+1, my sentiments exactly
I wouldn't be surprised if we worked at the same place. You've described my department pretty well.
Why don't some like the fire mix?
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+1, my sentiments exactly
I wouldn't be surprised if we worked at the same place. You've described my department pretty well.
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Sounds like a great job. If I could get politicians to extort enough money from the taxpayers to pay me $70k a year plus benefits & retirement in exchange for 2 days per week worth of work - much of which I spent watching TV or sleeping - I'd like my job whole lot, too.
But liking my job doesn't make an economic or patient-oriented argument for it. I'd need to do much better than brag about how good I have it if I wanted to convince others that the model itself was superior.
I'm not personally against fire-based EMS; I am for the most efficient and effective delivery model. I don't see how increasingly complex medicine fits into a firefighter-based system, and I don't see how responding to a chest pain call with 8 personnel and a half-million dollar piece of fire apparatus that is incapable of transporting a patient is efficient, but I am open to being convinced.
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Angel
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THIS.
@46Young , I also agree with you as I did some Fire based EMS for internship and being on the medic getting beat to crap day in and day out does wear on you. but at the same time, once seniority is built up, those guys dont have to rotate to the medic if they dont want to. posting does suck, for 10-12 hour shifts though, i guess its doable.
on the other hand, if EMS was more how fire was (I think (atleast) where @LACoGurneyjockey) works, itd be better. Station based EMS, unrelated to fire. Would that change your mind then?
If as a Medic, I could have station based EMS, the same or similar benefits, pay, retirement I would never consider moving to the fire side. Since none of that exists (yet) I am pursuing fire so when im in my 30's and 40's I can have better job satisfaction.
so I agree with Rin as to why NOT have fire based EMS, and agree with 46Young as to why TO have fire based EMS. I think egos (and unions) are too strong to ever make it the perfect/ideal situation for both. Where Medics arent forced to do suppression and vice versa.
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sjukrabilalfur
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I appreciate what you have to say about that. I'm still fresh and my experiences with other services is really limited. That's also why I wanted to make sure to point out that everyone I rode with was still highly proficient. I can see how ambulance days may raise the concern about being another small brick in the burnout wall for someone working in the fire services and I'll make sure I keep all of that in mind.
Rin, your post was pretty much why I was thinking FOR the mix of two. If I had to choose one In would never choose fire, but I have entertained the notion on a number of occasions as a secondary thing because of the reasons described. We have an all male department right now, except for one EMT who does no fire work. We had a female ff several years back but she moved away. So I look at it not as an ego thing but I think that I would be a good, relatable responder to women, children, etc. in a fire or rescue response situation.
On a side note, I really didn't realize this was such a hot topic. I appreciate all the good insight, though.
On a side note, I really didn't realize this was such a hot topic. I appreciate all the good insight, though.
If I was more concerned with just having good protocols/guidelines/equipment but with mediocre pay I would focus my efforts on places like Wake Co. and Charleston County. Just be prepared to be stuck in a lower middle class pay scale, which also means that your retirement will be modest, which means that you can't take it and move somewhere cheaper, because you're already living there. Where work is concerned, I'm looking at pay/benefits first, and then I'm going to focus on the best departments that offer that.
I spent 6 months in a station based third service municipal EMS department before I went to fire. Yes, we had stations, beds, a kitchen, living room etc. but we were hardly ever there to use the facilities. I tried to bring my lunch and dinner to work, but we would be stuck out on the road for hours, with my food spoiling in the microwave or drying out in the oven. We worked a 24/48 w/o kellys, with very frequent 12 and 24 hr. holdovers. There was the same lack of a career ladder that is problematic in EMS in general. At my current employer, I've had one promotion already, and I'm studying for the next promo. exam that's being held this winter. If I had stayed in single role EMS, there's a 95% chance that I would still be on an ambulance, with no raises other than step increases.
The problem with non fire based EMS is that most places put out barely enough ambulances to cover normal call volume, and hire barely enough people to staff them. This results in busy tours and frequent holdover OT. A lot of places just burn through their people and replace them with new ones. No place is going to put out extra ambulances and hire more people just so that the units can be less busy. Their solution is to enter into automatic aid/mutual aid agreements as a fix, or far worse - System Status Management/PUM.
Besides the lack of a career ladder and poor pay, what ruined single role EMS for me was the high call volume. I'm not saying that we should just screw off all day and run two calls. What I am saying is that on a 24 hour shift, it should be understood that some on-the-clock sleep should occur. IMO this should amount to a minimum of four hours sometime between 2200 and 0600, preferably more. If it's a busy urban system, then the shifts should be 8's and 12's, with perhaps a day/evening 16 at the most. With these shorter shifts, dedicated off-the-air OOS meal breaks need to be implemented, just like employees in other industries. No more eating breakfast at 2 in the afternoon and dinner at 1 in the morning, and no more grabbing fast food because that's what's available on the road, and having to eat it on the road like damn animals. In my fire based experience, employees have options to get off of the box, and do something else entirely. Just off the top of my head, there's EMS training for the field and the academy, fire training, various suppression apparatus, Hazmat, Tech Rescue, Peer Fitness, and many promotional opportunities in and out of the field.
Don't forget that dual role providers are subject to FLSA, where time and a half only starts at 212 hours over a four week period, or 53 hours a week. The 48 hour guy has to do five more hours of straight time before getting OT pay. My system has a 56 hour workweek, similar to a 24/48. A $70k/yr salary equates to around $23/hr as a base, less if you have night diff. added. In NYC I was making $30/hr as a medic on a 40 hour workweek, non FLSA. Getting me for $70k/yr where my hourly is only $23/hr and OT starts on the 54th hour is a real bargain IMO. It's even more beneficial to the employer because for every five 56 hour employees hired, they would have to hire seven forty hour employees to have the same coverage. That saves benefits/retirement etc.for two employees on every five.
Really, any single role medic that works a 56 hour week for less than $50k/yr to start is getting ripped off, and should look to trade up for a better department ASAP. %50k/yr is around $16/hr for an FLSA employee. I shudder to think what the hourly rip=off rate is for a medic starting at around $35k as is common in the Carolinas (I think this includes Wake Co.).
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There is nothing inherently wrong with fire based EMS, and properly designed fire-based systems can certainly provide excellent care. As with all agencies, it comes down to the culture and the people. If the fire department does not embrace EMS like it does fire or other disciplines, the care delivered will be substandard as its people have no reason to do otherwise. This is not soley an issue with fire based EMS. There are plenty of third service EMS agencies that also lack the culture needed to provide excellent care.
That said, I have a huge issue with fire departments using EMS to sustain their staffing without putting effort into it despite it being the majority of the department's call volume. I get the putting out a fire takes a lot people and training. But that cannot come at the expense of the EMS service.
That said, I have a huge issue with fire departments using EMS to sustain their staffing without putting effort into it despite it being the majority of the department's call volume. I get the putting out a fire takes a lot people and training. But that cannot come at the expense of the EMS service.
Thanks.
That describes me as well - I strive to be professional and proficient on-scene - any disdain towards the job does not show on a call. On the EMS side, I pretty much look at it as something mundane that pays real well, the very occasional good call notwithstanding. My enthusiasm has shifted significantly to fire at this point. I still very much enjoy medical discussions and learning new things, it's just that I hardly ever get the chance to put any new knowledge or skills into action. Basically, I have a deep interest in medicine, but not in the non-acute mundane hand-holding that EMS really is. 11 years into the game feel that I am allowed to hold that opinion.
+1000
It is a hot topic. Many formerly single role coverage areas are being replaced by fire departments, for better or worse. By replaced I mean that many single role EMS employees are losing their jobs or are being forced to relocate to stay with the company. I would be against fire based EMS if my job was in jeopardy. I chose to go where the money and power is. In addition to the reasons I stated earlier for leaving NY and eventually going fire based, there was always the threat that the city would end their partnership with the hospitals for EMS coverage (I was a hospital based NYC medic). A whole hospital chain, St. Vincent's CMC went down like dominoes, and FDNY EMS now has those ambulance tours. Municipal single role EMS, in many areas, is going to be unstable and unreliable as a long term career choice due to the threat of fire takeover and hospital closings due to the scourge of uncompensated cases if you're in hospital based EMS. The fire department will never go away, but EMS continues to be absorbed by fire. It's really like survival of the fittest out there.
Many larger departments have quotas to fill, so female hiring usually isn't a problem. The only problem is when the females choose not to do dedicated strength training, and just focus on cardio and maybe some light weights or calisthenics. Being able to run a 5:30 minute mile is fine for self rescue, but not for performing fire ground tasks or rescuing victims or other firefighters. It's a simple fix. I could take most females and get them to a level where they're physically superior to at last a third of the men with proper training.
Your reply is full of assumptions, innuendos, and flat out ignorance.
First and foremost, I don't see any "extortion" taking place to pay my salary. My salary is dictated by a union contract that is renegotiated every 2 years. That contract is negotiated between the union and the elected officials of the city. The public continues to elect our numerous multi term officials who agree to our public record contract. The fact that they continue to re-elect these folks speaks to the lack of cicitzen contempt for my salary. The contract stipulated salary is funded by tax dollars in the form of tax levies, sales tax, property taxes, and impact of service assessments. Our levies pass at nearly 90% every time including during the peak of the recession. Clearly our voting populace is ok with this "extortion" as you put it. Our business community is vibrant, varied, and thriving. Our commercial real estate has a less than 3% vacancy rate which is excellent for a city of our size. We continue to add businesses both large and small. Clearly the business community feels that our taxes are reasonable and provide a return.
Secondly, I don't work "only 2 days a week" as you put it. I work 50 hours a week. Do I sleep at night? Absolutely. Do I sleep through the night uninterupted? Almsot never. While I may be sleeping at work I am still at work. I am unavaliable for anything but work. I can't attend social functions and I am away from my family therefore I refuse to not be compensated for this time. On top of that, 24 hour shifts sleeping or not save the citizen money. To switch to 12 or 8 hour shifts would require more FTE's than 24 hour shifts. Do I have down time on my shift? Most days yes. That being said, my days are not spent doing nothing. We have some type of on shift training every day. On even days we drill on fire and on odd days we drill on EMS. We are allotted 90 minutes for PT every shift unless calls for service dictate otherwise. Some may view this as a luxury and leisure item. I view this as a neccesity. Ensuring my health, wellness, and physical capabilities is a benefit to myself, my crew, and most improtantly the citizens. The citizens have the right to have a physically fit and mentally sound employee responding to their calls for service. PT is protecting the investment made in me by the taxpayer. Outisde of PT and drill we maintain a robust public education program that addresses both fire and medical issues. We routinely conduct school visits for fire prevention as well as fall and disease management / prevention visits for the elederly. Beyond this we spend a decent amount of time cleaning and maintaing our fleet and quarters. Again the citizens have invested in us so we find it appropriate to care for that investment.
As far as your comment regarding our 8 man response to EMS calls goes, that is patently false. We do not routinely send 8 guys to a medical call. Our standard response was historically 2 in the ambulance and 2 on the engine. However due to budgetary constraints we at the officer's discretion send two on the squad and one on a chase car. Say what you want, but I like the help both medically and for safety's sake both in lifting and scene safety. An extra pair of hands, an extra strong back, an extra pair of eyes securing the scene.
You also commented on our ability to keep pace with the advances in prehospital care. That is a bold assumption that has no merit. We work under a very involved medical director who affords us significant clinical freedom. We operate a more than adequate in house training program in conjunction with our medical director. This is legitimate training not pencil whiped con ed. We also participate in clinical trials with a local university hospital. Part of are annual training includes a visit to the OR and / or cadaver lab for invasive procedure competencies. Many of the anti fire based EMS folks tout education. More than half of our department has significant post high school education with many having degrees. Myself, I have a 4 year biology degree. I am more than confident I can keep pace.
The problem is most of the anti fire based EMS folks do two thing; they pain with a very broad brush and they sell themselves short. Don't assume all fire based agencies are created equal as they are not. The pay, benefits, retirement, and career progression in single role jobs is poor because so many single role providers have reduced themselves to believing that it is ok and the fire guys are "extorting". They always talk about advancing clinical standards which is very improtant but they should also not settle and advance their career standards as well.
Press releases should be filed with the press officer, please.
gotbeerz001
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BEN52 makes a solid, well-thought out case. Why would you try to take away from that?
because I disagree with what he's saying...
but I can't be arsed to spend twenty minutes going through why because what's the point?
gotbeerz001
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Then post your own thoughts on the matter. To simply try to weasel out of a discussion which is (clearly) one-sided amongst the group is a cheap move.
gotbeerz001
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If you "can't be bothered", then simply sit back and read the commentary train silently. Your input added nothing.
gotbeerz001
Forum Deputy Chief
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I agree with BEN (obviously).
If you choose to feel sorely about those who have (arguably) better jobs than you do, call up your retired co-workers who agreed to do away with pension-based retirement systems in lieu of the 401k that you have now.
The fact is that, by design, fire based EMS can be superior simply because of established infrastructure and overall lower costs of doing business for that specific line item. Are we paid well? Sure. Do we arguably do much more than the standard single-function? Yes.
Those who say that EMS is 80% of what we do are comparing apples and oranges. Depending on the response area, call volume will likely be 65-85% EMS, but if you consider hours worked per member, the numbers start to reflect more accurately what we do.
Example: 3 person engine crew and 2 person medic respond to a medical. Engine is committed for 20 minutes and medic unit committed for 1 hour. That total 3 working hours for that call.
House fire call requires 3 engines (9 personnel), 1 truck (4 personnel), 1 medic (2 personnel) and a Chief. If the engine companies are committed for 3 hours each, the truck for 1 hour, the medic for 1 hour and the Chief for 2 hours, the total commitment for the call is 35 hours to run one call... And a simple residential at that. If it were a multi-alarm commercial or significant vegetation fire, the hours will grow exponentially.
We are required to respond appropriately to all calls at any time. To deny us that reality is to preach and maintain ignorance.
As for EMS, the quality of care is determined by the individual. I have worked with every kind of medic partner, both private and municipal. There are ****ty medics on both sides of the fence.
Are there plenty of single function medics who are better than I am at that one discipline? Absolutely. You ****ing better be... That's your ONE JOB.
That being said, am I proficient in my skills and able to serve my community adequately, especially in a busy urban area with short transport times? Absolutely.
Bottom line is this: if you don't like the job you have, apply for mine and be a great fire medic. My guess is that if your chosen mode rebellion is to complain, you'll complain wherever you are.
If you choose to feel sorely about those who have (arguably) better jobs than you do, call up your retired co-workers who agreed to do away with pension-based retirement systems in lieu of the 401k that you have now.
The fact is that, by design, fire based EMS can be superior simply because of established infrastructure and overall lower costs of doing business for that specific line item. Are we paid well? Sure. Do we arguably do much more than the standard single-function? Yes.
Those who say that EMS is 80% of what we do are comparing apples and oranges. Depending on the response area, call volume will likely be 65-85% EMS, but if you consider hours worked per member, the numbers start to reflect more accurately what we do.
Example: 3 person engine crew and 2 person medic respond to a medical. Engine is committed for 20 minutes and medic unit committed for 1 hour. That total 3 working hours for that call.
House fire call requires 3 engines (9 personnel), 1 truck (4 personnel), 1 medic (2 personnel) and a Chief. If the engine companies are committed for 3 hours each, the truck for 1 hour, the medic for 1 hour and the Chief for 2 hours, the total commitment for the call is 35 hours to run one call... And a simple residential at that. If it were a multi-alarm commercial or significant vegetation fire, the hours will grow exponentially.
We are required to respond appropriately to all calls at any time. To deny us that reality is to preach and maintain ignorance.
As for EMS, the quality of care is determined by the individual. I have worked with every kind of medic partner, both private and municipal. There are ****ty medics on both sides of the fence.
Are there plenty of single function medics who are better than I am at that one discipline? Absolutely. You ****ing better be... That's your ONE JOB.
That being said, am I proficient in my skills and able to serve my community adequately, especially in a busy urban area with short transport times? Absolutely.
Bottom line is this: if you don't like the job you have, apply for mine and be a great fire medic. My guess is that if your chosen mode rebellion is to complain, you'll complain wherever you are.
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MrJones
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