Can we stop some of these, please ?

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rescue99

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I love the volllies! In fact, a small town with no money in which to spend on services must rely on whatever they can get! As long as there are rural towns with tiny little budgets (or no budget at all) I say; thank goodness for those men and women who give their precious time to help a neighbor. I look forward to changes, to more education but the reality is, we still need MFR's, EMT's. Most of all, we still need our vollies.
 

46Young

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We wouldn't need them if paid ALS was considered the national standard of care. Ah, if only...

Ah, if only rural depts with an inadequate tax base were able to afford paid ALS. If not for vollies, many areas of the country would have no emergency response at all, let alone ALS within an hour or so away.

It's nice to say that every corner of the nation should be mandated to have fully staffed, paid ALS 24/7, but what do you recommend these depts do to ensure coverage for their jurisdictions without any money? Grants and state handouts only go but so far.
 

rmellish

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I work in a rural area. I understand this.

Sadly it's not a legislative priority, probably because the constituents in these areas don't realize they are getting the shortest end of the stick by combining BLS with geographical separation from definitive care.
 

Shishkabob

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Do what I do-- pick your fights.


There are a couple of people here (medics AND basics) that make some pretty naiive general statements that I'll fight tooth and nail. But that's about it. Until I learn more, I keep my mouth shut on the majority of the things.


More for my low self esteem and huge ego than anything else. ^_^
 

EMT11KDL

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What numbers did you pull that from? Have any real proof or just spouting numbers?

R/r 911

You do know that 59% of all stats are made up on the spot correct :p
 

ffemt8978

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I posted this in another thread, but this bears repeating.

If you've got an issue with a post you've got three choices. Use the report post function for something that violates our forum rules, counter the post with a civil rebuttal, or ignore it.

If you've got an issue with a member, take it up with them in private or place them on ignore.
 

irish_handgrenade

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I can assure you these "attitudes" as you define it, will not change. There is absolutely nothing that has been said in this thread from highly educated and respected individuals that is demeaning or "high and mighty". It's called the truth, should you wish to be successful in this career, you need to have the ability to see the importance of what is being written. Throughout your EMS career, you will have preceptors and mentors that may have similar views as posted here. What are you going to do? Follow your advice and ignore them. You will not get far..................

Sorry, but the truth is sometimes harsh. Provide a sound argument with credible and verifyable statistics and then the matter can be discussed. The problem is that this very subject has been hashed out many times on this and every other EMS site out there. There are valid reasons why volunteering is problematic and why the EMT-B level is substandard for primary pre-hospital care. Do a search, read and learn. Ignorance may be bliss, but it is frustrating to us who have dedicated and sacrificed many years to improve our industry. For you to come in with no discernable experience and say we are wrong is not only ignorant by true definition, but also disrespectful as well. You've got a lot to learn, hopefully you will take the opportunity to do so.

I'm just going to assume you went straight from nothingness to LP with experience? Did you and the others not start somewhere? Something I have been dealing with in my clinicals and so far have bitten my tongue is all the people with experience didn't just magically get it they started out somewhere too and it is completely unacceptable to bash someone for sticking their foot in the door. As for volunteers I think it is pathetic that small towns will spend money on bullcrap festivals and seasonal decorations and ridiculous"repairs" on perfectly fine roads, all the while they have a broken down fire truck and a bunch of ECAs doing the first responder/firefighting. I think all municipalities should be required to pay their fire AND ems systems.
I have been going to school for 2 years at the end of this month and I will have my LP by the end of the year, and I have only been working on an ambulance for 6 months so I don't know the ropes as well as some of you. But I have been around stuck up people and bullies my whole life and that's what I see when I read the replies yall leave when a newbie posts on these forums and it is not cool or professional in any way.

EDIT: By the way I am not flaming anyone in particular... at least I don't think and my comments are not entirely forum based they are also coming from people I have met in the world. I am merely adding my 2 cents to the debate.
 
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irish_handgrenade

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Ah, if only rural depts with an inadequate tax base were able to afford paid ALS. If not for vollies, many areas of the country would have no emergency response at all, let alone ALS within an hour or so away.

It's nice to say that every corner of the nation should be mandated to have fully staffed, paid ALS 24/7, but what do you recommend these depts do to ensure coverage for their jurisdictions without any money? Grants and state handouts only go but so far.

There is a vollie BLS service 45 minutes south of clyde but still in callahan county, texas. This particular service Buys 1 NEW ambulance EVERY year with the grant money they get from the gov. and replaces the oldest one that they have. I am not exagurating(spelling?) they really do this but they "can't afford" to pay for a paid staff? This reaks of BS, and I know that Cross plains can't possibly be the only service pulling this crap.
 

fortsmithman

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There is a vollie BLS service 45 minutes south of clyde but still in callahan county, texas. This particular service Buys 1 NEW ambulance EVERY year with the grant money they get from the gov. and replaces the oldest one that they have. I am not exagurating(spelling?) they really do this but they "can't afford" to pay for a paid staff? This reaks of BS, and I know that Cross plains can't possibly be the only service pulling this crap.


I deal with govt grants in a non EMS setting. With our grants we can only use the funding for one purpose. If we don't use the funding for what it is meant for and spend it say on payroll we would be required to repay the grant monies not used for the specified purpose. So with these municipalities who do buy new ambulances once a year with grant monies if they spent it on wages they would in all probability have to repay in full the grant monies spent on the items not covered by the grant instead of what the grant is for new ambulances.
 
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Maya

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I have to say, I can understand the argument for lobbying for higher education standards, leading to higher wages and a more respectable position for EMS in the medical field. Perhaps the very presence of volunteers and EMTs does make it more difficult to implement a change in EMS. However, that problem is on a systemic level. A lot of the negative remarks I've been reading have been on a more personal level.

If someone is willing to spend their time serving their community -- unpaid -- that is an honorable thing, whether or not it serves your cause. What do you expect people to do, anyway? This is the way things are NOW. We can advocate for change in the FUTURE, but what more do you want? Should we quit our EMT jobs and stop showing up to volunteer?

By the way, if I don't work as an EMT, I can't even get into some of the paramedic programs I'm applying for. What exactly would you suggest?
 

TransportJockey

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By the way, if I don't work as an EMT, I can't even get into some of the paramedic programs I'm applying for. What exactly would you suggest?

That's part of the system that's broken. No where else in healthcare will you find that you have to do a stepped system. I personally think the requirement of field experience before you can apply to paramedic school is asinine. I've seen basics that have been on a truck for years that flunk out of medic school. And my classes top student has never been on a truck except for internships
 

bmennig

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As long as small towns across the US have low call volume and small populations, Volunteer's will continue to be the staffing of choice for fire and EMS. As far as the education standards go for an EMT, they should definatey be increased as well as be more extensive. I can honestly say after taking the class, I feel as though I dont know much more than before I took it and sadly I don't. I'm a volunteer through and through, always will be. I've been a paid "professional" and to be honest I don't like it as much, but that's just my opinion. Volunteers have a place in small town USA and they will for a time to come.
 

PotatoMedic

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King County has the requirement of 3 full years of basic work before applying to the medic program. From my understanding it is not the education that they are worried about but getting PT care experience as well as being able to handle EMS work. They really don't want to invest that much money into one person who ends up flunking out because they can't stand the sight of blood.
 

Flight-LP

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I'm just going to assume you went straight from nothingness to LP with experience? Did you and the others not start somewhere? Something I have been dealing with in my clinicals and so far have bitten my tongue is all the people with experience didn't just magically get it they started out somewhere too and it is completely unacceptable to bash someone for sticking their foot in the door.

As with most assumptions, you are incorrect. I started out as an ECA, then an EMT-B, I, P, and LP. I gained valuable experience along the way. The most valuable of which is that the educational standard on our country for pre-hospital care is substandard at the Paramedic level. What does that say about the abilities and education of an EMT-B working in a BLS emergency environment? How can we remotely justify placing 2 individuals with minimal protocol and algorhithmic training on a primary 911 unit? This is where I have an issue. NOT EMT-B's working on an emergency ambulance with a higher trained and educated individual that they can collaborate with.

Volunteers are a different story. Yes they can be a valuable asset to the community. However, traditions run deep, especially in the volunteer fire departments. The dynamics of society demand a better approach than the disorganization found in many departments. We are in the business of delivery high quality medicine. We must promote professionalism. That is currently not being performed by a high percentage of volunteer departments, nor is there a strong push to advance their education or professional capabilities. Add to that the factor of compensation and it paints a negative picture for many in this industry. Directors, administrators, and local politicians will always take something for free vs. having to pay for it; it is simple economics. But most professionals will not give there services for free, nor should they be asked to. If your volunteer agencies were viewed as professional, then the pay would be there. The "we are poor and can't afford it" speech is null and void in 95% of representative examples and has been discussed to death right here on this forum. Most of the time, it can be done, people are just not willing to do it. I worked one of the poorest counties in Texas as a paid Paramedic; paid a decent salary at that.

In fact the 2 poorest counties in the State of Texas, Starr County (#3 poorest in the nation) and Maverick County (#9 in the nation), BOTH HAVE PAID ALS! This is factual and the basis for a good argument. Opinions on the other hand are sheer emotionality and prove nothing.

Your opening line was irrelevant to this discussion. There is and has been no bashing in this thread, nor has the acquisition of experience been a front running discussion. Again, some folks do not like hearing the truth to how our industry does and potentially should operate. Just as the boss said, you can read and listen, ignore, or report your concerns. Outside of that, you may as well let it go as all it will lead to is a locked thread and people getting sent to the corner......................
 

VentMedic

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King County has the requirement of 3 full years of basic work before applying to the medic program. From my understanding it is not the education that they are worried about but getting PT care experience as well as being able to handle EMS work. They really don't want to invest that much money into one person who ends up flunking out because they can't stand the sight of blood.

Not wanting to invest money into a person who has become an EMT for the wrong reasons is probably the best reason they require 3 years. Those who stick it out may be motivated. Many companies want a person's loyalty for one year before giving them the education benefits. They want to know you will stick around and not job hop.

If you work for a slow service or volunteer, you may only see 40 patients in a year in some places. In other places, you will be a shuttle and some Paramedic programs have come to expect this so they spend the first few weeks reviewing very basic skills and unlearning bad habits. When the program is based on "hours of training" and barely meets the state minimum, the clock is ticking.

It would be preferable if those 3 years were spent getting an education along with work experience. 3 years is a long time to just perform the same few skills over and over. As well, if it takes you 3 years to master those few skills in EMT-B, maybe you are not the best candidate.

Hospitals are more than willing to reimburse new grad RNs for their education. They figure the RNs are more motivated for a career if they stuck it out through a 2 or 4 year degree. As well, those who go through degree programs have continuity in the first few weeks of basic skills through the advanced application of both theory and skills. Their clinicals are also long enough to give them an excellent idea of what they are getting into when it comes to patient care. And yes, they can work as a CNA, phlebotomist or unit secretary to earn money throughout their eduation. I have yet to hear an RN advise a CNA to work 3 more years before applying to nursing school where they will spend another 2 -4 years. RT also doesn't tell their equipment cleaners and stockers to work for 3 years in that position. In fact, you can only get that position if enrolled in a college program for Respiratory Therapy. They want students who are continuing their education.

The EMT program with 10 hours of clinicals which may be done around the TV at a slow station is not even an entry into a career. Then to see the "real world" for 3 years with some burned out EMT who has nothing but excuses for not moving on to Paramedic or any other "career" is NOT what one should call a quality experience. Learning terms like "BS" calls and lizard transports will not enhance your patient care abilities especially when you know so little about medicine that you feel inclined to hang on to every word this older and wiser EMT you have for a partner and mentor has to offer.
 
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rescue99

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A Grant may dictate exactly what it can be spent on. Giving the FD you mention the benefit of the doubt, trade-in suggests they have to trade, or not be able to afford the new one at all. I assume the grant is a repeating grant applied for each year. Losing it will leave them with an ambulance that will get old and worn out eventually. Just a guess.

As for small towns holding festivals and parties and heavy on the decorations....I wish!
In the tiny rural farm town (population 150) I came from, we had a stamp licking dog in the 10x12' post office, a feed store, a school and 2 churches which were nearly as small as the post office. Oh yes, a general store until the one and only convience store/gas station opened on the edge of town and shut it down. I mean this is a seriously small town surrounded by seriously small towns! The closest "city" (population 28000) is over 20 miles away. FD is a private service but there is a mini-pumper manned by a few vollies housed at the school garage. I really wish it were as simple as just changing a few minds. Far fewer people would die unecessarily. I worry everyday about my aging mother.
 

PotatoMedic

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First off I will say I have not gone through the testing process (yet) to become a medic in King County. From what I have read and been told you go through a series of skills assessments, interviews, written tests, and psychiatric tests. All that in attempt to weed out unqualified EMT's. I can only speculate but I believe that would help greatly remove the necessity for reteaching of basic skills.

I can't speak why there is not experience requirement for RN students. Maybe because there is not a negative financial impact to the school if the student quits. I honestly don't know. What I do know is that if you get into the paramedic program you have a job and are employed. You are getting paid while in training and you are not allowed to hold a side job. I don't know if you have to compensate the county for the cost of training if you end up quitting. All I know there is more of a direct impact to the county while training the medic students.

I'm not trying to ruffle any feathers or say you are wrong. I am just speaking on what I know about ONE program, and what I believe the reasons are behind some aspects of it.

Here is the page regarding employment: http://www.kingcounty.gov/healthservices/health/ems/MedicOne/careers.aspx

EDIT: If any of my information is wrong please let me know so I can learn.
 
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VentMedic

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First off I will say I have not gone through the testing process (yet) to become a medic in King County. From what I have read and been told you go through a series of skills assessments, interviews, written tests, and psychiatric tests. All that in attempt to weed out unqualified EMT's. I can only speculate but I believe that would help greatly remove the necessity for reteaching of basic skills.

Essentially there are many factors involved and in actuality the 3 years being certified as an EMT may not be the biggest factor as those who continue their education may be better prepared to perform those skills and have better success in Paramedic school. Also, King County has a better medical oversight which also gives credit to its system. Thus, I would not say the 3 years of experience as an EMT-B is solely responsible for a good EMS system.

I can't speak why there is not experience requirement for RN students. Maybe because there is not a negative financial impact to the school if the student quits. I honestly don't know. What I do know is that if you get into the paramedic program you have a job and are employed. You are getting paid while in training and you are not allowed to hold a side job. I don't know if you have to compensate the county for the cost of training if you end up quitting. All I know there is more of a direct impact to the county while training the medic students.

It does matter to the school if students drop out especially to state colleges. Their funding may be based on the number of graduates. Medic mills, however, will have you loan amount in their bank and the student is the one who is SOL.

Hospitals also have earn and learn programs where you work PT and go to class PT or even FT while signing a contract that you will stick around once you graduate. They may also have a requirement that you be employed for one year before they will start paying your way. However that doesn't restrict you from going to college through their other educational benefits or on your own. They may only want the one year to show loyalty and to see if you will be a good employee.

Hospitals also may also want to know of any outside employment to track if it becomes an issue with missed work days or your job performance.

I'm not trying to prove you wrong since King County does have a good system. I am just showing there are many reasons why companies and schools do what they do.
 
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