We have actually increased the amount of training we offer our EMT's. If all the EMT wants to do is take grandma to dialysis, this isn't the company for that EMT. We do mandatory weekly scenarios, we have online courses offered, initial training and annual training online. Elite is a stepping stone to 911 and fire departments but our EMT's need to learn while they are here. I started off at an IFT company, worked my way through medic school and got hired onto a 911 ambulance company and eventually a fire department. I try to give our EMT's the experience and training they need to do the same.
We are making attempts at decreasing our dialysis patients. For the dialysis patients we do transport, they are evaluated for medical necessity every 90 days. We don't tell our EMT's to lie on the paperwork either. We are doing some back up for a fire department (not Compton) so that the guys can get some experience.
We still allow CIEMT students to ride with us and many come back after they get their EMT certification for employment. I think our guys do a good job of showing the students what the job is like.
As far as the "crappy management", there are 2 managers here. One does the billing and payroll, had major surgery but still managed to get the paychecks out to the guys. The other does operations, training, QI/QI, etc. and works 16 hours a day to make sure everybody has what they need and the company is operating within the requirements of the EMS Agency. Both do whatever they have to within reason to give everyone what they need. Both have open door policies and know each employee by name and know who is in paramedic school, has a sick family member or a new baby. Management is tough on tardies and unexcused absences, vandalism to the ambulances and poor patient care or customer service. If that makes management crappy then yes, management is horrible.
It is a shame that LA County won't let all privates run EMS and as a result, privates run what is available to them. That isn't going to change. All privates have dialysis patients. That won't change either. There are dialysis patients that must go by ambulance due to medical necessity and medical necessity isn't just bed confinement. Medicare pays for those patients. We currently run a mix of dialysis, IFT, medical aids and a unit posts for 911 back up. Work sucks, and as an EMT, your not going to make a lot of money but what you do with the job you have speaks volumes about you to your manager and the person who looks at your employee file when you apply for the firefighter position. The best you can do is to find a company that follows the rules, pays you correctly (daily or weekly overtime, no bounced checks, not in cash, etc.) gives you the hours you need, provides you with uniforms at no cost to you, and gives you a clean ambulance that is well stocked. Show up every day to that job on time and do the best work you can do and once you have done your time, get hired on with a 911, fire department, RN or whatever you want to do.
