What's the Deal With Vegas?

RocketMedic

Californian, Lost in Texas
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So I saw that AMR and Medicwest are recruiting paramedics fairly aggressively, and a look at Facebook shows that things seem to be impacting fans routinely. What's going on out there?
 

Handsome Robb

Youngin'
Premium Member
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It's high volume, SSM private service EMS with a very weird relationship with Fire.

I have a few buddies that used to work at AMR and hated it then an old student who currently works at MW and loves it.

@SandpitMedic has done pretty extensive write ups on their system.


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BossmanGifford

Forum Crew Member
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So I saw that AMR and Medicwest are recruiting paramedics fairly aggressively, and a look at Facebook shows that things seem to be impacting fans routinely. What's going on out there?
Community Ambulance from what I've read is the private to be at. They work 7 shifts a pay period (not sure the schedule) and the last four hours of each shift are OT.

I haven't heard anything nice about AMR, but have heard okay things about MW.

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RocketMedic

RocketMedic

Californian, Lost in Texas
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I think the pay is a Nevada state thing; MWA did the same thing when I worked there back in '07.

It's just interesting to me how many of these gripes are common between systems. From an outsider's view, a lot of the same problems EMSA had in 2014 seem to be present there as well. It's like the ability to fix problems is lost and must be rediscovered.
 

BossmanGifford

Forum Crew Member
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I think the pay is a Nevada state thing; MWA did the same thing when I worked there back in '07.

It's just interesting to me how many of these gripes are common between systems. From an outsider's view, a lot of the same problems EMSA had in 2014 seem to be present there as well. It's like the ability to fix problems is lost and must be rediscovered.
What do their FDs work?

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SandpitMedic

Crowd pleaser
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The pay is the same and the schedules are the same at all privates. 3/4 split. Overtime after 8 hours.

Fire has varied schedules.

There is a lot to be said about the way ops are going. I'll get back to you on that.
 
OP
OP
RocketMedic

RocketMedic

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I'm curious about it.
 
OP
OP
RocketMedic

RocketMedic

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UPDATE:

I understand the panic-rush to maintain compliance, but this is pretty demoralizing.
 

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NysEms2117

ex-Parole officer/EMT
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"i want double time".
 
OP
OP
RocketMedic

RocketMedic

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The issue seems to be that the employees don't have a union or protections from this -and- that AMR is unable and/or unwilling to recruit and maintain enough people to staff the system at the level it is being used at, which is evidently in excess of their predictions. In the long term, the answer is more money, more people and more incentives, but to get to the long term, you have to get through the short term, and in the short- to mid-term, they have to maintain compliance with their contracts and remain profitable (especially with a sale in the works), so they would rather put their people through the wringer than hire new people they may not need in six months.

The terrible thing is that this disproportionately punishes the loyal employees who want to be there and disincentivizes people like me from wanting to work there because we value our time. They're competing with everyone else for paramedics who want to work in hot trucks for mediocre wages, and that pool is shallow.
 

DrParasite

The fire extinguisher is not just for show
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I understand the panic-rush to maintain compliance, but this is pretty demoralizing.
Not for nothing, but I think this is an awesome policy. All the white shirts and office staff will be on the trucks helping out. If the field staff are getting screwed, so are the bosses. All too often management makes policies that hurt the staffer, but management doesn't care because it doesn't hurt them at all. Now your director will be on the ambulance helping out, doing charts, and answering calls. True, management might not get done, but at least everyone is getting put through the wringer, not just the guys who put boots on the ground.

As for the holdover, well, it happens in public safety. The job needs to get gone, and as much as it sucks (and I agree that it does), someone needs be on the ambulance. If you don't like it? quit and find another job, because the needs of the public do come first. Sorry to be so blunt, but it's not the first agency to force people due to staffing, and it won't be the last. I've been forced to stay due to coverage, and it sucks. Maybe with enough management personnel being stuck working on the trucks, and enough people leaving because of all the forced time, they will hire people people. Staffing is a management concern, and I can only answer one call at a time.

BTW, they can hold me all they want, but there is no way I will be forced to come in when I'm not at work. Every time they call me, I'll be drinking alcohol.
 

EpiEMS

Forum Deputy Chief
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Staffing is a management concern, and I can only answer one call at a time.

Hopefully it also leads to better system design - and medic initiated refusals. We should only be so lucky to get those.
 

DrParasite

The fire extinguisher is not just for show
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Hopefully it also leads to better system design - and medic initiated refusals. We should only be so lucky to get those.
http://www.emsworld.com/article/10773595/fatal-mistakes-prehospital-medicine
https://www.ncbi.nlm.nih.gov/pubmed/9737402
http://www.jems.com/articles/2011/01/ems-system-abuse.html
http://naemsp.org/Documents/Positio...minationoftransport-Resource Doc-PEC_2011.pdf

As much as I would love to see that, remember to think about lowest common denominator..... you might be comfortable initiating a refusal, but do you trust the judgement of all your coworkers? how about the local dialysis IFT crew?

I don't see that happening without an increased education shift and a really aggressive medical director.
 
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RocketMedic

RocketMedic

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Management in the field is a temporary fix and a good patch, but it is not a substitute for more people. The real answer here is a significant increase in funding.
 

DrParasite

The fire extinguisher is not just for show
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The real answer here is a significant increase in funding.
I agree, the long term permanant solution is an increase in funding, staffing, and more resources available to handle the workload.
 

EpiEMS

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As much as I would love to see that, remember to think about lowest common denominator..... you might be comfortable initiating a refusal, but do you trust the judgement of all your coworkers? how about the local dialysis IFT crew?

I don't see that happening without an increased education shift and a really aggressive medical director.

I agree that there is quite a bit of risk here, but it can be safely mitigated with carefully designed policies & clinical oversight. Heck, you could even restrict field refusals to ALS providers, or require medical control consultation.

The real answer here is a significant increase in funding.

Hear, hear. Of course, we all know the problem - the political process doesn't love EMS the same way they love, say, Fire.
 

Tigger

Dodges Pucks
Community Leader
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Not for nothing, but I think this is an awesome policy. All the white shirts and office staff will be on the trucks helping out. If the field staff are getting screwed, so are the bosses. All too often management makes policies that hurt the staffer, but management doesn't care because it doesn't hurt them at all. Now your director will be on the ambulance helping out, doing charts, and answering calls. True, management might not get done, but at least everyone is getting put through the wringer, not just the guys who put boots on the ground.

As for the holdover, well, it happens in public safety. The job needs to get gone, and as much as it sucks (and I agree that it does), someone needs be on the ambulance. If you don't like it? quit and find another job, because the needs of the public do come first. Sorry to be so blunt, but it's not the first agency to force people due to staffing, and it won't be the last. I've been forced to stay due to coverage, and it sucks. Maybe with enough management personnel being stuck working on the trucks, and enough people leaving because of all the forced time, they will hire people people. Staffing is a management concern, and I can only answer one call at a time.

BTW, they can hold me all they want, but there is no way I will be forced to come in when I'm not at work. Every time they call me, I'll be drinking alcohol.
Holdover as a policy is absurd. This is still a job and I still have a life. Late calls happen, but being held over to deal with staffing means the system is broken. Quit and find another job is not the answer, the system does not get fixed that way. Neither does putting management on the street, turns out that management actually needs to do their jobs to keep a system running. Saying it might not get done is absurd, these things need to be done if you want success.
 

wtferick

Forum Captain
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I'm assuming Community Ambulance does a lot of mutual aid? I saw one of them responding down the strip last time I was on vacation. Don't really know how the system works up here.
 

Onceamedic

Forum Asst. Chief
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The biggest problem I saw in my years with AMR was poor management. It was an old boys club with superstar de jour coming in every year or so to shake thngs up. I did my job in spite of management. When my personal goals were no longer being met I skedaddled. I am lucky that I am able to do so. AMR as a career is a non-starter.
 
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