encouragement that has made me want to pursue EKG education.
Our system is unique yes. The relationship between fire and private is good. That doesn't mean that everyone gets along. Just because some crews may have personality issues doesn't mean the system is flawed. I would assume that in every system there are those that have conflicts. Besides, its not like FF's never have a bad day.
I enjoy working for AMR in Seattle and I enjoy my interactions with Seattle Fire and Police. If you can't hack our system then get out. Not everyone will fit in and be accepted.
sir.shocksalot
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I'm surprised that not every patient sees a paramedic in Seattle. Not that every patient needs a paramedic but it makes me wonder if some patients in pain or nauseated or whatever go without comfort measures because they aren't "sick" enough.
Sounds like a hit and miss thing with personalities though. I know personally that I don't ever have a problem getting along with fire or LE on scene, but there is still the occasional guy that has some deep internal desire to be a feminine hygiene product. I think individuals can have totally different perceptions of peoples behavior though. There was one FD paramedic at a place I worked who most people didn't like running calls with because he was "bossy", I never had a problem with him because I interpreted it as simply giving instructions. There was another guy I hated because I constantly thought he was mocking me, when everyone else thought he was funny. Different strokes for different folks.
Seattle sounds like a system that is set up to have problems between FD and EMS, as is almost every system where two separate agencies with the same training wind up on the same scene.
Sounds like a hit and miss thing with personalities though. I know personally that I don't ever have a problem getting along with fire or LE on scene, but there is still the occasional guy that has some deep internal desire to be a feminine hygiene product. I think individuals can have totally different perceptions of peoples behavior though. There was one FD paramedic at a place I worked who most people didn't like running calls with because he was "bossy", I never had a problem with him because I interpreted it as simply giving instructions. There was another guy I hated because I constantly thought he was mocking me, when everyone else thought he was funny. Different strokes for different folks.
Seattle sounds like a system that is set up to have problems between FD and EMS, as is almost every system where two separate agencies with the same training wind up on the same scene.
sir.shocksalot
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I don't like it when people say this. It never exactly fosters an environment where learning and growth can happen. I've watched some good people get kicked to the curb who weren't exactly given the best guidance to succeed in this work.
Nothing personal and not saying an individual might not be a good fit in EMS, I just see that saying thrown around a lot in this business without any regard to why that person can't "hack it". In my personal experience, 50% of the time that is said to someone it's simply the person saying it can't be bothered to train or guide the non-"hacking it" guy.
NomadicMedic
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The first post, from the guy that works in the hospital, clearly shows it's "just me". Nice try, thanks for playing.
I've seen some amazing King County paramedics. I've worked on scene with some. I've also seen some amazing fire department EMTs. However, KingCountyMedics post shows that even he is aware of issues between the various factions. He tried to gloss over them, but he knows they're there. I appreciate the fact that he addressed them and advised EMTs that have issues to be patient advocates and to talk to the battalion chief. However, if you do that at a private ambulance company, the chance of you getting fired is very high.
And LEOEMT, let me give you a piece of advice. The fire guys cooking you dinner aren't doing anything but buying your continued complacency. As long as you dont question anyone, show up quickly in the big white Taxi and believe that transporting hypoglycemics and anaphylaxis patients without ALS is a good idea, you just feed the machine.
King County EMS is a different animal... some think it works great others think it works poorly. Again, it's perception. Somebody said to me once, "King County Medic One writes great press releases. The problem is, they believe them."
Anyone who comes from a system where ALS and BLS are tightly integrated would find the King County disconnect to be disconcerting. I'm giving you a pass, simply because you are new and you don't know what you don't know. I'm sure as long as you keep drinking that Kool-Aid you'll continue to be an excellent employee.
I've seen some amazing King County paramedics. I've worked on scene with some. I've also seen some amazing fire department EMTs. However, KingCountyMedics post shows that even he is aware of issues between the various factions. He tried to gloss over them, but he knows they're there. I appreciate the fact that he addressed them and advised EMTs that have issues to be patient advocates and to talk to the battalion chief. However, if you do that at a private ambulance company, the chance of you getting fired is very high.
And LEOEMT, let me give you a piece of advice. The fire guys cooking you dinner aren't doing anything but buying your continued complacency. As long as you dont question anyone, show up quickly in the big white Taxi and believe that transporting hypoglycemics and anaphylaxis patients without ALS is a good idea, you just feed the machine.
King County EMS is a different animal... some think it works great others think it works poorly. Again, it's perception. Somebody said to me once, "King County Medic One writes great press releases. The problem is, they believe them."
Anyone who comes from a system where ALS and BLS are tightly integrated would find the King County disconnect to be disconcerting. I'm giving you a pass, simply because you are new and you don't know what you don't know. I'm sure as long as you keep drinking that Kool-Aid you'll continue to be an excellent employee.
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Wow...
Hmmmm.... I guess could weigh in here, but there isn't really much to say, it seems like everyone is pretty well entrenched. But I guess I'd like to address things in my perspective. I have been involved with King County EMS for a decade, starting with TriMed in '03. I am also a WA State EMS evaluator and King County CBT evaluator. In my experience, there are definite personality conflicts that lead to very poor working relationships, and unfortunately those faces get tied to the AMB company, so sooner rather than later, the poor experience is associated not with the crew, but with the sign on the side of the ambulance. Guess what, then the next (insert name here) AMB shows up, all they remember was the poor experience that they had. From that point on, it becomes an accumulation of bad experience blamed on the company, and good experiences credited to the crew. There are crews that have been running together for a significant amount of time, and they work well with the FD crews. They do community events together, superbowl, fill the boot stuff, etc... Kind of like an extended family, which in an ideal world is how things should be. They recognize that each has a specific role, and make very sure to fulfill their role to the best of their ability. I was lucky, I guess.
There are bad crews though, both on the FD side and on the AMB side. The outcome of that is never pretty. We'll use AMB crews for instance, crews that are regularly late, lost, argue onscene with FD are probably not going to make friends. It's never really about what you know, but how you present it, especially if you try to help someone instead of coming off as a know it all. Unfortunately, new EMTs are usually in that boat, they don't understand the system that they are working in, and they are just trying to show how much they know. They also have a poor ability to think outside of the box, and ultimately what is best for their patient. (guess what, sometimes it's faster for the patient to get them to a hospital then to argue about medics) My personal issue with EMTs is those who don't know their protocols. Now on to the bad FD crews, the ones that don't have any interest in EMS are really easy to pick out, and provide the most cookie cutter service (when it's convenient) and are most likely to turf without any patient care/evaluation or even a med/hx. The bad FD crews are also the least likely to have any clue about protocols, and perpetuate the "this is the way it's done" attitude. The upside with the bad FD crews is that if you've worked with them and they trust you, it becomes your call. They step back because they don't want to be up at 3a in some stinky apartment trying to figure out what cookie cutter approach will work, and they know that you do the "medical" stuff and really want to help the patient. The hard part is earning their trust, and getting to that point. Once you've hit that point, you can not only run your scene, but help your FD co-workers learn the medical side better. I don't like fire or extrication, but they like to explain how things happen, that is usually how medical works, just inverse. Now bad Medics, well, I do have to give them their due, most of the KCM1 medics that I have worked with have been far easier to discuss the patient in detail as well as the plan, and answer questions regarding the hows/whys. There are definitely calls that you know you're going to take (depending on the crew and dinner time, etc...) but those are the exception, generally not the rule, and it's usually based on the probability of the patient tanking in the 10min to get to the ER. Some of the most valuable lessons that have helped me in my career (tactical/disaster/remote and military medic) were taught to me in my first year on a rig by KCM1 medics, alot of them from Lee and Michael.
LEOEMT, I can empathize with your position, as I'm assuming from your posts that you primarily work Seattle, however alot of this focus is at S. King. Also there are alot of jaded responses particularly from TriMed. AMR has the benefit/detriment of being a union organization. (I'm not going to get into the benefit/detriment argument here) TriMed is not union. For me, personally I liked it, but it does bring a certain amount of uncertainty about the future. It is a well known fact that for most employees that if a FF calls the company with a complaint, there is a high probability that you need a new job. This causes animosity from the begining especially when someone dictates a questionable course of action and you feel stuck between what you feel is substandard care and your ability to provide an income. This also causes the feeling that "you can't talk on scene." FDs in S. King are guard their reputation very jealously, and if you’re going to make them look stupid, be prepared to pay the piper. From my personal experience, I have never been quiet on scene, and between dumb luck and what I'd hope is skill, but probably more dumb luck, I was never fired.
I guess that I would summarize South King County EMS as a work in progress, but it has improved for the basic level transport EMT significantly since I first became involved with the system. From my perspective there are a lot of personalities, they don’t always agree, and they can't always behave like adults. It is a progressive system that is trying to drag along some very cookbook minded individuals and departments (FDs and AMBs) into the future. Are there some issues that I think could be handled differently? Absolutely, but they are being considered and adjusted according to the vision of the Medical Director, and his vision is different than mine, but he’s got a whole lot more education, insurance, a license and several thousand prehospital providers at stake, and I’ve got an opinion. Having met with him though, he is very open to new ideas, provided they are properly thought through, have data to back them, and a concrete educational plan. I think that there are various issues which cloud the water, including EMS/FD funding based on municipalities instead of county, companies’ strategies, as well as education at the basic provider level.
Well, that’s my two cents, and it’s worth all you paid for it.
Hmmmm.... I guess could weigh in here, but there isn't really much to say, it seems like everyone is pretty well entrenched. But I guess I'd like to address things in my perspective. I have been involved with King County EMS for a decade, starting with TriMed in '03. I am also a WA State EMS evaluator and King County CBT evaluator. In my experience, there are definite personality conflicts that lead to very poor working relationships, and unfortunately those faces get tied to the AMB company, so sooner rather than later, the poor experience is associated not with the crew, but with the sign on the side of the ambulance. Guess what, then the next (insert name here) AMB shows up, all they remember was the poor experience that they had. From that point on, it becomes an accumulation of bad experience blamed on the company, and good experiences credited to the crew. There are crews that have been running together for a significant amount of time, and they work well with the FD crews. They do community events together, superbowl, fill the boot stuff, etc... Kind of like an extended family, which in an ideal world is how things should be. They recognize that each has a specific role, and make very sure to fulfill their role to the best of their ability. I was lucky, I guess.
There are bad crews though, both on the FD side and on the AMB side. The outcome of that is never pretty. We'll use AMB crews for instance, crews that are regularly late, lost, argue onscene with FD are probably not going to make friends. It's never really about what you know, but how you present it, especially if you try to help someone instead of coming off as a know it all. Unfortunately, new EMTs are usually in that boat, they don't understand the system that they are working in, and they are just trying to show how much they know. They also have a poor ability to think outside of the box, and ultimately what is best for their patient. (guess what, sometimes it's faster for the patient to get them to a hospital then to argue about medics) My personal issue with EMTs is those who don't know their protocols. Now on to the bad FD crews, the ones that don't have any interest in EMS are really easy to pick out, and provide the most cookie cutter service (when it's convenient) and are most likely to turf without any patient care/evaluation or even a med/hx. The bad FD crews are also the least likely to have any clue about protocols, and perpetuate the "this is the way it's done" attitude. The upside with the bad FD crews is that if you've worked with them and they trust you, it becomes your call. They step back because they don't want to be up at 3a in some stinky apartment trying to figure out what cookie cutter approach will work, and they know that you do the "medical" stuff and really want to help the patient. The hard part is earning their trust, and getting to that point. Once you've hit that point, you can not only run your scene, but help your FD co-workers learn the medical side better. I don't like fire or extrication, but they like to explain how things happen, that is usually how medical works, just inverse. Now bad Medics, well, I do have to give them their due, most of the KCM1 medics that I have worked with have been far easier to discuss the patient in detail as well as the plan, and answer questions regarding the hows/whys. There are definitely calls that you know you're going to take (depending on the crew and dinner time, etc...) but those are the exception, generally not the rule, and it's usually based on the probability of the patient tanking in the 10min to get to the ER. Some of the most valuable lessons that have helped me in my career (tactical/disaster/remote and military medic) were taught to me in my first year on a rig by KCM1 medics, alot of them from Lee and Michael.
LEOEMT, I can empathize with your position, as I'm assuming from your posts that you primarily work Seattle, however alot of this focus is at S. King. Also there are alot of jaded responses particularly from TriMed. AMR has the benefit/detriment of being a union organization. (I'm not going to get into the benefit/detriment argument here) TriMed is not union. For me, personally I liked it, but it does bring a certain amount of uncertainty about the future. It is a well known fact that for most employees that if a FF calls the company with a complaint, there is a high probability that you need a new job. This causes animosity from the begining especially when someone dictates a questionable course of action and you feel stuck between what you feel is substandard care and your ability to provide an income. This also causes the feeling that "you can't talk on scene." FDs in S. King are guard their reputation very jealously, and if you’re going to make them look stupid, be prepared to pay the piper. From my personal experience, I have never been quiet on scene, and between dumb luck and what I'd hope is skill, but probably more dumb luck, I was never fired.
I guess that I would summarize South King County EMS as a work in progress, but it has improved for the basic level transport EMT significantly since I first became involved with the system. From my perspective there are a lot of personalities, they don’t always agree, and they can't always behave like adults. It is a progressive system that is trying to drag along some very cookbook minded individuals and departments (FDs and AMBs) into the future. Are there some issues that I think could be handled differently? Absolutely, but they are being considered and adjusted according to the vision of the Medical Director, and his vision is different than mine, but he’s got a whole lot more education, insurance, a license and several thousand prehospital providers at stake, and I’ve got an opinion. Having met with him though, he is very open to new ideas, provided they are properly thought through, have data to back them, and a concrete educational plan. I think that there are various issues which cloud the water, including EMS/FD funding based on municipalities instead of county, companies’ strategies, as well as education at the basic provider level.
Well, that’s my two cents, and it’s worth all you paid for it.
I will no longer comment in this thread as I feel it is leaning more to the non-informative. I will conclude my participation with this: The system is what it is. It works for us. Some of us work well with fire and others don't. I would assume this is true nationwide. I enjoy my job, I enjoy my relationship with Seattle Fire and Medic One and I enjoy the respect that I am shown by them. Maybe I am unique in that. I have tremendous respect for them and for our system.
Is our system perfect? No it is not. I have my own ideas as to how it can be improved as I am sure others do as well. That said, I am fortunate enough to work with some of the best in the business. Some people like it others don't. We all have our own opinions and you are entitled. But, unless you have worked here recently you don't really know.
I will leave with this thought: I am here for the patient. Regardless of what interventions have been started, if you are given to me I will do for you what is in your best interest.
With that said, I conclude my involvement in this topic.
Shishkabob
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My view of getting FD out of medicine, where it doesn't belong, is no secret and I don't try to hide it to make friends. Fire departments should not do medicine. Fire departments do medicine to boost their budget.
Generalizations? Sure. But generalizations backed up by the fact that darn near every single world renowned EMS agency is NOT run through a fire department but is infact, separate of them, despite that fact that 1/3 of EMS agencies in this country are fire-based.
Aidey
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"Works" is a very subjective term.
And if any interventions have been started, there is an excellent chance the best thing to do for your patient is refuse to accept care and make the medic do their freaking job.
Well there are only 7 Medic units available in all of Seattle, and we're a prettyyyy big city, so if every Pt was to see a medic... you can see how that just wouldn't work.