dialysis runs generally blow, theyre monotonous, con homes suck, and the patients are often lifeless shells, but they are also our bread and butter. Without them, most EMS workers would not be getting a paycheck...where I am, pay rate for 911 runs is about 28%(which is considered decent), then consider that BLS is all pre-scheduled and approved by insurance, so while medicare/medicaid may not pay the full amount, they are still getting payed almost 100% of the time....
It you read the chart you might find that the many of these patients may have been some EMS crew's "save". No everyone walks out of the hospital and throws you a party after you save their life or screw up in the field. See if you can find out how many were botched intubations or given the wrong meds and might have had a chance of full recovery if something had not gone very wrong. Yeah it sucks to be in a nursing home but I doubt if any of these patients had a choice. Most are in less than desirable places because they can not afford more. I doubt if any of these patients planned on being a dialysis patient either. So cut these patients a little slack. Even if they made bad lifestyle choices they still deserve respect and care.