Volunteer EMS needs to become non-existent.

[bigbaldguy]

I would say that unless you're making more than you're spending you would be a volunteer although that might not be the literal definition. If you make 5 dollars a call and run ten calls a day but spend 20 dollars in gas getting there and eat 3 meals out for a total of 50 dollars expenses then it comes out to volunteer work in my opinion.

I'm very pleased with the respectful tone everyone is maintaining. This is one of those hot button topics and it speaks to the maturity of everyone who is posting that is has stayed productive and on topic.

 

[DeepFreeze]

71 Heavy Rescues? Where are you? Dix Hills Strong Island?

 

[Jon]

Also in my area, the amount of volunteer vehicles we have in relation to the need for them is RIDICULOUS. The city of new york, one of the busiest departments in the country, has 5 heavy rescue vehicles for the entire city. My home town has 71... 71!!!! But this i guess is for a different discussion.

This is probably a false comparison. Remember, FDNY also has Squads (rescue engines) as well as every Truck (aerial) has basic rescue equipment. That allots to much more than the 5 "Rescues"

But if you're talking about Long Island - yeah, there is a fair amount of apparatus (and station) silliness.

 

[rescue1]

I was in a town once that had two heavy rescues and a rescue engine...for a town of 4000 people.

Still, it's easy to see why. The largest expense of a career department is salaries, and a well funded volunteer department is free from those expenses and able to purchase extra equipment. There may be better ways to spend the money, but there have been times when having a spare engine or rescue is nice. It's when it gets into an "apparatus war" that it gets fishy. This is more of a fire side thing, but there are times when a station will buy a brand new ladder because XYZ station down the street just got one, and we can't let XYZ be better then us. This gets into wasteful spending.

 

[ffemt8978]

This is probably a false comparison. Remember, FDNY also has Squads (rescue engines) as well as every Truck (aerial) has basic rescue equipment. That allots to much more than the 5 "Rescues"

But if you're talking about Long Island - yeah, there is a fair amount of apparatus (and station) silliness.

Also, doesn't the NYPD ESU have extrication and some rescue equipment also?

 

[bahnrokt]

I was in a town once that had two heavy rescues and a rescue engine...for a town of 4000 people.

Still, it's easy to see why. The largest expense of a career department is salaries, and a well funded volunteer department is free from those expenses and able to purchase extra equipment. There may be better ways to spend the money, but there have been times when having a spare engine or rescue is nice. It's when it gets into an "apparatus war" that it gets fishy. This is more of a fire side thing, but there are times when a station will buy a brand new ladder because XYZ station down the street just got one, and we can't let XYZ be better then us. This gets into wasteful spending.

My town is about 5000 people and we have 4.5 VFDS (4 full fire districts and one that straddles the town line) each with a heavy rescue rig, an engine, tanker, fly/chiefs car etc. One 2 Chiefs actually live in district. Two of the VFDs are less than a 1/2 mile from each other. Durring the daytime the town may have have man power to staff 1 depts equipment.

 

[WuLabsWuTecH]

Funding is important, but not essential, nor does funding immediately equate to better volunteer agencies. Does it help? Absolutely. But even a well funded agency requires a certain mindset to be considered a "professional" volunteer EMS agency.

DrParasite makes a good point, though. I would say my one rebuttal is that with paid EMS you can mandate certain training or activities. Obviously, this requires an agency to decide to mandate such things, but it is much easier to say "everyone will do 24 hours of CEUs a month" as the chief of a paid agency then as the elected chief of a volunteer agency where you could lose half your membership with that statement.

It's about finding a happy medium. I think if our department said everyone had to do 24 CEUs a month, some of the full-timers would quit much less the volunteers! But once a month for 2 hours at a time might be reasonable. The thing is you have to find the balance between everyone quitting and everyone staying. If you have people who don't think they need to do any training, you want those people out the door anyway. If they can't dedicate a minimal amount of time to training each month then do you really want them on the street.

The way we have it set up at one of my departments:
Each month there are two trainings, sometimes a third. One of them is mandatory, and happens at the same time each month. If you miss it, you need a good excuse unless you live reasonably far away, in which case you need to show proof that you have done some other CEU that month. The second one is optional, but if you make these two every month, the department will ensure that you have all the CEUs you need to recert. If for whatever reason you don't have the CEUs and you have made the past 24 trainings, the department pays for you to go get them. The third one is often just for special interest, and can cover some very obscure topics (one of them was Osteogenesis Imperfecta). They are generally offered by outside agencies wanting to do outreach.

If you are paying someone, they are no longer volunteer...

Not true at all. I get paid a stipend that covers the cost of me driving nearly an hour to get to the station, uniform expenses, the cost of food while I am down there, and some miscellaneous expenses I might have related to being a member (for example, I wanted a new knife to carry while on duty).

 

[rescue1]

Is this Pennsylvania we're talking about? PA is famous for having a huge amount of tiny volly departments

EDIT...in response to bahnrokt's post

 

[NYMedic828]

This is probably a false comparison. Remember, FDNY also has Squads (rescue engines) as well as every Truck (aerial) has basic rescue equipment. That allots to much more than the 5 "Rescues"

But if you're talking about Long Island - yeah, there is a fair amount of apparatus (and station) silliness.

LI is the comparison yes.

In my department all of our trucks and engines have every form of equipment. The heavy rescue just has more of them.

 

[DrParasite]

I think the OP hit the nail on the head by saying it's not reasonable to be viewed as a professional when half of your profession is doing it for free and almost as a hobby.

than please explain how firefighting is considered a profession.

Paid agencies are certainly hit or miss. As an employee of FDNY EMS, I can definitely agree with Parasite that a good portion does in fact suck. The main thing FDNY stays on top of is response times. It is all about statistics with FDNY.

EMS response times, or response times until someone (sometimes a first responder) makes it on scene? When you have 250+ ambulances, but still need a fire engine to make it there first to "stop the clock," there is a problem. Disclaimer: I know many FDNY Firefighters, know many FDNY EMS people, as well as several who work for the hospitals that do EMS in NYC. Lots of good guys, some guys who I don't know how they got jobs, and others who I wouldn't trust to assess my worst enemy if they were complaining of a hangnail. I'm just painting everyone with a very broad brush, which is exactly what the OP is doing.

FDNY will get rid of me for not doing my job. The vollies won't.

that is true at my places, but the corollary is, FDNY might get rid of you for something stupid knowing there are 100 more who are willing to take your place. Sadly (depending on your point of view), the volunteer agency doesn't have 100 people to take your spot, so they won't get rid of you that easily.

Also in my area, the amount of volunteer vehicles we have in relation to the need for them is RIDICULOUS. The city of new york, one of the busiest departments in the country, has 5 heavy rescue vehicles for the entire city. My home town has 71... 71!!!! But this i guess is for a different discussion.

I call BS on this. If you have a hometown (not county, just 1 town) with 71 heavy rescues, than I want to see that town, because I don't believe it.

and FDNY might only have 5 heavy rescues. But as others have mentioned, NYC has quite a few other Rescue trucks. There are 12 NYPD ESU Heavy Rescues, 40 NYPD ESU Patrol trucks, 7 FDNY Squads, and 144 Truck companies, all of which carry a full assortment of hydraulic rescue tools, and the Truck companies and squads all carry a full set of airbags. And that's not including Port Authority PD ESU (which I know carries a full set of rescue equipment in their Rescue and their ESU Patrol truck), NJ Transit PD ESU, Amrak PD ESU, and I can't even imagine who else might have rescue equipment. So now you have a total of 203 emergency vehicles that carry rescue equipment, plus 5 heavy rescues of FDNY, plus the assorted police department ESUs, and you get a real picture of how much equipment your paid departments have when compared to the neighboring volunteers.

 

[crazychick]

This is such a touchy situation for the simple fact is that the bigger your area, the more money can be spent for private ems. I live in a small area, with a lot of farms. We need to have our VFD that runs EMS with it. I feel that we are running calls quite well but we lack the manpower to really do anything. We are correcting that by getting more people on the squad and paying for the education with a contract in place. There are to many times that out in this area, you have a critical patient and have to wait ten min to get an ambulance out there. Plus we are 25 min away from the hospital. VFD's are needed for those calls to start assessing the scene and getting things rolling, saving critical min.

The system is flawed yes but it works for the most part.

And me personally will be running with private ems as well as my VFD. When I get my basic I will get my medic through the VFD

 

[rescue1]

than please explain how firefighting is considered a profession.

The paid/volly debate rages just as hotly on the fire side (just look at some old posts on firehouse.com) as it does here.

Firefighting, though, has the advantage of having better PR, being around longer, and a long established union. Firefighting also is a fairly independent system. Firefighters and fire inspectors make rules for fire departments and determine standards for how FD's operate.
EMS is run by doctors, EMS officials, private company CEOs, fire departments, police departments, hospital directors...etc. Therefore it's difficult for general consensuses to be made about EMS since it's kind of the red-headed stepchild of public safety agencies, and that ignores the whole "is EMS public safety or healthcare" debate.

All in my only semi-educated opinion, of course.

 

[NYMedic828]

Sorry I meant county. Not one town.

 

[bigbaldguy]

For those of us who aren't fire based and have no idea what a heavy rescue vehicle is.

from wiki

A heavy rescue vehicle is a type of specialty firefighting or emergency medical services apparatus. They are primarily designed to provide the specialized equipment necessary for technical rescue situations such as auto accidents requiring vehicle extrication, building collapses, confined space rescue, rope rescues and swiftwater rescues.[1] They carry an array of special equipment such as the Jaws of life, wooden cribbing, generators, winches, hi-lift jacks, cranes, cutting torches, circular saws and other forms of heavy equipment unavailable on standard trucks.

rest of discription here.
http://en.wikipedia.org/wiki/Heavy_rescue_vehicle

 

[Tigger]

Thought I was more clear, a well funded volunteer department does not by default operate as a well functioning organization on par with career EMS. However without hat funding, a volunteer organization stands little chance of meeting similar standards. Considering that many municipalities use volunteer organizations as a means to cut costs, it should come as no surprise that many volunteer or paid on call organizations struggle. It doesn't matter if it's paid or volunteer, without funding your screwed right?

Also, many "volunteer" organizations would be better classed as "paid on call" as that's what they are. If you get a stipend, you aren't volunteering, at least for tax purposes (the agency and provider's) in many states. Volunteer does have a lot more cachet in the community I suppose, but let's call a rose a rose.

 

[SARMedic51]

I think the paid vs. volunteer question is valid, but there are many regional factors that apply. I work for two services. One is a full ALS paid ambulance service. The other is a more rural "volunteer" service. I really like the way the volunteer service is run. We get about 3,500 calls a year. We have two crews on 24/7 and a third crew on Fridays and Saturdays (which tend to have more calls). By "on" I mean standing by AT QUARTERS in full uniform. A "full crew" is a BLS and an ALS provider, although sometimes we'll have two ALS providers. Basically, all the EMT-Bs are volunteer while all the ALS providers (Paramedics and AEMT-CCs) are paid. The agency does have some full time ALS providers that work solely at this one agency, but most are part time and work at another paid, private service. The BLS providers are actually very good in my opinion, but, either way, the ALS provider is always very experienced. This way, BLS providers can get volunteer experience. We have a lot of young EMT-Bs who volunteer for a year or two, get some experience, and decide to take a paramedic or AEMT-CC class and work full time somewhere else. Also, the agency is saved the cost of paying EMT-Bs (we generally have no problem finding volunteers) while always having experienced ALS on the crew as well.

 

[46Young]

My two beefs with volunteer departments are the inconsistent mandatory training/minimum pt contacts to remain active and failure to cover shifts. This is not all departments, but it's a problem enough of the time that it bears mentioning. It's worse in the fire service, since some members can go interior, some can't, some can only drive, etc.

It's a worthy goal to mandate training and such, but in reality a department can be like a fiefdom, where the chiefs are resistent to any change. It's really hit or miss, and change can be difficult to impossible.

As the volunteer departments continue to see dwindling participation,
I feel the true value with volunteers will be to upstaff the existing units. This can be third and fourth on the ambulance, or perhaps putting another unit in-service. Volunteers should not be counted on as minimal staffing unless there's absolutely no other recourse as is the case in regions with a poor tax base. It's too risky. The schedule may be covered today, but anything can happen in the coming months and years. This is exactly why there are paid on call volunteer houses that move to M-F 0700-1900 career houses (volunteer at night), that eventually progress to 24/7 career with perhaps supplemental volunteers.

Volunteers are great for extra manpower on a unit, or in the fire service to be fourth/fifth on an engine or truck, to align with national safe staffing recommendations.

As far as the whole "job stealing tick" deal, I'm not sold on that. If the volunteers can truly handle the call volume 24/7/365, are trained the same as a career person, and have similar ongoing education, then that's appropriate. As their shift coverage gaps become more and more evident, career shifts and stations will develop as a matter of necessity. Until then, use that deferred career staffing expenditure to fund local capital projects. If the volunteers are incompetent and refuse to train and educate themselves, then they need to go. I don't want someone staffing the ambulance that comes to my home that rides just for kicks and giggles or to be part of the social club.

The best is when volunteers tell me how they only go on certain call types, that they don't go on sick jobs and such, like it's beneath them.

Volunteering for free does not give one the right to cherry pick their roles and responsibilities. That's the main issue IMO.

 

[thegreypilgrim]

The fact that this is still an issue is utterly disappointing.

This problem by no means approaches the level of a conundrum or vexation. It's an easy fix. I guess I should say it's an easy organizational/structural fix. Unfortunately, as evinced by this thread, it's a ridiculous hornet's nest of political nonsense.

Everyone knows we should get rid of volunteers, and transition to professional services but the question of what to do with rural towns with populations below 1000 people. Well, it's obvious. If we insist on burdening local communities with having to finance their own ambulance services this will always be the result.

So, that's why EMS has to be financed and provided at the state level. To avoid this constant source of needless drama the state governments need to just take over.

 

[rescue1]

Do you think state tax dollars will be sufficient to provide effective coverage in all areas? Not knocking the idea (though try getting that passed in today's economy...) but something to consider. I'd rather have a volunteer agency that gets to me in 10 minutes then a paid service that takes 20, which could be an issue if the state chooses to understaff an area.

 

[Sandog]

If you are paying someone, they are no longer volunteer...

The agency I am speaking of the volunteers must work 'four' 24 hour shifts unpaid per month. If they work more shifts after that initial 96 hours, then they get a small stipend. I would also mention that this agency is roughly an hour or more drive for most of the guys, the gas money being on their dime.