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Alameda County, CA

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Tigger

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That might be one of the best medic gigs in the USA. Powerload, twelve hour shifts in a busy urban setting...
I can think of plenty of places that offer that. There's a lot more to a decent employer than that to me at least.
 

Aprz

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Edit: I didn't like working there (Alameda County, CA). I wouldn't recommend it.
 
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jgmedic

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The cost of living in the Bay Area is astronomically high. Look at the FD jobs in the area. Most pay over 100k base for a probie. You have to make that much just to survive. It's not that great financially.
 
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gotbeerz001

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Edit: I didn't like working there (Alameda County, CA). I wouldn't recommend it.
Aprz, what didn’t you like about it? I’m glad you found a better fit in Santa Clara. I am accredited in both Alameda and Santa Clara Counties and (hands down) prefer Alameda.

Maybe you should be more specific before making such a (non) recommendation?

FALCK is new to the County and this is their big push into (CA) 911. There is definitely a lot of “talk” about how things are going to be but so far they have been very good about making a positive transition from an (increasingly) difficult situation. Time will tell but the management seems to be workforce-focused.
 

RocketMedic

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What’s an “average” work week there?

Even with high costs of living, the wages might make it extremely interesting.
 
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gotbeerz001

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What’s an “average” work week there?

Even with high costs of living, the wages might make it extremely interesting.
12/42
Long week (48) and short week (36)
Paid every 2 weeks
OT after 40 hrs
Shift are either same 3 days + 1 on long (e.g. SMT/SSMT)
Or modified so you get every other weekend off (e.g. MWS/STHF)
 
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RocketMedic

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Do they put you on night rates if you work a night shift?

Off of my math, you'd have to find somewhere with rent costs <$2300 to make it work financially well, but if you commute in or can find something under that, you make a lot. Looking at the Internet, where do most of the AlCo employees live?



How is overtime availability there?
 

Aprz

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@RocketMedic Have you looked at their protocols yet? I imagine you would be very bored out here.

Here is Alameda County's protocols.


Compared to other counties, Alameda County does have a more expanded scope of practice, but not by much and it's still minimal/behind compared to many agencies outside of California. In my personal opinion, it is a very overrated county.

@gotbeerz001 What do you like about Alameda County better than Santa Clara County?

Here is Santa Clara County's protocols.


So differences that I can recall/see based off my experience working both is Alameda County has: Atrovent, TXA, Sodium Thiosulfate, and Zyprexa.

That's not really a lot. Two of those drugs, TXA and Sodium Thiosulfate, are very rarely used. When I worked there, Sodium Thiosulfate was only on the supervisor trucks. Santa Clara County DID have it as well on every ambulance, but since it was essentially never used over years, it was discontinued along with needle cricothyrotomy.

San Mateo County has had video laryngoscopy and Santa Clara County just got it. Has Alameda County gotten on board with that yet?

In regard to equipment, Alameda County did use the impendance threshold device (ITD) for cardiac arrest.

That's about it? I personally don't think there is much difference in everyday calls.

The culture at Alameda County is very clinically focused. They talk about being "clinicians", using "sound clinical judgement", and "evidence based medicine". They take it to a whole new level when they talk about, but in my opinion, the paramedics there are about equal to paramedics in adjacent counties and fall short of what they preach. When I was there, many of them that I interacted with couldn't do basic math. @gotbeerz001 How many paramedics in Alameda County can actually do the math for Amiodarone drip or Dopamine drip with some confidence? When they say they are aggressive, how many do you see are truly aggressive or just "turf" things to the hospitals since they are close anyways? Would you say many of them had cardioverted or paced patients? What I really disliked was this very egocentric culture while not really being any different from other paramedics in other counties in practice. I am not saying they are bad paramedics, but they aren't better than paramedics in other counties either.

Oh, I didn't like that many paramedics acted like we saw more critical patients or traumas in Alameda County. A lot of them bragged about all the shootings they get in Oakland (usually those guys did everything they could to stay in Fremont anyways, haha), how busy the system was, but it really is no different from East Palo Alto in San Mateo and East San Jose in Santa Clara. Although it is a busy system overall, there are more ambulances too, so you run about the same amount of calls per shift. Honestly, I felt like we just ran mostly homeless patients and 5150s (psych holds) more than anything in Alameda County, haha.

In 2016, the pay was...

San Mateo EMT step 1 $17.60/hour 12/48 ($42k annually)
Santa Clara EMT step 1 $20.39/hour 12/43 ($42k annually)
Alameda Paramedic tier 2 step 1 $21.63/hour ($43k annually, about $1,300 a year total more than EMTs in San Mateo)
Santa Clara Paramedic step 1 $27.74/hour 12/42 ($63k annually)

I believe San Mateo Paramedics step 1 were ~$21.50/hour with daily OT (1.5x after 8 hours), they had 9.5/47.5 shifts and 12/48. Santa Cruz paramedis worked 24/56 I think and made $63k annually as well I think? Alameda County's paramedics I believe at the time was the lowest paid more similar to EMTs in other counties. That could've changed since 2016.

Anyways, that's some specifics. I am not a fan. Low pay, egocentric paramedics, protocols that aren't that much better than adjacant counties in my opinion. Sorry. That's my opinion.
 
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Aprz

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I forgot to mention another difference which is Alameda County has Fentanyl 50-100 mcg while Santa Clara County still use Morphine up to 15 mg.
 

gclol

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Aprz some of what you say are true but consider this most of our hospitals are less then 15 mins away from your location. Yea our medic pool has been going down in terms of quality due to the fact that paramedics plus won't let fto fail people. They would simply be shuffled through different fto till someone passes them. Hopefully ces in falck will allow fto to actually fail people
 

Aprz

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Aprz some of what you say are true but consider this most of our hospitals are less then 15 mins away from your location. Yea our medic pool has been going down in terms of quality due to the fact that paramedics plus won't let fto fail people. They would simply be shuffled through different fto till someone passes them. Hopefully ces in falck will allow fto to actually fail people
I get that the hospitals are close by and I am not suggesting that the protocol needs to be expanded more, but for what Alameda County's paramedics brag about, I don't really see what's so good about their protocol versus other counties "hands down"?

I know from experience that they fail people. I am one of those people who failed FTO. Just like everyone else, I got 2 FTOs. Santa Clara County and San Mateo County gets all of Alameda County's rejects so I see them regularly. I know that Alameda County gets all of our rejects along with San Mateo County's rejects. Your quality isn't going down because you guys aren't able to filter out bad paramedics, but because there really isn't special about Alameda County. They fail people for the same reason as any other county (including mine), because they didn't get into the good old boys club. The paramedics there are about the same quality paramedics as other county, but in my opinion, more egocentric, and they are paid a lot less. I was very let down.
 

gclol

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I get that the hospitals are close by and I am not suggesting that the protocol needs to be expanded more, but for what Alameda County's paramedics brag about, I don't really see what's so good about their protocol versus other counties "hands down"?

I know from experience that they fail people. I am one of those people who failed FTO. Just like everyone else, I got 2 FTOs. Santa Clara County and San Mateo County gets all of Alameda County's rejects so I see them regularly. I know that Alameda County gets all of our rejects along with San Mateo County's rejects. Your quality isn't going down because you guys aren't able to filter out bad paramedics, but because there really isn't special about Alameda County. They fail people for the same reason as any other county (including mine), because they didn't get into the good old boys club. The paramedics there are about the same quality paramedics as other county, but in my opinion, more egocentric, and they are paid a lot less. I was very let down.
There isn't in terms of protocol. It's the volume of calls that happen in the county that makes it a good learning experience but that's my opinion. As for fto process no idea when you didn't pass but as of last couple academys there has been an increase in ****ery of ftos not allowing to fail people and instead shuffled though different ftos. Sorry it didn't work out for ya but glad that you found a county that works for you
 

Aprz

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You guys have more ambulances to deal with the overall higher call volume just like any other county. Unlike Santa Clara County and San Mateo County, you also do not go available until your patient care report for the calls is done and printed for the hospital. San Mateo County has a 30 minute timer and Santa Clara County has a 20 minute timer at hospital! I am often getting dispatched to calls while still giving report/transferring care. I don't see how they could be busier than the average (South County units like Morgan Hill/Gilroy are slow) shift/unit in Santa Clara County. In my opinion, you guys have it easier not having to stay after work to finish a bunch of incomplete patient care reports at the end of the shift on top of the fact that we (like you guys) often get held over 1-2 hours running calls.
 

RocketMedic

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Whoa; 63k a year was 2016-acceptable pay? That's insanely low for the area.

The VL question is a good one.

As far as protocols and medicine go...I'm honestly pretty over the differences. It's all basically the same everywhere, and that's coming from a guy used to deep Texas med boxes and protocols. 75% of that stuff goes unused anyways, and there's a lot to be said for effective, simple fixes. RSI/DSI is a nice thing to be able to do, but I care less about being able to RSI people than I care about high wages, 12-hour shifts, and nice places to live.

What is AMR like out on the coasts?
 

Aprz

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$63k/year (Santa Clara County 2016) is a hecka a lot better than $43k/year (Alameda County 2016).

Do you mean the coast in general or literally able to respond to the coast/beach? AMR in Northern California is ironically usually one of the better places to work than other ambulance companies. They usually have the 911 contract, union, and significantly higher pay. It is usually a pretty safe bet if you are going to work in Northern California.
 

RocketMedic

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$63k/year (Santa Clara County 2016) is a hecka a lot better than $43k/year (Alameda County 2016).

Do you mean the coast in general or literally able to respond to the coast/beach? AMR in Northern California is ironically usually one of the better places to work than other ambulance companies. They usually have the 911 contract, union, and significantly higher pay. It is usually a pretty safe bet if you are going to work in Northern California.
Both, I suppose. Santa Clara County also seems very expensive, but I'm open to anywhere.
Do y'all have VL yet?
 

Aprz

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Both, I suppose. Santa Clara County also seems very expensive, but I'm open to anywhere.
Do y'all have VL yet?
Yes, Santa Clara County uses King Vision. San Mateo County uses Vividtrac. Morale is pretty low at Santa Clara County.
 
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gotbeerz001

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Aprz, I hear some of that. Every system has the overzealous badass medic who tries to intimidate trainees... not my style, but not uncommon. Every system has those who don’t math very well. And as for whether people know the calculations or use an appropriate and functional shortcut... as long as the dose is right, who cares.

As for skills, I can’t speak for everyone, but I know math. I’ve paced and cardioverted successfully. As for my personal view of my skills against our OG medics, I got nothing on them. As a county, however, rest assured the opportunities are there.

While opinions are subjective and you’re entitled to yours, I believe most would say that you should successfully clear FTO before voicing an opinion of any significance.

As mentioned before, I’m glad you found a better fit. I’ve been impressed by your knowledge in posts (esp cardiology) but forgive me if I take some offense to your digs at our county.
 
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