The (Often) Forgotten: EMS In America

[BlauerMfg]

Hi all,

JEMS picked up our blog article, curious as to your thoughts on it.

http://www.blauer.com/dispatch/the-often-forgotten-ems-in-america/

or

http://www.jems.com/articles/2016/04/the-often-forgotten-ems-in-america.html

Thanks.

 

[redundantbassist]

Why do fire and PD always receive more recognition than EMS? The answer is simple. FD, PD, and EMS all work to protect and save human life. However, PD and FD regularly find themselves in dangerous situations ("Firefighting is an ultra hazardous, unavoidably dangerous activity.") while EMS is staging a few blocks down waiting for the scene to be declared safe. When I go to work everyday, I put myself in the same amount of danger as a mail carrier or pizza delivery guy.

Honestly, I'm sick of hearing stuff like this-it only encourages the "i'm a hero, I save lives" attitude.

 

[Chewy20]

X2. Constantly hear people saying "oh I don't need the recognition." Yet they complain when they don't get any. Do your damn job and go home, be a normal person.

 

[akflightmedic]

+1000 Chewy...

Never hear people complaining about plumber not getting respect, electrician not getting respect, dog catcher, mailman, pot hole filler...on and on and on....for some reason we think because we chose a profession to help others, then we are more special than anyone else doing a job. Baffles the brain...

 

[BlauerMfg]

Perhaps not personal recognition so much as recognition of the profession - with attendant funding, programs, etc.

 

[akflightmedic]

What programs do you want?
What special funding do you want?
What do you want recognized about the profession?
Why does the profession need this recognition?

Why can we not just go do our daily duties at our chosen profession and exist like every other profession in this planet?
Why do we need to compare ourselves to PD or FD?

(Yes, I may be playing Devil's Advocate to a degree, however I want to hear justification for these questions)

Why is our profession "special"?

 

[BlauerMfg]

I don't think it's "special" any more or less than other public safety.

As far as programs go, personally I'd like to see:

1. Better overall training options for all areas of the country, including national-level funding, so that education does not rely upon local options only (most often those provided through your service, however a lot of people pay for their own con-ed as well.)

2. A more centralized research aggregation/coordination entity that moves data into practice more quickly - I still see a lot of local-authorized protocol investigations that don't operate in more than one environment (and consequently, more than one patient base) simultaneously. These seem to progress through multiple areas one at a time with multiple variations (BOSS for stroke versus Cincinnati, etc, where subtle variations may or may not effect dx/treatment/progression), and while NREMT does a fair bit, I don't think it's on the same scale as an IACP, IAFF, NLEOMF, etc. Overall, I still feel like EMS clinical research is mostly locally-based. I may be wrong (I'm sure as a flight medic, you know far more than I do.)

For special funding, see the above. I'd also like more research into safety on the job and preventative measures that can be taken - do we have nationwide data on assaults and injuries in EMS? Not to the degree that occurs with the FBI's LEOKA data, that's for sure, and definitely not IAFF level (they seem to know every detail.)

Recognition of the profession: leads to the above. We're not just transports anymore, but a full-fledged care provision entity. Many of us know more in a real-patient sense than many nurses/docs - but our reports may fall on deaf ears if those folks don't know what we're trained to do and capable of. That in turn affects continuity of care and overall patient outcome, especially in trauma. I don't know about you, but I've had docs literally ignore my trauma reports and just start their exams all over again or even talk over me, even when working for one of the most prestigious EMS systems in the country. Many listen, not all do.

Hopefully that provides some answers.

 

[Chewy20]

All depends on where you work. We get a lot of funding and are always on the news for something. Being on the news doesn't make me feel better about my job. I remember when a cardiac arrest drove up to the ambulance bay at the hospital. A few of our crews got him back on the pavement and then he was brought inside.

What do you think the newspaper talked about? The nurses and doctors. Not one mention of EMS. Doesn't bother me, later saw the same guy alive and well in the news paper. That's what matters.

 

[mgr22]

Many of us know more in a real-patient sense than many nurses/docs - but our reports may fall on deaf ears if those folks don't know what we're trained to do and capable of. That in turn affects continuity of care and overall patient outcome, especially in trauma. I don't know about you, but I've had docs literally ignore my trauma reports and just start their exams all over again or even talk over me, even when working for one of the most prestigious EMS systems in the country. Many listen, not all do.

I'm curious: Where and how did you get the idea that "Many of us know more in a real-patient sense than many nurses/docs"? Do you include yourself in the "many of us"? What does "real-patient sense" mean, anyway?

Have you considered the possibility -- and I'm just speculating here -- that the reason docs ignore you is your reports need to be better, or at least more relevant?

In your full reply, you speak of the need for "better overall training options." Do you see a gap between your training and the education of the average doctor or nurse? If so, have you considered closing that gap by pursuing medical education beyond the level of EMT?

 

[titmouse]

I am with Chewy on this one. I believe that it depends on where you live as well. Couple of weeks ago we had a transport to Key West and after the call we stopped at a fast food place to eat and the locals were really nice to us. Now, yesterday we have brought a patient to major hospital in Miami, a call that we got from the county, and the lady at the county looks at us and straight up tells me "you are not EMS"....

 

[Tigger]

I do not do this job for the recognition though if someone says something nice about us I appreciate it.

That said, too often I see people get all pissy about fire and police actively looking for recognition. While some of it is undoubtedly in bad taste, a lot of it is also called good PR. We are not a visible service when compared to Fire and EMS. This is a problem, an it is not good for our compensation. Nobody throws a fit when EMS service gets cut. A fire station loses a company and everyone freaks out. People should be pissed when they lose EMS service, but they don't even know we exist, and we are partly to blame.

I could not be happier to work with quiet, no nonsense people that get the job done and move on. But maybe it's time we aren't so scared of being in the public eye. We have to seek out opportunities for good PR, even if we feel a little dirty about it.

 

[NUEMT]

+1000 Chewy...

Never hear people complaining about plumber not getting respect, electrician not getting respect, dog catcher, mailman, pot hole filler...on and on and on....for some reason we think because we chose a profession to help others, then we are more special than anyone else doing a job. Baffles the brain...

I would point out that almost all of those jobs have professional organizations that have established baselines for compensation, care, insurance and the like. I am not disagreeing with the nobility of being the quiet professional. Been there. But I read the article to mean more than just look at me. Not being noticed is precisely how state and federal laws get passed that end up hurting or totally ignoring EMS.

 

[NUEMT]

All depends on where you work. We get a lot of funding and are always on the news for something. Being on the news doesn't make me feel better about my job. I remember when a cardiac arrest drove up to the ambulance bay at the hospital. A few of our crews got him back on the pavement and then he was brought inside.

What do you think the newspaper talked about? The nurses and doctors. Not one mention of EMS. Doesn't bother me, later saw the same guy alive and well in the news paper. That's what matters.

It probably should bother you. In a few ways. Fire service is a brotherhood. Police... the same. EMS.. not so much... and a lot of that has to do with the limited view of each individual practitioner in there individual ambulance. That is how we have paramedics being paid 9 dollars an hour. That is how we as a profession are often looked at as the operations arm the rampant medicare fraud that is currently being cracked down on.

 

[NUEMT]

I haven't read a post here that I totally disagree with... I would simply ask that we as a community try to look beyond the surface of the article. What is at the base of what the author is talking about.

 

[Carlos Danger]

I don't think there is anything at all wrong with EMS as a profession looking for ways to improve its public image and elevate its status in the public eye. In fact I think one could argue that the relatively bland image of EMS helps perpetuate the profession's other problems.

I do think it is as much a mistake for EMS to constantly compare itself to fire/PD as it i to constantly compare itself to nursing. Sure there are parallels and similarities, but there are just as many differences.

The advantage that fire and PD have is that they have cultivated the "hero" image. We know that's largely BS, but it is the public's perception, and perception is reality.

 

[Chewy20]

It probably should bother you. In a few ways. Fire service is a brotherhood. Police... the same. EMS.. not so much... and a lot of that has to do with the limited view of each individual practitioner in there individual ambulance. That is how we have paramedics being paid 9 dollars an hour. That is how we as a profession are often looked at as the operations arm the rampant medicare fraud that is currently being cracked down on.

And my answer to that is, no one makes you work for 9 dollars an hour. I make more than double that, without built in OT and benefits...and I am a basic.

Like I said before. Don't like the way you are being treated? Move or find a new career There's a reason some companies pay so little. Because there's some naive person that will accept that wage even after getting a 1-2 year education. That's a whole different topic. So I'll stray away from that.

I'm all about good PR, but for the people who just sit there and whine about not being noticed, while doing nothing to fix it. I have no sympathy for.

Every department and company has a PR division, or should. Talk to them about what you can do, to improve your call areas outlook on EMS.

 

[NUEMT]

And my answer to that is, no one makes you work for 9 dollars an hour. I make more than double that, without built in OT and benefits...and I am a basic.

Like I said before. Don't like the way you are being treated? Move or find a new career There's a reason some companies pay so little. Because there's some naive person that will accept that wage even after getting a 1-2 year education. That's a whole different topic. So I'll stray away from that.

I'm all about good PR, but for the people who just sit there and whine about not being noticed, while doing nothing to fix it. I have no sympathy for.

Every department and company has a PR division, or should. Talk to them about what you can do, to improve your call areas outlook on EMS.

I think failed to make my point. What you have said in your response is exactly why EMS can't hold anyone longer than five or six years on average. You make double and sit fine while members of your profession struggle to eat and you remain ok with that. Support, even in as little as a passing thought, or a word of encouragement, is a lot. Especially when the "PR" you talk about reaches the desk of someone who actually can craft pieces of structure to build us up.

1-2 years of Basic and Medic School....does not qualify as an education. It qualifies as technical training. That is not a statement out of thin air. That is how the various forces that oppose EMS progression see us and how they argue against us when they have an opportunity for "PR".

Read one or two position papers from state nursing associations on the idea of community Paramedicine or the role of Medics within the hospital continuum and you may not be so quick to see your self in YOUR town getting YOUR amount of pay and YOUR ot and benefits.

Infringing on the basic working rights of EMS in any form is a detriment to all of us. One of the biggest examples being the lack of LODD recognition. Call that "PR" too sir?

 

[Carlos Danger]

Infringing on the basic working rights of EMS in any form is a detriment to all of us. One of the biggest examples being the lack of LODD recognition. Call that "PR" too sir?

Who is talking about "infringing on the basic working rights of EMS"?

 

[NUEMT]

Happens all over ems remi.. forced shifts beyond agreed limits... shady overtime pay schemes.. lot has been covered by ems one.. and in the ems agenda for the future.

 

[Chewy20]

I think failed to make my point. What you have said in your response is exactly why EMS can't hold anyone longer than five or six years on average. You make double and sit fine while members of your profession struggle to eat and you remain ok with that. Support, even in as little as a passing thought, or a word of encouragement, is a lot. Especially when the "PR" you talk about reaches the desk of someone who actually can craft pieces of structure to build us up.

1-2 years of Basic and Medic School....does not qualify as an education. It qualifies as technical training. That is not a statement out of thin air. That is how the various forces that oppose EMS progression see us and how they argue against us when they have an opportunity for "PR".

Read one or two position papers from state nursing associations on the idea of community Paramedicine or the role of Medics within the hospital continuum and you may not be so quick to see your self in YOUR town getting YOUR amount of pay and YOUR ot and benefits.

Infringing on the basic working rights of EMS in any form is a detriment to all of us. One of the biggest examples being the lack of LODD recognition. Call that "PR" too sir?

Whether you like it or not, EMS is a money making business. As much as you'd like to think other wise, that's exactly what it is. The owners of private companies for the most part just care about their profit margins. So why would they pay someone more, when they are fine with accepting so little? New people just want to be EMTs and are willing to accept anything. I started with a low paying EMS jobs and got fed up with it. Guess what I did, moved cross country to a place I could make a career, if I chose to do so. So I do not have sympathy for the paramedic making $9 an hour, because no one is holding a gun to their head making them work for pennies. Was that to harsh for you?

Unless you work for a tax paid system, which most do not. You can expect shady business and poor wages. Why? Like I said, they are there to make their pockets fatter. Just like any other career field, those companies will continue to pay you squat until there is no supply for their demand.

You come at me saying my views are the pitfalls of EMS. Yet you put down my statement of calling EMS training an "education"? Makes sense.

Baffles me that in other fields, people that are "forced" to work more shifts, are paid little etc. don't stick around long. They find a new job, or further their education. While people in EMS believe they entitled more just because they put on a uniform. It's a freaking job, stop getting butt hurt when people tell you other wise.