Why are Paramedics paid so little?

[NysEms2117]

You know how it goes.. dispatched to possible drug overdose.. everyone's gone but the person laying there half dead from an opioid overdose. You don't know what you have until you see syringes laying around, little baggies everywhere, etc.. find out later what the substance was carfentanil laced heroin and a small whiff of the powder could quickly send you into respiratory arrest.


There is standard precautions, but it's not a perfect system. A patient can become violent at any time in a seemingly "safe" situation.

I do know how it is. On both sides in fact. If i'm wearing my EMT hat, first whiff*see what i did there?* of a patient becoming combative, "hello yes i'd like a police officer to assure patient and crew safety". I'm also going with option 2, my option of, remove patient from possible containment areas, or wait for somebody else stupid enough to go "running in", i do my job, however i'm not looking to be a hero, so no running into mysterious drug houses for me. Walk in after i have assured my crew's safety, as well as mine, sure! Or theres the option to wear a mask.
Trying not to be an *** here, just trying to show theres a million different things that can happen. You can ask the question, why are garbagemen/women paid so little, they inhale fumes all day. Why are teachers paid so little, they work in gun free zones. See where i'm going?

Edit: EMT's at the cheapest company in albany, start at 41k from what i can gather. However, working for any of the other 3 EMS providers they start at 46k, and only go up. Well beyond enough to live off of.

 

[NomadicMedic]

You know how it goes.. dispatched to possible drug overdose.. everyone's gone but the person laying there half dead from an opioid overdose. You don't know what you have until you see syringes laying around, little baggies everywhere, etc.. find out later what the substance was carfentanil laced heroin and a small whiff of the powder could quickly send you into respiratory arrest.

Curious how many scenes you've been on like this? Or how many scenes period?

 

[MikeC]

Curious how many scenes you've been on like this? Or how many scenes period?

This scene was just shared by our county coroner. Ultimately the man that overdosed died with his head in the toilet. The carfentanil-laced heroin in powder form was on the edge of the sink. It would have been easy to knock off and breathe in. As the man was confirmed DOA, the PD and Coroner was on scene. I didn't have to be there to see the implications. The PD is now carrying Naloxone for themselves due to the opioid epidemic in the area which may take up to 4 or 5 doses of Narcan to restore the respiratory drive.

 

[MikeC]

I do know how it is. On both sides in fact. If i'm wearing my EMT hat, first whiff*see what i did there?* of a patient becoming combative, "hello yes i'd like a police officer to assure patient and crew safety". I'm also going with option 2, my option of, remove patient from possible containment areas, or wait for somebody else stupid enough to go "running in", i do my job, however i'm not looking to be a hero, so no running into mysterious drug houses for me. Walk in after i have assured my crew's safety, as well as mine, sure! Or theres the option to wear a mask.
Trying not to be an *** here, just trying to show theres a million different things that can happen. You can ask the question, why are garbagemen/women paid so little, they inhale fumes all day. Why are teachers paid so little, they work in gun free zones. See where i'm going?

Edit: EMT's at the cheapest company in albany, start at 41k from what i can gather. However, working for any of the other 3 EMS providers they start at 46k, and only go up. Well beyond enough to live off of.

Agreed 41k to 46k is good for an EMT. While I hear those types of numbers, what I see locally is $10/hour offers. This area must be at the bottom of the barrel of the spectrum. Full time isn't even breaking 20k/year gross.

 

[NysEms2117]

Naloxone for themselves due to the opioid epidemic in the area which may take up to 4 or 5 doses of Narcan to restore the respiratory drive.

again trying not to be an absolute prick, but your title says student. Not saying your not smart, but i am certainly more inclined to believe that when somebody with higher proven education tells me that.
Wherever "here" is i'd presume has an extremely low cost of living. Also you can move to a higher EMS paying area if you so choose.

 

[SandpitMedic]

 

[SandpitMedic]

Enjoy nursing dude...
Thanks for sparing some poor soul 12 hours in a rig from your pretentious rantings.

 

[VentMonkey]

 

[SpecialK]

I don't think ambulance personnel are paid "little" at all; for example a new national agreement has been reached which sees reasonable pay increases and a fair approach taken to ensuring access to the legislated 11 statutory holiday days plus five weeks annual leave. Paramedic will begin in the mid 60ks and top out almost at 70k while an ICP will start in the early 70ks and top out near 80k.

From what I understand Australia pays similar as does England, particularly London when considering the London weighting supplement.

 

[EpiEMS]

@SpecialK, aren't your folks required to have a bachelors' degree (or something along those lines)?

 

[MikeC]

Feel free to add something objective to the discussion.

 

[MikeC]

I don't think ambulance personnel are paid "little" at all; for example a new national agreement has been reached which sees reasonable pay increases and a fair approach taken to ensuring access to the legislated 11 statutory holiday days plus five weeks annual leave. Paramedic will begin in the mid 60ks and top out almost at 70k while an ICP will start in the early 70ks and top out near 80k.

From what I understand Australia pays similar as does England, particularly London when considering the London weighting supplement.

Thanks for posting. Could you provide a link?

 

[MikeC]

Enjoy nursing dude...
Thanks for sparing some poor soul 12 hours in a rig from your pretentious rantings.

I neither have all the answer nor am ranting. Simply looking for answers. Feel free to contribute instead of sitting on the sidelines criticizing.

 

[MikeC]

again trying not to be an absolute prick, but your title says student. Not saying your not smart, but i am certainly more inclined to believe that when somebody with higher proven education tells me that.
Wherever "here" is i'd presume has an extremely low cost of living. Also you can move to a higher EMS paying area if you so choose.

"Be ready to administer naloxone in the event of exposure. Naloxone is an antidote for opioid overdose. Immediately administering naloxone can reverse an overdose of carfentanil, fentanyl, or other opioids, although multiple doses of naloxone may be required. Continue to administer a dose of naloxone every 2-3 minutes until the individual is breathing on his/her own for at least 15 minutes or until EMS arrives."

https://www.dea.gov/divisions/hq/2016/hq092216.shtml

According to local EMS providers that have treated this, it will be required. Naloxone is intended for heroin overdose. Pure cartentanil is 10k times more potent than morphine.

 

[EpiEMS]

A patient can become violent at any time in a seemingly "safe" situation.

Bank tellers make circa minimum wage, too. They don't ask to get robbed at gunpoint.

The key reason why EMS providers don't make very much money (in most places) are pretty simple, and align pretty nicely to a very simple supply/demand framework. This reason is low barriers to entry for EMS providers (i.e. relatively high supply/low price at any quantity demanded). It doesn't take much to get into EMS, and lots of people will do it (because, say, they like the woo-woos). Compare EMS initial entry criteria to similar fields (from the same source, the Bureau of Labor Statistics' Occupational Outlook Handbook) and you'll see that EMS barriers to entry are (relatively) low.

Also, don't forget - if I own an ambulance company, I can't bill Medicaid for more money if I have better providers (ceteris paribus). For example, if I have a transport from Hospital A to Hospital B for Elderly Patient A, I can only expect reimbursement for the transport of $X dollars, regardless of whether my personnel are paramedics with college degrees or paramedics with a non-degree certificate. Obviously, I'm oversimplifying the issue - but the core point is that there is no explicit link between things like provider quality and revenue, so what reason does a provider have to pay more for more education (beyond the statutory minimum)?

You should read this document. It provides a lot of insight.

 

[NysEms2117]

"Be ready to administer naloxone in the event of exposure. Naloxone is an antidote for opioid overdose. Immediately administering naloxone can reverse an overdose of carfentanil, fentanyl, or other opioids, although multiple doses of naloxone may be required. Continue to administer a dose of naloxone every 2-3 minutes until the individual is breathing on his/her own for at least 15 minutes or until EMS arrives."

https://www.dea.gov/divisions/hq/2016/hq092216.shtml

According to local EMS providers that have treated this, it will be required. Naloxone is intended for heroin overdose. Pure cartentanil is 10k times more potent than morphine.

Do you know what naloxone does? what route should this be given? Have you ever given it? In my personal real life application of narcan/naloxone, it wakes them up right away, however if BLS narcan doesn't do anything, giving them more and more BLS(IN) narcan is like pissing on a fire. They need to have a line, and narcan pushed through the line.

On a side note, with your current attitude towards some of the senior members here, the folks that really know what they're talking about, your not going to get very far. If i were you, i'd apologize to @SandpitMedic, and whoever else you were being hasty towards. There are multiple reasons to your original question, and you got most of them.. ranging from education(lack there of), cost of living, and if i'm honest, just you being rather wrong. It seems to me EMT's around the country make enough to live, your not driving beamers, but you can survive(except where you are ofc, because they only make 20k a year).

 

[VentMonkey]

"Be ready to administer naloxone in the event of exposure. Naloxone is an antidote for opioid overdose. Immediately administering naloxone can reverse an overdose of carfentanil, fentanyl, or other opioids, although multiple doses of naloxone may be required. Continue to administer a dose of naloxone every 2-3 minutes until the individual is breathing on his/her own for at least 15 minutes or until EMS arrives."

https://www.dea.gov/divisions/hq/2016/hq092216.shtml

According to local EMS providers that have treated this, it will be required. Naloxone is intended for heroin overdose. Pure cartentanil is 10k times more potent than morphine.

@MikeC your passive-aggressiveness isn't getting you very far. I get that you may have life-experience, but you're new to this. You know? The whole two ears, and one mouth principle.

The "I'm all ears" approach, then turning around and citing facts about a drug we're all well aware of does nothing to make anyone here, and most likely on an ambulance, or wherever you'll end up want to help you. You need to take it down a bit.

So you know facts about EMS, and aren't happy about the wages? So what. EMS doesn't need you anymore than you need it.
Instead of spewing repeated facts about it maybe effect change first. You're still a student, yes? Humility, it really does transcend even through an online forum; you sincerely seem to be lacking this, and aren't fooling anyone so they (we) called your bluff.

As far as carfentanil, this isn't something super new, or that anyone isn't aware of. Here, take a look, I made a thread about it a while back:

https://emtlife.com/threads/carfentanil.44467/#post-619811

Again, do your research yourself, actually work in the field maybe about 6 months to a year then see why it is you think $10/ hour is insufficient. No one likes a fresh, new whiner.

P.S. Your Carfentanil scenario was ridiculous.

EDIT: includes waiver not to get @EpiEMS started on EBM, and stats. Lol, he's got us all beat

 

[MikeC]

@MikeC your passive-aggressiveness isn't getting you very far. I get that you may have life-experience, but you're new to this. You know? The whole two ears, and one mouth principle.

The "I'm all ears" approach, then turning around and citing facts about a drug we're all well aware of does nothing to make anyone here, and most likely on an ambulance, or wherever you'll end up want to help you. You need to take it down a bit.

So you know facts about EMS, and aren't happy about the wages? So what. EMS doesn't need you anymore than you need it.
Instead of spewing repeated facts about it maybe effect change first. You're still a student, yes? Humility, it really does transcend even through an online forum; you sincerely seem to be lacking this, and aren't fooling anyone so they (we) called your bluff.

As far as carfentanil, this isn't something super new, or that anyone isn't aware of. Here, take a look, I made a thread about it a while back:

https://emtlife.com/threads/carfentanil.44467/#post-619811

Again, do your research yourself, actually work in the field maybe about 6 months to a year then see why it is you think $10/ hour is insufficient. No one likes a fresh, new whiner.

P.S. Your Carfentanil scenario was ridiculous.

EDIT: includes waiver not to get @EpiEMS started on EBM, and stats. Lol, he's got us all beat

The Carfentanil scenario came directly from the coroner and actually happened. If you believe it's ridiculous, so be it. It's not a new drug, but is becoming more popular than ever in this area specifically.

 

[MikeC]

Do you know what naloxone does? what route should this be given? Have you ever given it? In my personal real life application of narcan/naloxone, it wakes them up right away, however if BLS narcan doesn't do anything, giving them more and more BLS(IN) narcan is like pissing on a fire. They need to have a line, and narcan pushed through the line.

On a side note, with your current attitude towards some of the senior members here, the folks that really know what they're talking about, your not going to get very far. If i were you, i'd apologize to @SandpitMedic, and whoever else you were being hasty towards. There are multiple reasons to your original question, and you got most of them.. ranging from education(lack there of), cost of living, and if i'm honest, just you being rather wrong. It seems to me EMT's around the country make enough to live, your not driving beamers, but you can survive(except where you are ofc, because they only make 20k a year).

The PD is carrying the .1mg intranasal atomizer spray as BLS crews are using. IM are available but expensive. From what I've heard, some ALS crews may or may not have it available.

 

[MikeC]

Thank you all for the responses. I received the answers to the questions I was looking for.