Vol EMS question

[jgmedic]

While i dont dispute that there are quality volunteers out there,as well as terrible paid personnel, i do think that when your livelihood depends on something you tend to work harder at doing it well. My problem with volunteers, is that they are out there devaluing my work. Why should a municipality pay for a service when they can get it done for free because someone wants to play Ricky Rescue on their off time?

 

[hometownmedic5]

I disagree with pretty much everything in those two paragraphs. There's no reason quality of work has to suffer because it's done for free. And I suspect there's just as long a list of paid people who do "hacky work."

There are incompetent volunteers, but being a volunteer doesn't make one incompetent.

I never said there weren’t professional hacks. What I did say was that, as a general overall rule, doing something for free will inevitably produce a lower quality product simply because it isn’t your livelihood, it’s hobby. An individual may perform at any number of levels, but the herd will settle like water finding the lowest point in a boat(or a flooding neighborhood etc).

I didn't say this has to happen, just that it inevitably will.

 

[mgr22]

While i dont dispute that there are quality volunteers out there,as well as terrible paid personnel, i do think that when your livelihood depends on something you tend to work harder at doing it well. My problem with volunteers, is that they are out there devaluing my work. Why should a municipality pay for a service when they can get it done for free because someone wants to play Ricky Rescue on their off time?

Lots of places can't afford to pay for EMS. Volunteers are then the only option. Also, wanting to "play Ricky Rescue" characterized some, but not most of the volunteers I've known.

I don't think being paid to do something automatically makes people want to be better at it. Some folks I know are much better at their hobbies than they are at their jobs.

 

[akflightmedic]

Lots of places can't afford to pay for EMS. Volunteers are then the only option.

Bull Shyte. Where are the volunteer pot hole fillers? Dog catchers? Snow plow drivers? And so on...they can pay, they choose to not pay because they have not been forced to come up with a solution. Paid EMS can easily be afforded....here in Maine, many of the largest, most rural areas have combined efforts with adjoining towns. They now have paid EMS providers. It is doable. Other states can force the county to make it a service. It takes effort and more importantly, it takes willingness of all the local players (Chiefs, Officers, FD hacks, EMS Hacks) to be willing to support a paid initiative whether it includes them or not once it comes to fruition.

Volunteers are never the "only option", they are just the easiest (fast) and cheapest (low cost/no cost).

Cheap, Fast, and Good....you can only have two out of three.

Cheap and Fast is not Good,
Fast and Good is not Cheap
Cheap and Good is not Fast.

Pick a scenario, and get started!

 

[hometownmedic5]

I second AK. If there were no more volunteers, the town would have paid ems. They don’t currently because there are enough people willing to do the job for free. This too shall pass. I work part time for a municipality on the verge of the call fire dept collapsing because there are no people left in town that have the free time to go to calls. It will eventually happen in your town too. I also work for a commercial service throwing money at people to work here. They’ll hire anybody that walks in the door and we don’t have enough staff. The times, they are a changing.

 

[mgr22]

Bull Shyte. Where are the volunteer pot hole fillers? Dog catchers? Snow plow drivers? And so on...they can pay, they choose to not pay because they have not been forced to come up with a solution. Paid EMS can easily be afforded....here in Maine, many of the largest, most rural areas have combined efforts with adjoining towns. They now have paid EMS providers. It is doable. Other states can force the county to make it a service. It takes effort and more importantly, it takes willingness of all the local players (Chiefs, Officers, FD hacks, EMS Hacks) to be willing to support a paid initiative whether it includes them or not once it comes to fruition.

Volunteers are never the "only option", they are just the easiest (fast) and cheapest (low cost/no cost).

Cheap, Fast, and Good....you can only have two out of three.

Cheap and Fast is not Good,
Fast and Good is not Cheap
Cheap and Good is not Fast.

Pick a scenario, and get started!

Ok, the scenario I pick is a rural area of, say, 150 square miles that generates 50-100 9-1-1 calls a year. There are many of those. It's difficult to justify -- and in many cases, afford -- a paid system under those circumstances. Volunteers are often a better option and sometimes the only option. Hybrid systems mixing paid and volunteer providers can be another option.

And I disagree that cheap and fast necessarily rules out good.

I can't speak for pothole fillers, snowplow drivers, or dogcatchers. I suspect there are many places where potholes are unfilled, snow is unplowed, and dogs are uncaught.

 

[mgr22]

I second AK. If there were no more volunteers, the town would have paid ems. They don’t currently because there are enough people willing to do the job for free. This too shall pass. I work part time for a municipality on the verge of the call fire dept collapsing because there are no people left in town that have the free time to go to calls. It will eventually happen in your town too. I also work for a commercial service throwing money at people to work here. They’ll hire anybody that walks in the door and we don’t have enough staff. The times, they are a changing.

I disagree with your assumption that the absence of paid EMS is necessarily due to the presence of volunteer EMS. Often, it's the other way around: volunteer EMS exists because there is no paid EMS, especially in rural areas.

As for the collapse of volunteer agencies, there is certainly some of that going on. One fix has been to supplement volunteers with paid providers in agencies that were previously all-volunteer.

 

[Phillyrube]

40 years in volunteer fire and EMS, with a couple stints in career fire and hospital based EMS. In the middle of that, finished a 20 year Navy career and 23 year police career.

The days of sitting home waiting for a call are over. Volunteering means sitting in a station for a 12. The only thing you volunteer for is showing up to join. After that, obligations. Not many people want to do that or have the time. I came from a large city with volunteer fire and EMS, which over time, led to a career ALS fire department with a couple volunteers, and volunteer EMS with a robust career staff.

The next time you get to volunteer is when you leave. Sad to say, I saw volunteers quit when they couldn't decorate their car with lights.

 

[mgr22]

40 years in volunteer fire and EMS, with a couple stints in career fire and hospital based EMS. In the middle of that, finished a 20 year Navy career and 23 year police career.

The days of sitting home waiting for a call are over. Volunteering means sitting in a station for a 12. The only thing you volunteer for is showing up to join. After that, obligations. Not many people want to do that or have the time. I came from a large city with volunteer fire and EMS, which over time, led to a career ALS fire department with a couple volunteers, and volunteer EMS with a robust career staff.

The next time you get to volunteer is when you leave. Sad to say, I saw volunteers quit when they couldn't decorate their car with lights.

I agree that most volunteers probably aren't sitting at home, waiting for a call. However, not all volunteer agencies have in-house crews 24/7, so sitting in a station isn't necessarily part of the deal.

 

[DrParasite]

EMS requires me to arrive quickly, sober, properly(subjective) dressed and commit to the call for its duration, regardless of what that might mean(think places with long transport time to specialty centers without a HEMS solution). That, right there, is enough for me to have given up any of my previous volunteer "jobs". If you want me to come to your house in the middle of the night, probably carry you out, then fix your wagon and transport you, I demand a paycheck. But wait, there's more.

I've heard plenty of stories where paid EMS doesn't show up quickly, less than sober, def not properly dressed (although agreed, it's subjective), and everyone needs to commit for the call for the duration.... Let me ask you a question: if the choice is a volunteer ambulance from your home down showing up in 10 minutes, and a paid ambulance showing up in 30-45 minutes from 25 miles away (because you live in the middle of nowhere), which you you prefer?

When you're good at something, don't do it for free, as a rule. You can choose to make exceptions based on the rules that you decide are correct for you, including all the way up to volunteering full time if that's your thing; but overall, as a rule, if you're good at something, don't do it for free. There are inevitably two results, generally not individually. One is that the quality of your work will suffer and two, you will decrease the value of everybody else's work.

No; when you are good at something, you don't do it for nothing. that's different than doing it for free. In the past, I have presented as Fire and EMS conferences for no pay; I spent hours researching the topic, designing the presentation, practicing, etc. and I got paid 0. and I would do it again too. I did it for name recognition, to make my agency look good, and because, quite honestly, I wanted to. I'm good at what I do. And now I do get paid, but I will likely present for free again at my state's Fire conference, and maybe even the EMS conference (haven't decided yet).

Also, I've helped out organizations, friends and colleagues, my kids school, etc, and asked for 0 pay. that's my choice. I've also provided my expertise to public safety entities, for no pay. Why? because someone asked for help. Heck, I volunteered to be the IT guy at my FD, maintaining the website, the email system, and all social media accounts. I'm good at what I do. Plus, no one else knows as much about IT as I do (we have several FFs and officers who have trouble with email......). It doesn't cheapen my work, or the IT work of our manage services provider (which I have called on the carpet several times for screwing up), but it ensure the work gets done to our satisfaction (and correctly).

As an individual, you can put the standards of your work above all else and not let it suffer because of compensation. As a group, there is no end to the list of examples of people who could not, because there are still volunteers out there doing hacky work and stating words to the effect of "Hey, I'm a volunteer" as their escape hatch.

apparently many of the volunteer fire departments in this nation would disagree with you... and all the auxiliary cops.... you can, and should, still have standards and rules, even if the organization is volunteer... after all, the last time you volunteered is when you submitted an application; after that, you became a non-compensated employee of the organization, and agreed to follow the rules they set for you.

One person may not care about volunteers but for as long as there is someone willing to do a job for free, the group(society) will wonder why they are paying you to do the job when the other guy will do it without sticking his hand out.

Easy. I will help out my neighbor for free, but that doesn't mean I will do my job for free. Or more plainly, I will volunteer for my local EMS agency, because I want my neighbors to get the best care possible, but I should be paid for any work I provide to my employer. And for full disclosure, I haven't been a volunteer on an EMS agency since 2008...

Have you ever seen a volunteer bricklayer, plumber, or mechanic? Not someone you know who is doing you a favor, or even somebody one or two degrees separated

got news for you: when you are doing that person a favor, you are working as a volunteer..... if you want to be high and mighty, you are actually cheapening the work of a professional bricklayer/plumber/mechanic, and taking money out of their pocket by doing it for free.....

but a total stranger whose number you called and who showed up immediately, did the job you asked, and then walked away without asking for payment? Why? because there are no volunteer bricklayers.

You ever went to a hospital? you know they have volunteers helping out, right? ever picked up trash along your neighborhood? you know that there are people who get paid to do that right? Ever been driving, saw a car on the shoulder with a flat, with a blonde lady standing on the side of the road, and helped her change a tire? if so, did you ask to be paid for that service, or did you just help her and drive away?

Sorry for the extremely long post, but there is a lot of inaccurate claims made by your post, many based on urban legends and downright stereotypes. If you don't want to volunteer, that is your choice, and I won't hold it against you; but don't look down on someone who does volunteer when there is no other option, provided they hold themselves to the standards set forth by the AHJ.

 

[Tigger]

I've heard plenty of stories where paid EMS doesn't show up quickly, less than sober, def not properly dressed (although agreed, it's subjective), and everyone needs to commit for the call for the duration.... Let me ask you a question: if the choice is a volunteer ambulance from your home down showing up in 10 minutes, and a paid ambulance showing up in 30-45 minutes from 25 miles away (because you live in the middle of nowhere), which you you prefer?

The paid crew for sure. Make it an hour, make it two, the answer holds the same.

Have you ever worked in rural America? To assume that an "ambulance crew" that runs 200 calls a year has any degree of competency is just not correct. Both medical direction groups that I work under and teach for have essentially banned volunteer BLS ambulances from transporting to hospitals because they were harming people with surprising regularity. They did not know when they needed help, and the patients suffered. I would much rather they show up in a pickup, get some vitals and a history, apply a tourniquet, or do CPR. Simple things. If that means the patient waits for another 30 minutes so be it, that's what happens when you live in an actual rural area.

This is not an attack on these folks. I love going out and teaching in-services to these agencies. They can make a serious difference. But they don't need to transport to do that.

 

[Kavsuvb]

What makes you think the population dynamics are different in Connecticut than in the mid-atlantic states? or the west coast? or north west? or even the south east? or even the midwest?

Have you see HOW much it cost to Live in Connecticut vs everywhere else. The taxes in Connecticut alone make it hard to live and even work in Connecticut.

 

[CCCSD]

Have you seen how much it costs to live in CA?

 

[DrParasite]

Have you see HOW much it cost to Live in Connecticut vs everywhere else. The taxes in Connecticut alone make it hard to live and even work in Connecticut.

honest answer? no. Is it really that much more expensive than NJ? or NY? or RI? or CA?

here, lets compare: https://www.cnbc.com/2018/06/28/these-are-americas-most-expensive-states-to-live-in-for-2018.html

Jersey is 10.... Connecticut is 8.... NY is 4.

When I put in "cost of living in Connecticut vs new jersey" into Google, there first response was 2020 Cost of Living Calculator: Hartford, Connecticut vs Jersey City, New Jersey

As for taxes, according to https://wallethub.com/edu/states-with-highest-lowest-tax-burden/20494/, there are 7 states with higher taxes than Connecticut...

So I guess the question is, do you know where Connecticut actually stands, when objectively compared to other states?

 

[DrParasite]

The paid crew for sure. Make it an hour, make it two, the answer holds the same.

Have you ever worked in rural America? To assume that an "ambulance crew" that runs 200 calls a year has any degree of competency is just not correct. Both medical direction groups that I work under and teach for have essentially banned volunteer BLS ambulances from transporting to hospitals because they were harming people with surprising regularity. They did not know when they needed help, and the patients suffered. I would much rather they show up in a pickup, get some vitals and a history, apply a tourniquet, or do CPR. Simple things. If that means the patient waits for another 30 minutes so be it, that's what happens when you live in an actual rural area.

This is not an attack on these folks. I love going out and teaching in-services to these agencies. They can make a serious difference. But they don't need to transport to do that.

To answer your first question, yes, I have worked in Rural America. My FD is (technically) a rural department. We have tankers, and farms, and trailer parks, and a whole lot of nothing. Previously, I worked for a county EMS agency, were we were located in the sticks; 30-45 minutes to a decent hospital from the deepest parts of our coverage area. maybe 2 calls in a 12 hour shift. I will also say that I teach in rural america (outside my home county), and some of the stories I have heard them say about the EMS agency can be.... questionable?

Now, have I ever worked in rural america, where people work 48s, and maybe get 1 call? no, but that works out to about 200 calls a year for the agency. Assuming 48 on 48 off, that means each crew only get 100 calls a year. But because they are paid, and not volunteers, does that mean you statement of "assume that an "ambulance crew" that runs 200 calls a year has any degree of competency is just not correct" does not apply? Or does that paycheck give them some super competency?

I will also say that I have never been on any agency that runs 200 calls a year. My first volunteer agency covered a town that handled between 4000 and 5000 calls a year. Another one I was on as an associate member got about 1000 calls a year. Neither were in rural america; they were in the suburbs After I started working for larger, urban based EMS agencies, my call volumes rose significantly at my FT jobs, and I still worked PT in the burbs at combination or PT career agencies and had call volumes of about 3000 annually.

If the volunteers in your area are that incompetent that they were harming people on a regular basis, than your EMT programs were passing people who they shouldn't have, and the agencies continuing education was failing them as well. I'm surprised the paramedics didn't experience the same issues, because their call volumes per shift were likely pretty low. I also didn't know you had volunteer providers waiting with a sick patient for over an hour until the paramedics showed up. based on what you said, I'm pretty sure you arrived to find many dead bodies or nearly dead bodies as a result of the first responder's incompetence.

I don't know your area, I am not asking for what part of the country to avoid, but I can assure you, there are plenty of places around the nation that don't display the level of incompetence that seems to be common in your area, while still being transport capable volunteers.

 

[SandpitMedic]

The more places that go to a paid, professional EMS service the better. Outside of some very rural areas, there really is no place for it anymore.

This

 

[Kavsuvb]

The more places that go to a paid, professional EMS service the better. Outside of some very rural areas, there really is no place for it anymore.

Well dud, the more places and especially the suburbs that use to be Volunteer EMS are turning to paid EMS or a combination of Paid/Vol. It's why the Rural areas of the country are becoming the last standing Vol EMS and how long can Rural Vol EMS stand before they fold. It's why I think Vol EMS is dying and it could have a domino effect such as EMT's who require Patient care hours for Paramedic School or Physician Assistant school. Makes you wonder is VOL EMS worth Salvaging?

 

[Kavsuvb]

Here's a good example to this topic

Study: Longer Ambulance Drives as Hospitals Close in Rural Communities

Study: Longer Ambulance Drives as Hospitals Close in Rural Communities - JEMS: EMS, Emergency Medical Services - Training, Paramedic, EMT News

People in rural areas of the United States wait, on average, nearly twice as long for ambulances as those in urban areas. New research from the UNC Gillings School of Global Public Health has found that hospital closures in rural areas increase those EMS transport times.

www.jems.com

 

[mgr22]

Well dud, the more places and especially the suburbs that use to be Volunteer EMS are turning to paid EMS or a combination of Paid/Vol. It's why the Rural areas of the country are becoming the last standing Vol EMS and how long can Rural Vol EMS stand before they fold. It's why I think Vol EMS is dying and it could have a domino effect such as EMT's who require Patient care hours for Paramedic School or Physician Assistant school. Makes you wonder is VOL EMS worth Salvaging?

Your statement about rural areas "becoming" the last volunteer EMS services is just wrong. There are heavily populated areas of the US that continue to rely on volunteer EMS -- hundreds of agencies, at least. Perhaps some of those areas would be served as well or better by fully paid services, but that's a different argument.

Also, when you question whether volunteer EMS is worth salvaging, I suspect your answer would be "Yes" if you lived in a rural area where volunteer EMS was all your community could afford.

 

[CCCSD]

Well dud, the more places and especially the suburbs that use to be Volunteer EMS are turning to paid EMS or a combination of Paid/Vol. It's why the Rural areas of the country are becoming the last standing Vol EMS and how long can Rural Vol EMS stand before they fold. It's why I think Vol EMS is dying and it could have a domino effect such as EMT's who require Patient care hours for Paramedic School or Physician Assistant school. Makes you wonder is VOL EMS worth Salvaging?

Your problem in this and other postings is that you read one article or story, and immediately assume that you now have all the information you need for a position statement. Everything you post is a mishmash of issues crammed together.

You really need to research a topic before you post.