EMS, a romantic notion.

Veneficus

Forum Chief
7,301
16
0
I have again over the last few days noticed and interesting pattern in the types of posts being debated.

One of the often lamented aspects of EMS is the lack of professional, or for that matter, any respect in the healthcare community.

What I have noticed is that there seems to be a growing level of romanticism in EMS providers.

Riding in on the blazing steed to singlehandedly combat death and aid one's fellow man in time of need.

EMS joins volunteer fire with being the last bastion of modern society where minimally trained and medically uneducated people can fulfl some childhood dream of making a difference.

There seems no shortage of providers who would like or maybe need to believe EMS is something other than what it is.

Afterall, where else can less than 200 hours get you a front seat ticket to be something more than another corperate cube organism, physical laborer, or fast food guru?

You can't even be a barber with such little training.

This "hero" perception is further perpetuated by elected leadership, who constantly laud "first responders" despite not being able to secure funding for adequete response or even to provide a standard level of care to most of the country.

I call attention to this because I see it as yet another step away from an EMS professional in the US.

I don't know about you, but in my family, we have a few relatives who are big in heart and short on brains.

That is basically the mentality new EMS providers seem to be shifting to.

I will confess that when I started I thought I was going to save the world. At least everyone in it.

But here is the rub. I was fortunate to be mentored by some very capable and professional people who took pride in what they really did. Not what they wanted to believe they were doing.

They tempered or rather preempted my enthusiasm by making it clear in order to be a part of their group, things like a light bar on the POV were unquestionably unacceptable.

They taught me safety as a proactive culture, to scrutinize everything I did to either be better, safer, or demonstrate my value.

But as more and more capable providers leave EMS, the only ones left and its new generation of leaders have no idea or want of these virtues.

They believe their ignorance and passion is just as, if not more valuable than experience and education. They are vollies, weekend warriors, tinkerers, or in a more brutal term, hacks.

With no pretense of even understanding what they are doing, it now seems popular for them to label as out of touch or burnt out any who do not agree with their romantic notions.

They cite personal feeling and N=1 experiences they cannot understand as obvious fact.

It is almost the EMS equivalent of "teach the conflict" of intelligent design.

With both a population and culture shift away from the "hardcore" difficult to replace professional minded, I suggest that the possibilities of a professional US EMS provider is a lost future.

I think I must re-evaluate my efforts and value to advancing EMS.

Is there a solution to this disturbing trend?
 

NYMedic828

Forum Deputy Chief
2,094
3
36
The answer to your question is no. There is no future
for the current model of EMS with 9/10 newer generation providers. Everyone at my volly house calls me Mr. Negative. I tell them I'm a realist. I hold an EMS review, no one attends because "the state said I'm good for 3 years." They just want to play with lights and sirens and tell war stories at the table.

It will go on this way for a little longer maybe 5-10 years but the economy is not improving and the costs of healthcare are rising. The system of you call we haul and charge $1400 is simply not going to survive.

Ultimately it falls onto the educational standards. My making an EMT class 1400 hours, or even making paramedic the minimum standard, you deter most of the people who only want to save the world and not actually do their job how it was meant to be done.

When, not if, healthcare needs to take a hit, the bottom of the food chain will without question be first.

I believe the sole reason EMS has even survived this long in its present state is the societal expectation of what they get when they dial 911. They would be appalled if a transport van with only a pair of orderlies showed up to take them to the hospital. If they actually knew what it took to be an EMT, let alone what you are even capable of doing then they may not care so much. Eventually, word will get out...
 
Last edited by a moderator:

ExpatMedic0

MS, NRP
2,237
269
83
While I concur with you that the many "Ricky Rescues" are not helping our profession, its a double edge sword.

How about all the burned out EMSers? Every time I visit this forum I feel as if half the people who post here need to either get out of EMS and accept it as a "lost cause" or get off there @ss and do try to do something about it. I disappear from this forum now again because I get so sick and tired of hearing the same old complaints about EMS. Don't like it? Fair enough, move on to something else that YOU ENJOY.

I see there being a TWO types of people destroying the future of EMS advancing.
1. Under educated buffoons who want to play hero with a couple hundred hours of training, along with the "advanced providers" who advocate "meat head medicine"
AND
2. Burned out providers who instead of being proactive about improving things simply tell new up and comers to "be a nurse" or discourage furthering of ones education in the name of EMS.
 

NYMedic828

Forum Deputy Chief
2,094
3
36
While I concur with you that the many "Ricky Rescues" are not helping our profession, its a double edge sword.

How about all the burned out EMSers? Every time I visit this forum I feel as if half the people who post here need to either get out of EMS and accept it as a "lost cause" or get off there @ss and do try to do something about it. I disappear from this forum now again because I get so sick and tired of hearing the same old complaints about EMS. Don't like it? Fair enough, move on to something else that YOU ENJOY.

I see there being a TWO types of people destroying the future of EMS advancing.
1. Under educated buffoons who want to play hero with a couple hundred hours of training, along with the "advanced providers" who advocate "meat head medicine"
AND
2. Burned out providers who instead of being proactive about improving things simply tell new up and comers to "be a nurse" or discourage furthering of ones education in the name of EMS.

I tell people to be a nurse PA or MD instead of a paramedic on the sole basis of having a better future.

I don't discourage education in the name of EMS, but that goal is only realistic for someone who has money in their pocket to remain in EMS, which is almost no one.

I do not feel right in steering a young mind in the direction of struggling to pay the bills and living one paycheck at a time.
 

Handsome Robb

Youngin'
Premium Member
9,736
1,174
113
I'm going to hold my tongue on this one...

I do agree with Schulz though
 

epipusher

Forum Asst. Chief
544
85
28
EMS is just like any other job where you get out of it what you put in. A person can be comfortable with a Paramedic's pay as long as you live within your means, which is the same for just about any pay. As far as being burnt out, that is a choice one makes. Change your attitude,and if that doesn't work, change partners, change stations, change locations, change city's, or change states. A person has options.
 

NYMedic828

Forum Deputy Chief
2,094
3
36
EMS is just like any other job where you get out of it what you put in.

No, that is unfortunately where you are mistaken. I can put countless hours into certifications and education but 99% of the time it is only for personal benefit. I will see no promotions or increased pay or even a good job for what I do. Mind you I do it anyway but regardless, it is otherwise a wasted effort.

As far as living within your means, sure, it's more than possible. Personally I like driving a decent car ($20-40,000) and I would like to own a modest home some day and be able to provide my children with the things they want.

Living in NY, more specifically Long Island @ 23 years old I live within my means comfortably. If I had to pay a mortgage, I would be in substantial debt. My $60,000 a year supports myself fine but a family? Not a chance.

$60,000 a year simply won't do that. Not even close.
 
Last edited by a moderator:

VFlutter

Flight Nurse
3,728
1,264
113
2. Burned out providers who instead of being proactive about improving things simply tell new up and comers to "be a nurse" or discourage furthering of ones education in the name of EMS.

How are providers supposed to go about improving things? There is so much resistance from so many different interests trying to keep EMS down.
 

Brandon275

Forum Probie
22
0
0
Schulz,

we all get burnt out at times. I'm not sure what sort of system you work in but I am sure it is something worthy of this knowledge. The reason people in EMS get burnt out is not always because of their attitudes. It is the low pay, the lack of respect we get as a profession and the lack of job security we have in EMS.


How many of us have bounced around to different companies? I have been in EMS for 6 years in a busy 911 system and I have already worked for two companies because my previous company lost the city 911 provider contract. Who knows how long this current company will have it.


I firmly believe if medics and other EMSers were paid what they deserved and were recognized as a true profession and had some sort of job security and as mentioned wouldn't have to work 60 hours a week to make ends meet then I don't think you would have such a high burnout rate in EMS. The reality of this profession is that in the longterm there is only so much money you will make in EMS and there is only so far to go. It is what it is man. I absolutely love EMS and I love taking care of people who need my help. But the previously mentioned issues at times outweigh the love I have for the profession. It is not about love and passion, its about longterm career sustainment.
 

VFlutter

Flight Nurse
3,728
1,264
113
I firmly believe if medics and other EMSers were paid what they deserved and were recognized as a true profession and had some sort of job security and as mentioned wouldn't have to work 60 hours a week to make ends meet then I don't think you would have such a high burnout rate in EMS..

*Devil's advocate*

I think that Medics/EMS are paid appropriately. What makes you think they deserve more? What do other similar jobs, non-degree vocational trained, pay? And maybe they will be recognized as a true profession when they actually become a profession.

*Let the hating begin
 

Hunter

Forum Asst. Chief
772
1
18
Schulz,

we all get burnt out at times. I'm not sure what sort of system you work in but I am sure it is something worthy of this knowledge. The reason people in EMS get burnt out is not always because of their attitudes. It is the low pay, the lack of respect we get as a profession and the lack of job security we have in EMS.


How many of us have bounced around to different companies? I have been in EMS for 6 years in a busy 911 system and I have already worked for two companies because my previous company lost the city 911 provider contract. Who knows how long this current company will have it.


I firmly believe if medics and other EMSers were paid what they deserved and were recognized as a true profession and had some sort of job security and as mentioned wouldn't have to work 60 hours a week to make ends meet then I don't think you would have such a high burnout rate in EMS. The reality of this profession is that in the longterm there is only so much money you will make in EMS and there is only so far to go. It is what it is man. I absolutely love EMS and I love taking care of people who need my help. But the previously mentioned issues at times outweigh the love I have for the profession. It is not about love and passion, its about longterm career sustainment.

+1

And this

...I can put countless hours into certifications and education but 99% of the time it is only for personal benefit. I will see no promotions or increased pay or even a good job for what I do. Mind you I do it anyway but regardless, it is otherwise a wasted effort.

...My $60,000 a year supports myself fine but a family? Not a chance....
Unfortunately this is the main reason a lot of people leave EMS, I love EMS, I study more than most of my co workers even though i'm done with school. I read blogs, articles, attend extra classes, medical directors meetings, ect. None of that has gotten me any closer to getting a promotion from EMT-B to Paramedic at work, Annual raise I got just as much as everyone else I was hired with, regardless of weather i show up 30 minutes instead of 15 minutes early to check my truck or write more detailed PCRs, treat my BLS Hospital Discharges with just as more dignity than my co-workers do. To management i'm just as good as the guy who shows up late, barely cleans the truck at the end of the shift, treats his patients like :censored::censored::censored::censored: because he's bitter that he doesn't work 911 yet.

The system is broken completely, but it's not just the management or everyone else's view about us that makes it broken, it's also how most providers view the system. Most providers don't behave like professionals, they don't like hoe doctors nurses and everyone else treats them, but they wont do anything about it. Like it has already been stated most people in EMS are either a "Rescue Randy or Burnt out.
 

usalsfyre

You have my stapler
4,319
108
63
*Devil's advocate*

I think that Medics/EMS are paid appropriately. What makes you think they deserve more? What do other similar jobs, non-degree vocational trained, pay? And maybe they will be recognized as a true profession when they actually become a profession.

*Let the hating begin

It could be said that nursing is probably overpaid considering the majority of their task boil down to tech level stuff and in the US don't particularly have a strong independent body of knowledge....


That said, I agree with Kelly Grayson's theory that 75% of EMS is far overpaid and 25% don't make nearly enough...
 

Hunter

Forum Asst. Chief
772
1
18
*Devil's advocate*

I think that Medics/EMS are paid appropriately. What makes you think they deserve more? What do other similar jobs, non-degree vocational trained, pay? And maybe they will be recognized as a true profession when they actually become a profession.

*Let the hating begin

Medics/EMTs are paid appropriately, if they want better they they need to improve their own standards.
 

Brandon275

Forum Probie
22
0
0
What makes me think they deserve more? Really dude, lets see, first off Medics and other EMS street providers are required to think for themselves and make clinical choices based off their experience and their training meaning all the responsibility falls on them this is especially the case with the paramedic. A nurse for example that makes much more than the paramedic is instructed to do things by the ER physician in terms of emergency medicine. They do not make their own choices nor are they ultimately liable, the physician is.

Second, I think Medics have just as good if not better assessment and practical skills than any hospital provider has because we have to constantly use them. I am an Intermediate, way below a nurse and a medic and I have had many patients tell me that EMS are better at IV's and overall care than most of the RN's they encounter. I have also helped the hospital with difficult sticks that they had a lot of trouble with even with their little light they use.

Third, the profession is not recognized as a profession because EMS are not appreciated by the Hospitals, FD, the police or the public in general. I have had patients in total shock because of the things we can do in the back of the ambulance because they had no idea we have the capabilities to do the things we do.


The public still refers to us as ambulance drivers, that is how little the public knows and appreciates EMS, sorry but your comment is totally off base. EMS are at a high stress with the long hours and nights we work without any shift differential. The profession will be recognized as a profession once we are appreciated and recognized instead of being forgotten by our own medical counterparts and the patients we take care of on a daily basis.
 

VFlutter

Flight Nurse
3,728
1,264
113
It could be said that nursing is probably overpaid considering the majority of their task boil down to tech level stuff and in the US don't particularly have a strong independent body of knowledge....


That said, I agree with Kelly Grayson's theory that 75% of EMS is far overpaid and 25% don't make nearly enough...

I think nursing pay is on par with other enters level degree jobs. I would not considered it overpaid but I am not complaining either. Eh I will agree that certain subsets of nursing or as you described but not the majority. And I would argue nursing is still better off then EMS in both regards.
 

NYMedic828

Forum Deputy Chief
2,094
3
36
That said, I agree with Kelly Grayson's theory that 75% of EMS is far overpaid and 25% don't make nearly enough...

Now there is a statement I can agree with.




Side note to anyone who thinks physically working hard is a grounds for higher pay, it isn't. Education is.


I would add more of my opinion but I already see this thread going down the same route as the other 100 threads that get into these debates.
 

VFlutter

Flight Nurse
3,728
1,264
113
What makes me think they deserve more? Really dude, lets see, first off Medics and other EMS street providers are required to think for themselves and make clinical choices based off their experience and their training meaning all the responsibility falls on them this is especially the case with the paramedic. A nurse for example that makes much more than the paramedic is instructed to do things by the ER physician in terms of emergency medicine. They do not make their own choices nor are they ultimately liable, the physician is.

Second, I think Medics have just as good if not better assessment and practical skills than any hospital provider has because we have to constantly use them. I am an Intermediate, way below a nurse and a medic and I have had many patients tell me that EMS are better at IV's and overall care than most of the RN's they encounter. I have also helped the hospital with difficult sticks that they had a lot of trouble with even with their little light they use.

Third, the profession is not recognized as a profession because EMS are not appreciated by the Hospitals, FD, the police or the public in general. I have had patients in total shock because of the things we can do in the back of the ambulance because they had no idea we have the capabilities to do the things we do.


The public still refers to us as ambulance drivers, that is how little the public knows and appreciates EMS, sorry but your comment is totally off base. EMS are at a high stress with the long hours and nights we work without any shift differential. The profession will be recognized as a profession once we are appreciated and recognized instead of being forgotten by our own medical counterparts and the patients we take care of on a daily basis.

Yes dude, really. First off I think you are seriously over exaggerating the ability of the average medic and seriously lacking understanding in what nurses actually do. So you can make independent decisions on your own without medical control and outside of protocols? Secondly, again I think your view is skewed. And third, that is the least of the problems of why EMS is not a profession.


And...We are ambulance drivers. Get over it. Getting upset about the term just shows your lack of understanding of where EMS is in big picture of health care.
 
Last edited by a moderator:

Brandon275

Forum Probie
22
0
0
I don't think I am overly exaggerating abilities of medics at all. I think Medics are highly skilled and highly unexaggerated. Yes, we have protocols but it does not mean there are not bad medics out there that don't get in trouble for messing up. Thats my point, the responsibility falls on the medic. Responsibility does not fall on the nurse. So you tell me, why is EMS not recognized as a profession, since you clearly don't see EMS or medics as professionals.
 

VFlutter

Flight Nurse
3,728
1,264
113
I don't think I am overly exaggerating abilities of medics at all. I think Medics are highly skilled and highly unexaggerated. Yes, we have protocols but it does not mean there are not bad medics out there that don't get in trouble for messing up. Thats my point, the responsibility falls on the medic. Responsibility does not fall on the nurse. So you tell me, why is EMS not recognized as a profession, since you clearly don't see EMS or medics as professionals.

Actually responsibility ultimately falls on the medical director but I get your supposed point. And nurses do have the responsibility, legally, for their patients. If a nurse walks out and quits it is patient abandonment. If a nurse makes a clinical decisions and it results in a poor outcome they are responsible. I don't see what you are trying to get at.

I will save that for its own thread. It would require way too much typing and really will have no point. I never said medics are not professionals but that does not make EMS as a whole a actual profession.
 

NYMedic828

Forum Deputy Chief
2,094
3
36
As a medic, I agree with chase.

While my physical scope of practical skills may ultimately outweigh a nurse my baseline knowledge does not. And that is what matters in providing good medical care.

In a perfect world, paramedics and nurses would have the same educational standards geared for their work environment. If paramedics had a BSN requirement to do their job then they would get the respect and pay everyone thinks they deserve.
 
Top