Why is EMS mixed with FD?

[Onceamedic]

Not without unions or strong political organizations to force employer's hands in that regard. ......

See the post above, I'm sure they could use some backing to improve their situation.

Attempts at unionization a couple of years ago led to supervisor harassment and other tactics that broke the attempt. We run 48 hour shifts and I personally average 20 calls on that shift. Standup 48s (2, may 3 hours of sleep the entire set) are not rare. You can be on the back end of the 48 and be forced to take a long distance transfer of 4 hours one way. It is dangerous. It may take massive lawsuits/deaths before anything changes. I am open for any advice or assistance any of you may care to render.

 

[46Young]

This is ridiculous!

The only reason fire has ANY involvement in EMS is because when EMS was created, the firefighters were already there. EMS back then consisted of a ride to the hospital, nothing more! When somebody realized that what was done in an emergency room wasn't physically impossible out in the world, the game started to change. Now EMS would be well on its way to being viewed as a genuine medical profession if it weren't for the fire departments with their three month medic mills, cookbook medicine, and medics who are medics just because they wanna wide in tha firetwuck! Do you think if a paramedic's educational level were on par with a PA or RN and medics everywhere were taught to operate autonomously instead of following protocols to the letter that people could say "oh, I can be a master of two trades instead of just a jack", or that we would even be having this conversation? Somehow I doubt it. Somehow I doubt I would be sitting here wondering how I'm going to score two full-time positions after medic school so that I can live with a little financial security.

I was like you once. I was trying to figure out how to survive on a medic salary, trying to schedule PT jobs, and somehow have more than a few bucks for retirement. Many medics become "stuck" because the money is just good enough to survive, if you're working 60-80 hours/wk or more. There's often no feasable way to continue your education if you need the two jobs to pay the bills, support a family, mortgage, etc. Catch 22. No time.

I was pointed in the direction of the fire service, and should be well off in retirement. I'd be happy to join, give money for and actively participate in activities to further the profession through union and other political organizations.

Rid says that higher educational standards and accountabilty will be a reality in the near future. I cerainly hope so. Any future providers should be "legit" and be proficient no matter what service they work for. Maybe my children will be able to work TSEMS with FD quality conditions.

You can remain bitter, and work yourself to the bone until you're 90, or you can take real steps to change your reality.
http://www.emtlife.com/showthread.php?t=14273

 

[46Young]

Attempts at unionization a couple of years ago led to supervisor harassment and other tactics that broke the attempt. We run 48 hour shifts and I personally average 20 calls on that shift. Standup 48s (2, may 3 hours of sleep the entire set) are not rare. You can be on the back end of the 48 and be forced to take a long distance transfer of 4 hours one way. It is dangerous. It may take massive lawsuits/deaths before anything changes. I am open for any advice or assistance any of you may care to render.

Move somewhere that has better conditions. that's what I did. seriously, our union supports certain candidates pulclicly for election/re-election, lobbies, and does various charities, such as the MDA "Fill The Boot", AHA Heart Walks, and the like. Each paycheck many of us volunteer $5 to be used for lobbying and other political gain.

You'll need almost everyone to be onboard to thwart efforts by management to break up organization. "Strength in Solidarty". If your people are easily intimidated, it'll never happen. You'll all need to stay the course. You could attach to another local, perhaps even the IAFF as some others have done. they'll be a valuable resource.

With political muscle, you'll be able to lobby or otherwise put forth legislation to abolish shifts in excess of 24 hours. Getting air time or other forms of advertisement to warn the public of the deadly dangers of extended shifts would be a great idea as well.

 

[Onceamedic]

This is ridiculous!

When somebody realized that what was done in an emergency room wasn't physically impossible out in the world, the game started to change.

I think what actually created our "profession" was a famous study that demonstrated that soldiers wounded on the battle field in Vietnam had a better chance of survival than a civilian in an MVA. This disparity was explained by trained battle field medics and fast transport to definitive care.

 

[atropine]

I believe we already calculated out your $100k from last year in another thread. You had to work well over 3000 hours to make that. The RN supervisor only had to work 3 - 12 shifts per week or about 1800 hours to make the same in CA. If you were to work the same number of hours as the RN, you would be in the low income group. The one thing that strikes fear into the heart of every FD employee and union is going to a 40 hour work week. The perks would be gone. Right now that is being discussed as an option for a FD in norther CA.

What are you talking about?, have you looked at a recruitment flyer latley, Orange County Fire Authority max out thier base salary for FF/medics at about 90k a year without any over time, so does the city of Anaheim. Not bad cas for dual role, agin we are taking the pt to the hospital for definitive care, you don't need a two year degree to do that.

 

[EMTinNEPA]

The medic supply isn't exactly going to dry up just because there's a mandated requirement of 2-3 years education or whatever. Medic pay will always be subject to supply and demand, unless a good union or political organization can negotiate for a better deal.

How do you know? Two or three years as opposed to six months would certainly separate "the boys from the men", as it was so put earlier in this thread. Also, if the states went with a national standard and started cracking down on accredidation, a lot of unaccredited medic programs would cease to exist. The remaining programs would still put out the same number of graduates. Higher demand and lower supply means you gotta sweeten the deal to meet your demand.

 

[46Young]

How do you know? Two or three years as opposed to six months would certainly separate "the boys from the men", as it was so put earlier in this thread. Also, if the states went with a national standard and started cracking down on accredidation, a lot of unaccredited medic programs would cease to exist. The remaining programs would still put out the same number of graduates. Higher demand and lower supply means you gotta sweeten the deal to meet your demand.

Good, I hope you're right. you shouldn't need two full time jobs to stay off of welfare.

 

[46Young]

I believe we already calculated out your $100k from last year in another thread. You had to work well over 3000 hours to make that. The RN supervisor only had to work 3 - 12 shifts per week or about 1800 hours to make the same in CA. If you were to work the same number of hours as the RN, you would be in the low income group. The one thing that strikes fear into the heart of every FD employee and union is going to a 40 hour work week. The perks would be gone. Right now that is being discussed as an option for a FD in norther CA.

How would a 40 hour workweek benefit a FD financially? We work 56 hours/wk here, and due to current FLSA mandates, all 56 hours are straight time. OT is paid at a higher rate, though, than if we were paid straight for 40 hours and 1.5 time for the last 16.

To reduce work hours to 40/wk would require a dept to hire additonal personnel, with all associated redruitment/academy costs, as well as medical, holiday, pension, sick benefits and such.

How are the powers that be saying that a reduction in work hours is more cost effective?

 

[ResTech]

agin we are taking the pt to the hospital for definitive care, you don't need a two year degree to do that.

I don't know why you keep saying this. All you really need to take a patient to definitive care is a motorized vehicle with four wheels.. that would do the job of getting them there but is far from adequate.

A degree in my opinion makes future learning and adapting more intuitive and serves to progress the profession. And not to mention a degree is a must for EMS officers.

Let's not have providers who only know how to recognize specific S/S and fit them to a page in a protocol book.

 

[EMTinNEPA]

Is transfer to definitive care all our profession is about? What about situations like a cardiac arrest where definitive care is actually within the paramedic scope of practice?

We can be a taxi service or medical professionals. The choice is ours.

 

[VentMedic]

What are you talking about?, have you looked at a recruitment flyer latley, Orange County Fire Authority max out thier base salary for FF/medics at about 90k a year without any over time, so does the city of Anaheim. Not bad cas for dual role, agin we are taking the pt to the hospital for definitive care, you don't need a two year degree to do that.

Max out? Have you actually checked their salary chart on their website lately? Either OC or Anaheim?

Do these FFs only work 36 hours per week? No.

Thus, the RN who only puts in a 12 hours day 3/wk and still makes $90k is still ahead in time and $/hr.

When I joined the FD, a degree as a Paramedic was highly respected and sort after. It is a shame that the FDs have recruited those like yourself who have no interest in maintaining EMS as a respected profession within the FD for it to receive the ridicule it does today.

 

[VentMedic]

How would a 40 hour workweek benefit a FD financially? We work 56 hours/wk here, and due to current FLSA mandates, all 56 hours are straight time. OT is paid at a higher rate, though, than if we were paid straight for 40 hours and 1.5 time for the last 16.

To reduce work hours to 40/wk would require a dept to hire additonal personnel, with all associated redruitment/academy costs, as well as medical, holiday, pension, sick benefits and such.

How are the powers that be saying that a reduction in work hours is more cost effective?

That is what your union is feeding you. If you actually work out the math, it is cost saving in the long run. There would be no 1.5x to figure out since 40 hours would be it. No 24 hours shifts. 2 -12 and 2- 8 or 5 - 8 hour shifts. The unions know this and usually as soon as the cities start talking 40 hour/wk, they compromise quickly on whatever issues they are holding out on.

The problem would lie in the fact that the FD would no longer be attractive to many if it became a normal job. There would be no playing house with the boys for a couple times a week and sleeping on the tax payers dollar. There would be little things scheduled throughout each shift to keep one occupied.

 

[Ridryder911]

The problem would lie in the fact that the FD would no longer be attractive to many if it became a normal job. There would be no playing house with the boys for a couple times a week and sleeping on the tax payers dollar. There would be little things scheduled throughout each shift to keep one occupied.

Gulp! WORK?!!! There would be decline of attractiveness of recruitment. Re-do the salary range upon the education and actual productivity alike the rest of the city employees and see what the salary would be. Think of the millions that would be saved upon salaries, retirement and injuries.

Require candidates to have a degree in Fire Science before application to an academy. Place them on 40 hour work week as you described with details at night alike all other citizens that have a job. Again productivity should be measured and evaluated for pay raises or even to maintain the positions.

The Fire Service should thank insurance companies everyday. Without the ISO cities would definitely decrease their city budget.

R/r 911

 

[46Young]

That is what your union is feeding you. If you actually work out the math, it is cost saving in the long run. There would be no 1.5x to figure out since 40 hours would be it. No 24 hours shifts. 2 -12 and 2- 8 or 5 - 8 hour shifts. The unions know this and usually as soon as the cities start talking 40 hour/wk, they compromise quickly on whatever issues they are holding out on.

The problem would lie in the fact that the FD would no longer be attractive to many if it became a normal job. There would be no playing house with the boys for a couple times a week and sleeping on the tax payers dollar. There would be little things scheduled throughout each shift to keep one occupied.

We only pay 1.5x over our prescheduled hours (over 56, per FLSA). All OT is either holdover, late calls, or prescheduled OT. I would think that more would need to be hired, maybe 20-30% more employees to cover the 16 hours lost per FF. We used to do two 10's and 2 14's.

If we are only paying OT over our prescheduled 56 hours/wk per FLSA, how is a 40 hour workweek saving money? All of our prescheduled work hours are straight time. More employees to pay medical benefits, pension, etc. etc. I'm not getting it.

 

[VentMedic]

All of our prescheduled work hours are straight time. More employees to pay medical benefits, pension, etc. etc. I'm not getting it.

That's what some EMS services thought when they changed to 12 or 8 hour shifts. Workmen's comp claims decreased, less sick calls and it was easier to fill a short shift. As Rid was mentioned productivity was measured.

I se this is a concept that is difficult for you to deal with but the rest of the working world has adapted to it very nicely including their budget. FFs just get a little frightened bcause there may be less TV time, shopping for groceries at least 3x a day, coffee run and showering with the guys for a little brotherly bonding. These are the perks that usually attract people into the FD and not really the fire fighting aspect of it. You see the FD also has some of the same johnny rescue recruitment issues as EMS. The quality of the average recruit has sank over the past couple of decades.

 

[Ridryder911]

We only pay 1.5x over our pre scheduled hours (over 56, per FLSA). All OT is either holdover, late calls, or prescheduled OT. I would think that more would need to be hired, maybe 20-30% more employees to cover the 16 hours lost per FF. We used to do two 10's and 2 14's.

If we are only paying OT over our pre-scheduled 56 hours/wk per FLSA, how is a 40 hour workweek saving money? All of our pre-scheduled work hours are straight time. More employees to pay medical benefits, pension, etc. etc. I'm not getting it.

Here is another way to look at it. Reduce areas or even eliminate areas that could be worked upon between responses such as pre-planning, code enforcement, etc. duties usually assigned to the man of the 9-5 shifts and eliminate their positions thus saving money and increasing productivity. In between calls, one would be doing something. Televisions and recliners could be removed .. "Gasp!" and be an actual workplace.

With all the "sleep deprivation" studies and increasing risks of known health problems associated with sleep disorders; why increase the risks and pay for it later?

Unions can't have their cake and eat it too. If there is no money and there is a way to modernize and increase productivity, and lower tax base rate, why would any fire service be against it? If they truly were for what is the best for the citizens! A more productive fire service, less tired firefighters (more safe for them) and less budget.. a win, win situation! Why should firefighters have any better retirement, benefit package than any other city worker? I would argue that animal control places their lives in danger on more a regular basis as well as the trash/sanitation and road worker than the majority of firefighters.

As well, each fire needs to be closely reviewed and scrutinized. Could better attack been done? Did the officer in charge, actually perform their job/role precisely? Did the team really do their best? Why not have independent audits perform reviews to ensure the best tactics was performed. Merit wages based upon knowledge and performance should be attached to promotions and benefits. No more "blanket" raises. Want a raise, show something more than showing up for work and working out.

Imagine, reduced taxes, better up-keep on equipment and firefighters having to work more than 10 days a month! Reduce the salary based upon the merits of the job as education and performance level. With this action, we would see how many would want EMS to be within the Fire Service area, as EMS is about 70-85% of fire services responses. It would be very interesting.

As more and more communities are looking at ways to reduce overhead and budgets, this could be a very manageable way of decreasing costs and increasing jobs.

R/r 911

 

[MrBrown]

This whole discussion is quite interesting. It was briefly on the wind here that Fire Service was being pegged to take over EMS mainly to stamp out chronic problems of fragmentation, funding, service delivery and pay parity but that seems to have gone away.

It would seem the that the Fire Service *****es every time it gets a bad rap about being hooked up with emergency medical care; well guess what, you did this to yourself!

I am sure there are a few departments who run EMS as part of the Fire Service and do it very well but there are those big city or county level departments where every firefighter is also a paramedic. These are the ones who deliver sub-optimal care and give fire based EMS a bad rap. I read firefighter/paramedics in Miami were averaging about one intubation a year per officer, that has to be good for skill maintenance right there and .... that LACoFD medics were trained to interpret ECGs by reading what the computer printed out!

Remind me to get sick in Seattle if I am in need of fire based EMS

 

[46Young]

There's a simple answer to shorter shifts - tour swaps! Just ask the FDNY. Any union worth it's salt will not stand for limitations on tour swaps, as it doesn't cost anything.

I chose this position at this particular place due to the benefits, perks, etc. I'd be crazy not to. If things aren't as they are, my wife would have never agreed to move here. Maybe there's talk (just talk, as I haven't seen any changes yet) in CA regarding changes to salary, shifts, etc. I haven't seen anything in regards in this neck of the woods, though. No well run FD would be willing to reduce what they're giving their employees as stated previously. Most of their good talent will leave for greener pastures. Strength in Solidarity!

I'm still not grasping how it's saving money to add positions for the reduction of work hours as you'll need to give each employee medical benefits, a pension, sick days, holidays/personal days, gear, so on and so forth.

Yes, we're sworn to help the public, but we're also looking out for our families and our own financial security. I have mouths to feed, so why would I want to give back what's already contracted to us? We're going to fight tooth and nail to keep what we've achieved thus far. We know how the game is played. And we play it well. Hey, if things take a dramatic turn for the worse for the fire service, I could always go back to school for my RN.

 

[46Young]

Serious question - it's high time we had an improvement in education and accountability. Additional educational requirements ought to translate to greater scope of practice, higher pay, benefits, etc. It's been suggested that a paramedic should hold a Bachelor's or even a Master's. that should be sufficient to legitimize the profession, and eliminate any pretenders.

Here's the question: How many are willing to complete a 4-6 year degree for a job as a medic given the current conditions? No one's going to give up 4 years to make maybe 30 grand or so. An increase in pay/benefits won't happen overnight. If it's something that will take 15-20 years from now to thin the supply, then I can understand that. Mandating a 4-6 year degree for medic credentials will thin the herd, but how long will that take? How many are willing to join political organizations, or unionize to achieve these goals?

I'm not trying to pee in anyone's corn flakes, I'm honestly interested what the complete game plan (educaton, political agenda, etc) is to bring the paramedic profession up to par with other healthcare careers, and what we can do to help. I have a good setup where I'm at, but that doesn't mean that I want the EMS profession to stay stagnant. When I first came into the field, I was taken aback at how much better the fire service and the police were taken care of compared to EMS. Tough to comprehend at the time.

 

[Ridryder911]

Serious question - it's high time we had an improvement in education and accountability. Additional educational requirements ought to translate to greater scope of practice, higher pay, benefits, etc. It's been suggested that a paramedic should hold a Bachelor's or even a Master's. that should be sufficient to legitimize the profession, and eliminate any pretenders.

Here's the question: How many are willing to complete a 4-6 year degree for a job as a medic given the current conditions? No one's going to give up 4 years to make maybe 30 grand or so. An increase in pay/benefits won't happen overnight. If it's something that will take 15-20 years from now to thin the supply, then I can understand that. Mandating a 4-6 year degree for medic credentials will thin the herd, but how long will that take? How many are willing to join political organizations, or unionize to achieve these goals?

I'm not trying to pee in anyone's corn flakes, I'm honestly interested what the complete game plan (educaton, political agenda, etc) is to bring the paramedic profession up to par with other healthcare careers, and what we can do to help. I have a good setup where I'm at, but that doesn't mean that I want the EMS profession to stay stagnant. When I first came into the field, I was taken aback at how much better the fire service and the police were taken care of compared to EMS. Tough to comprehend at the time.

Although I am all for increase in pay, many do go for the professional route making little and having a heck of a lot more than an associate or masters degree. I know of school teachers making as little as $25K a year and Professors of History that barely make $40,000 that have an PhD and decades of service. When I exited nursing school I made more than those that taught me, and I was a field medic, for true professionals money usually has little to do with the intent of those serious of entering the profession. Again, a choice I hope that we can bypass but one of the benefits should be monetary gains; but not the whole emphasis.

I still have heard anyone describe on the whys, we should be paid more? In reality one usually goes for 10 months of trade school training which in comparison is equal to a LPN/LVN (actually they go longer). The salary is slightly more for Paramedics in most areas or comparable. Why should this so called profession be making more when the emphasis is placed upon how one can obtain the goal the easiest and fastest route? Never the best or increasing the role or demands to justify the respect and of course financial rewards.

I keep hearing retirement, pay, etc.. yet have read of what we could do to provide for the patient... (you know the reason we are supposed to be in it?)

Most are only with 1 patient for < than an hour. Consider what level of care was provided and what performance was done, it was actually pretty good pay.

Increase the education, increase the care and then and only then expect and demand a change!

R/r 911