Cleveland EMS

[MattB1557]

Applied for Cleveland EMS, I know some about it. But not as much as I'd like to know. I just need to hear the truth from someone with inside knowledge. What's it really like? I know the high volume, bunch of bs calls, gun shot stab wound type stuff but I'm looking for organizational info. Would you recommend working there? Could you ever make it a career or just a stepping stone? I've got 8 years of experience as a medic from a few different services so I'm not "looking to get my feet wet". I'm looking for a steady career. I can handle busy, crazy, getting your *** kicked. But I can't handle unstable work environments. So am I on the right track or will I hate it after a year? Any inside info would help.

 

[VentMonkey]

Applied for Cleveland EMS, I know some about it. But not as much as I'd like to know. I just need to hear the truth from someone with inside knowledge. What's it really like? I know the high volume, bunch of bs calls, gun shot stab wound type stuff but I'm looking for organizational info. Would you recommend working there? Could you ever make it a career or just a stepping stone? I've got 8 years of experience as a medic from a few different services so I'm not "looking to get my feet wet". I'm looking for a steady career. I can handle busy, crazy, getting your *** kicked. But I can't handle unstable work environments. So am I on the right track or will I hate it after a year? Any inside info would help.

These kind of seem like one in the same, don't you think?

Sorry I don't have any direct info on Cleveland EMS, but if you want to make it a career why not somewhere that seems much more respected, and invested in employee retention such as Wilco EMS, SCEMS (Delaware), or Wake EMS? There are tons more if your tour the forum some more.

FWIW, when I think of a "crazy busy" system that I would ever want to make a career out of or at, I think of Denver EMS. I don't know if relocating is an option for you, but if it is perhaps do some more research.

Inner-city urban EMS rarely yields career-long individuals, especially without it becoming an unstable environment, good luck.

 

[NomadicMedic]

When I think of a career department, I also think of the place where @Tigger works. A unique, tight knit small department with lots of opportunity to do different stuff. Working in a place that does SSM and has a high UHU doesn't smell like a career to me.

 

[VentMonkey]

OP, seriously most of Texas, parts of Colorado, and a handful of ALS intercept services on the East Coast (bonus if they are fully-functional ED paramedics who deploy to calls as needed) are probably the way to go in terms of making this job a career.

Your 28, physically speaking this job will wear you down inevitably, add into the mix inner-city blight over a 20 plus year career. Can you see your self doing that into your fifties? It's a seriously question to ponder.

 

[CleOhEMS]

Cleveland is like any other inner city ems system, as you noted. The overall majority of those hired use it for the experience to get hired on a local fire department. The rest are lifers.

No reason to think it to be unstable, it's been around since 1975 as a third service and will not be replaced by private. If anything it could be merged with fire, but not likely to happen any time soon. Current compensation is excellent, starting at $17 and topping out at $26 per hour in 5 years with plenty of OT available. Benefits are very good with full coverage. Retirement with pension is currently 32 years, however the union is working on lowering it to 25 and out.

They run 18 units 24/7 out of the city fire stations and recieve 116k calls a year, however transport about 75k per year. They work hand in hand with fire on most calls, who are mostly emt's with a handful of medics on several ALS first responder engines. The City just passed an income tax increase, with much of it going to public service. The plans are to increase to 25 day units and 21 at night in 2017, while hiring 3 classes of 35 cadets in 2017. Obviously a huge expansion which most there say they will believe when they see it.

They run mostly double medic units with permanent partners rotating calls however way they choose over seven 12-hour shifts every 2 weeks. They hire a mix of emt's to medics, however emt's are required to become functioning medics within 3 years of hiring. They work with emt's scheduling to help them go to medic school.

Politics are what you would expect, however they still remain a fairly close knit group.

Some advancement is there, but limited to those who really want it. They have roughly 180 in the field split between 4 shifts (estimate 175 medics to 15 emt's). They have 11 Captain supervisors in the field split between 4 shifts too, which will be increasing by 4-5 next year due to the tax increase. Captain tests are given and you can qualify after 2 years in the field. They also have sergeant positions who work at headquarters, running day to day operations including education, supply, QI etc.

As for whether you'd hate it, is up to you. The only ones who don't like it are those using it as a stepping stone and are getting frustrated with not getting hired on in the suburbs. For the lifers, it's a public relations job, if you know what I mean.

That's everything I learned while there. As you noted, mostly typical bs calls (easy BLS), surrounded by the occasional trauma or true medical call.

Whether a stepping stone or not, they're supposedly hiring this large group in 2017 and it's a great opportunity to get on board into an expanding city run service. I know they REALLY want medics to be recruited so you should consider it, and pass the word on! The only hard part is getting through the 12 week academy!

Good luck!

 

[VentMonkey]

@Birdman264 what are protocols like? I don't mean the kind that are shown on an app or website I mean more along the lines of in reality.

How involved is (was?) the departments medical director?

 

[CleOhEMS]

The long time medical director actually became an employee of the city before the RNC over the summer. He splits his time now between the ER and the city and is in the process of revamping the protocols. As for reality, they're pretty standard (iv, o2, monitor).

Keep in mind that the major of calls are bs BLS. Plus they transport to 17 area hospitals, so transport times are 5-10 min or less. Paramedic stuff is usually limited to traumas and real medical emergencies. Although some crews will work up everyone, it's the crews option and available via protocol. It's all in how you document.

 

[VentMonkey]

Plus they transport to 17 area hospitals.

I did not realize the Cleveland metro area had this many hospitals.

 

[Handsome Robb]

18 units for 116k calls? How does that even work? We run 14 units plus a single medic squad and three demand trucks on during the day for ~30k calls and are going to be adding at least 1-2 units in the next few years...

That sounds unbearably busy to turn that many calls with so few units.


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[WolfmanHarris]

That sounds rough. We're ~45 24hr (coverage not shifts) trucks (depends on staffing whether our swing shift trucks are running or not), 6 12 hr coverage, 9 RRU, 3-5 Superintendents or Captains, 2-3 Special Response Units and the Bus/ESU for a pop of 1.1M and ~80k calls/yr.

 

[CleOhEMS]

Cleveland clinic (8)
Fairview
Lakewood
Lutheran
Main campus
Euclid
Hillcrest
Marymount
South Point

University (7)
Richmond
Ahuja
Main campus
Parma
Southwest
St. John
Bedford

Metro (3)
Main campus
Severance
Parma

Independent (2)
VA Hospital
St Vincent

Putting pen to paper there's actually 20 er's. They have to call for permission from a boss to transport to 7 of them, but its always permitted.

7 are in the city itself. Another 8 are in inner ring cities on the border. The othere 5 are in county, but a little further.

Yes that means there are about 20 er's for medics to get part time work in, plus probably another 12 free standing er's too.

 

[CleOhEMS]

That sounds unbearably busy to turn that many calls with so few units.

Yes it could be. Hopefully it will change with the passage of the tax levy and increasing from 18 to 25 units. It's all about reducing response times.

Here's the breakdown of 2015:
www . care1975 . com/run-stats/

Remove the spaces, I don't have enough posts to post the link yet, lol. 2016 is similar.

Run the numbers. 18 units x 12 runs per day avg x 365 days = 78k. They transported 74k in 2015. Obviously some units are busier than others, while days are busier than nights.

I think I ran about 8-10 day avg in 12 hours. With 7 of them not doing anything more than vitals. Easy money. Just have to be ready for when it's "game on" and getting caught off guard!

 

[VentMonkey]

Helpful posts, @Birdman264. Also,welcome to the forum.

 

[DrParasite]

When I think of a career department, I also think of the place where @Tigger works. A unique, tight knit small department with lots of opportunity to do different stuff. Working in a place that does SSM and has a high UHU doesn't smell like a career to me.

With all due respect, working in a place where you only do one or two calls every 12 hours doesn't make for a competent provider, especially not in the beginning of your career

Most people I know who have worked in busy areas usually aren't looking to make it a career, unless they have a way to get off the ambulance and stay with the agency (training, special OPs, rescue, communications, supervisor/management, etc). I know of several former providers from Boston, NYC, and Newark who worked several years of experience with the high number of patients, so they were familiar with those high acuity calls and how to deal with them, before moving to a slower system where they were able to have a long career.

 

[NomadicMedic]

Sure, but I worked with a medic from Newark who had never given Zofran. Ever. In 10+ years. Learning how to manage sick patients with a longer transport time can make a newer medic much better than half a dozen scoop and run "ALS" calls per shift.

 

[Tigger]

When I think of a career department, I also think of the place where @Tigger works. A unique, tight knit small department with lots of opportunity to do different stuff. Working in a place that does SSM and has a high UHU doesn't smell like a career to me.

If my place was located some place that was a little more aligned with my goals, I would stay there forever. I will never work someplace again that does not embrace its staff's talents and encourages (and pays us) to improve the service and our own standing. I love going to grant hearings and whatnot, its dozens of chiefs and me, a 25 year old with a PoliSci degree attempting to wing it. We avoid people who just want to run calls, and as a result have a small but diversely talented workforce.

With all due respect, working in a place where you only do one or two calls every 12 hours doesn't make for a competent provider, especially not in the beginning of your career

I disagree entirely. While we are slightly busier than that (six or seven in a 24 on average), I am privileged to work with some exceptionally competent providers who were also hired because of their educational background. My shift has three adjunct faculty for the local paramedic program and an AHA train the trainer instructor. Their knowledge and ability to teach combined with seeing a much higher proportion of sicker patients makes up for the lower volume of urban systems.

I have not particularly struggled working in the city, which I do part time just to ensure that my credibilty remains above board.

 

[DrParasite]

Sure, but I worked with a medic from Newark who had never given Zofran. Ever. In 10+ years. Learning how to manage sick patients with a longer transport time can make a newer medic much better than half a dozen scoop and run "ALS" calls per shift.

I suspect that more do to with NJ considering a nausea or vomitting patient to be a strictly BLS call, so a Newark medic wouldn't even get dispatch to it, as they only get dispatched to calls meeting ALS dispatch criteria, than not seeing sick patients. The truth is that despite many urban cities having a reputation for major trauma making up the bulk of their call volume, the reality is they have some really sick patients who don't go to the doctor until it's too late, and often after years of neglect to their bodies. So while there is a lot of scoop and run, and you don't get to see the outcome of your interventions, you are still expected to initiate said treatments.

 

[NomadicMedic]

Oh no, this guy was a minimizing medic. And you give Zofran to more than BLS sick calls.