Volunteer EMS providers

hfdff422

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There have been several discussions that have carried on about the merits of volunteer fire and EMS providers, as well as the problems facing the department's ability to cover the needs of those they serve. There has even been some criticism of the dumbing down of the B level to ensure there are enough providers.

This is a subject that is near and dear to my heart as I am sure many of yours as well. There are no answers that are readily available. The rural areas that volunteers normally cover cannot afford to pay fulltime personnel. Even combination departments are stretched to make ends meet in all but the largest towns. People cannot afford large tax increases to fund more full time personnel. There is no guarantee that ambulance bills will be paid, and chasing after your friends and neighbors for payment or turning them over to collections for faliure to pay for services rendered in a traumatic/emergency situation is hard to swallow. In our state there are very few private providers, so they are wary of dedicating units to coverage of areas that may not be profitable.

We cannot force people to become volunteers, and if we did it would only backfire. Our department only has about 60% of its members certified as EMT's, even though several others are competent to do it, they just want "the fun stuff" and are not willing to commit to the training which is a minimum of 200 hours initially with additional for A+R and CE. There is no way to reduce the training, that is not an option.

I would like to hear realistic ideas on ways to fix this system (ways that don't involve long term funding on short term budgets). Please feel free to provide any links that are of legislation or departments that are having success. Also, if anybody has information on territory establishment, I would appreciate it.
 

TTLWHKR

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Didn't we already discuss this on another thread?

Nothing good will come out of it.. Someone will aim to piss you off, and it will become someone vs. someone else.. etc.
 
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hfdff422

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Yes we have, and yes they will, but it would be nice to get some real and productive input.
 

rescuecpt

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You say that only 60% of your department are EMTs? What kind of department is it? Fire and ambulance, or just ambulance? And if it's just ambulance, why are they allowed to remain members (ie, what function do they serve?)?
 
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hfdff422

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Yes it is a fire department, but I think all FF's should be EMT's (non-EMT's can drive, I just dont think it is good enough) regardless of whether or not a department provides ambulance coverage (and we are the sole EMS provider for our area outside of other FD's mutual aid- mainly ALS). But I am wondering what kind of things have worked for fire or ambulance services to bolster the volunteer ranks out there, there is or at least should be a close correlation between the two.
 

Jon

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My AMbulance Co - id say at least 20% are not EMT's... that would be the "attendants" who haven't take the course yet, and some of the drivers.

The squad will pay for you to go to EMT class (heck, we Teach the EMT class) and also encourages EMT students to join and run with us.

Jon
 

Chimpie

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HF... are you running an ambulance as part of your FD?

Most Indiana departments are rural departments. Cities are small (compared to other states) but you usually you have a good turn out for volunteers. Also, most Indiana FDs are just that, fire departments. They do run ambulances.

In Vanderburgh County (Evansville), as of the last time I visited, they had 5 township departments and 1 city dept. The city was paid, township volunteers. None of the departments except for one of the townships ran ambulances. They used AMR. The one township that had an ambulance actually had two because their area is so far away from a hospital. This tgownship which is almost all volunteer has two paid ambulance people on duty at all times. Sometimes their both EMTs, sometimes one EMT one Medic.

Other than those members no one had to be an EMT. Most, however, are MFRs. Seeing how most departments are just BLS, and money is always tight with Volly Departments, there is no good reason to justify making all volunteers EMTs.

(sorry for the bad grammer, it's still early)
 
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hfdff422

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All of our county runs ambulances through the FD's, most of central Indy has FD ran ambulances, some are supplemented by hospital ran services (Indianapolis-Wishard). But yes, FD's do run a good bit of the ambulances in the area I have had contact with, and until recently I thought that was the standard statewide. It was only about a year ago that I found out that there were some FD's that had no ambulances in the area (2 other counties).

But I don't want to get far from the topic, I am wondering what services and FD's do to get new volunteers and participation from current members to provide the necessary services. We had an MVC at 06:00, I called for a second tone due to being the only one on station after 4 minutes and then called an ambulance from another dept. since I finally got one other member there so we could rightfully take the engine. These are the situations that need fixed and I want to hear some success stories.
 

TTLWHKR

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Originally posted by hfdff422@Nov 14 2005, 11:54 PM
There is no way to reduce the training, that is not an option.
Yes there is... It's called a First Responder. If they aren't on an ambulance, why train to be on one. They still get the same training for the most part. Just no meds. They can do O2, splinting, first aid, aed, airways, etc... Why force them into unnecessary training, if they won't be using it.
 

squid

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I wish I had a success story, but we're in the same boat. Thank goodness we have good mutual aid -- we just had a structure fire and I think fewer than 10 folks from out department showed up. Which is not to bash our department; it was before 5 on a weekday and those ten people represent most of our active personnel. But jeez! That is *not good.*

We go up and down in membership, but I think one of the really hard things is that when we're down, we're all too strapped to find the time to recruit. Also, it seems that peopel really are too busy. Seriously. I know I'm too busy for this stuff, and were it not for having invested a few years already, I'd never find the time to join. Most of the folks in our district are middle-aged, partnered with kids and pretty busy. The others are college students with little or no community invovlement who probably don't know they're really in our service area. And we're the least busy department around so we don't get the adrenaline junkies.


Sorry, this is mostly musing in a whiny way and not not too helpful. But, given the low population density here and the low call volume, there is no way to pay people. We do have one paid day staff, but that's it. Also, as with most rural deaprtments, we all cross-train for medical and structure fire and wildland fire. There's no way to keep the training requirements down. So... I'd also love to hear from others with ideas.
 

Jon

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On the topic of recruitment and retention - the State of PA's DOH just rolled out their new teen recruitment video.

Here's the link: [url='http://www.rollwithit.com']http://www.rollwithit.com[/url]

First of all - Does it truly portray our job?

Second, the website says NOTHING about pay and pay rates.

Third - will it recruit anyone? Will anyone "lured into EMS" stay??


It looks like it was put together mostly by the ESHF of PA.


Jon
 

Chimpie

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Cool site. Combine that with going out to the schools and giving talks, yeah, enrollment should be up.
 

Jon

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Yeah... but is it really "What we do?"
 

MedicPrincess

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Cool Video. I had seen the link somewhere else.

Three problems I see....

1. How many of you work for EMS companies that have "No Doctor." The county neighboring us is known for their "Mother May I" System. Only BLS (on ALS trucks) can be provided per protocols. Medic must call med control for any skill above BLS. That is how their current medical director wants it. So you tell me how that = no Dr.

2. If there are "No Hospitals" then where in the heck are you taking the pt too? The 7-11 so they can meet their dealers maybe?

3. After it says No Doctors and No Hospitals, it ends with them taking the patient into a hospital and talking to a Dr.

But still a very cool video. Its hard to say its an accurate representation. Really the only thing is shows them doing is driving and shocking someone.

But, yes, I do think it will attract the younger crowd.
 

Jon

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I think they are saying that you don't have a doctor or hospitl WITH you.... but I know of 2 command docs who have a habit of showing up on scenes.

Jon
 
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hfdff422

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Originally posted by TTLWHKR+Nov 15 2005, 06:04 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (TTLWHKR @ Nov 15 2005, 06:04 PM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-hfdff422@Nov 14 2005, 11:54 PM
There is no way to reduce the training, that is not an option.
Yes there is... It's called a First Responder. If they aren't on an ambulance, why train to be on one. They still get the same training for the most part. Just no meds. They can do O2, splinting, first aid, aed, airways, etc... Why force them into unnecessary training, if they won't be using it. [/b][/quote]
In our area, first responders can only do O2, splinting and airways under the supervision of a B or higher, and they cannot transport without a B. FR is training that is designed for police officers and non-transporting FD's primarily. I would rather have them around than the personnel on our dept. that barely have their AHA bcls card though.
 

TTLWHKR

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Originally posted by MedicStudentJon@Nov 16 2005, 06:30 AM
On the topic of recruitment and retention - the State of PA's DOH just rolled out their new teen recruitment video.

Here's the link: [url="'http://www.rollwithit.com'"]http://www.rollwithit.com[/url]

First of all - Does it truly portray our job?

Second, the website says NOTHING about pay and pay rates.

Third - will it recruit anyone? Will anyone "lured into EMS" stay??


It looks like it was put together mostly by the ESHF of PA.


Jon
The EMS director emailed that to us...

They forgot to show people puking into our shoes, drunks punching us in the face, 24 hours of wheel chair transports, getting stuck with needles, etc...
 

VinBin

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They are worried about the low retention rate while AT THE SAME TIME advertise EMS as all fast driving with sirens and "shocking" people to life. People go looking for this, see it isnt and leave for something else.

Random comment, this video was very similar to the way EMS was portrayed in the movie "Bringing out the Dead." Anyone feel that way?


And a question for MedStudentJon, you said that docs sometimes respond to scene. First, what kind of doctors are they? Second what do they respond in and Third, do they help out or just watch?
 

ResTech

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I like the initative and love the video! Whatz not to like :) I mean itz targeted at the "net-generation" and they need to see that type of portrayal to get them hooked or at least get their attention. Honestly, I can tell from my own experience when I was in high school, fire and EMS was looked at as being nerdy and something all the dorks did... and yes I was a jr. firefighter. Something like this really changes that sentiment I think.

And I must say very well put together.
 
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