letmesleep

sorry chris, I was still waking up from a nap when I responded and missed the gear thing.....we have rescue gear, and helmets for any extrication

There has been some discussion over on another thread (CCEMTP what does it mean) that has taken us a little off the OP. I thought i'd bring it to a new slate and ask all of you....How does your service support itself? In this day and age billing has taken control of a lot of what we (as medics and EMTs) do in the street. The increased cost to an ambulance service each year continues to grow, your pay and benefits, Fuel cost, supplies, station maintainance, etc. So how does it get done where you work? how involved are YOU with your billing process? Do you even know? At my District we have a property tax at a rate of 18 cents/ assessed $100 value, We also have a communication tax at 3 cents/ assessed $100 value. Recently we were able to pass a sales tax of .25 cents per sales dollar. We also bill for our services. The sales tax is bringing in money to the district and allowing us to lower our property taxes, we have already cut it down from 29 cents to the 18 cent rate, and with increased growth and retail headed this direction we will continue to drop it. This sales tax is not allowed to be charged against Fuel/ food/ or prescribed meds. The communications tax pays for any and all means of communicating from dispatch/ computers/ phones and the service/ cable tv in the station. Finally billing, we have taken on the job of retrieving the information for the bill by getting a facesheet at the hospital or copies of the insurance cards (auto insurance if it was an MVC). This information is then turned over to the bill department for processing and collection. So how do you do it?

I think there was a misunderstanding somewhere. We do bill for services, but don't have the need for increasing that cost to our taxpayers. We do have property tax, and have past a sales tax to start off setting that cost to the tax payers. I'm quite clear that it takes money to run an ambulance every year, but is there really a need to rake the residence we serve if there is other money out there? If so, are you really serving those residents as responsibly as possible? I have never believed that it was our job to keep the poor (that we tend to run on the most)....poor, but by continuously running on these people then hitting them with huge charges such as the ones discussed here, we are doing exactly that. Savvy? I call it irresponsible, but if thats how things need to be done at your service then so be it.

This is just another example of parents needing to take responsibility for their children. If you know that mat is going to burn their little feet, either MAKE them keep their shoes on or take their little ass home. Heres another idea.....find another place or something else to do with your child. If the info is put out there then why wouldn't a "good" parent take the precautions needed to keep their child safe? What about taking your kid out on the lake for a ride on the boat? Going to let them take off their life jacket too?

Rid, let me start off by admitting that I know nothing about you or where you work. If you have been able to bring in that kind of money for your service thats great, but only if that is the objective of your service. I work for a tax based 9-1-1 service that serves the residents of the district. It is a district that covers 244sq miles and approx 30% is farm land, we have a major Interstate that cuts it in half (north to south), and we are approx 30miles from St Louis. With all that said the last objective is to make a "buck" off the backs of our taxpayers. As I stated before there is NO need for an extra charge to the residents of this district just because we sport an extra couple of letters on our title. We provide the same amount of EMS care as any one with the CC. Many of us have taken the class, and I do believe it is worth taking, but only in the interest of knowledge and CEUs. I have NO problem with you wearing your title proudly, and as stated above making more money for your service, by all means, have at it. I will take offense tho at your uncalled for accusations and continued attempts at insulting any one of us who don't see the need for your CC to treat PTs. I believe your statement was along the lines of: "If one don't like the title so be it", but as far as sour grapes, your trying to compare apples to apples my friend. There is nothing in the back of a truck that the CC ALLOWS you to do over and beyond my skill level. We handle transfers from the local hospital here that need to go to a higher level facility. We have vents on our trucks, we can handle drips....of any kind (much like you), if we get a balloon pump transfer out of the crap hole they call a cath lab, throw in a nurse and we are down the road. I am all for furthering our knowledge base as medics, and quite honestly if any one wants to display their accomplishments on the paperwork you sign, on the collar, or on a sleeve then go right ahead. We should be proud, but don't knock those of us down just because we choose to wear a duty shirt that simply states......Paramedic!

I also work for a strictly EMS district, but we work along side 3 different fire departments that have NO issues getting us in to a vehicle to start Pt care. We are all paid (EMS and FD), and all have our jobs to do out there. I will say that in St Louis co. that most FDs are joint services and do require medic.....notice I said MOST. On the other side of that last statement tho, the FDs in that co do pay much better for running fire and EMS.

My motto is: you have to love stupid, you have to fold it up and stick it in your pocket, carry it close to your heart, stupid is job security!

Ok, but check this out ECC, by closing your mind on the history of nursing you can not change anything that WE need to change as you listed above. I too am all medic, and don't have the interest in nursing, but in order to better ourselves, shouldn't WE look at the Nurses and their HX to move us along? If there is no need to reinvent the wheel then why should we? This is the other problem out there...closed minds! Nursing can help us in so many ways as professionals your head would spin. Vent said that we need to get past the: "just like them stuff", and how right that statement is, but on the "flip side of coin" we all could use a little, get over ourselves and work better as MEDICAL PROFESSIONALS!

Kaisu, That wasn't pointed at you. I am just wondering why FFs have such an adversity to furthering their knowledge when it comes to EMS calls. If their FD wants them to have an EMT license, then why not? They go on EMS calls, and most of the time WE as health care providers can't stand them being around other than helping carry equipment. I too am a paramedic, and also have NOOOO desire to pull a hose. My question was to the OP who seems to have a problem with being an EMT or at least required to get an EMT license. sorry for any confusion!

May I interrupt this discussion for a moment? Vent, I will agree that RNs have their "act" together, but they are a profession that has been around for what, 200+ years or so? The fact that they are sitting on EMS boards is (in my opinion) a good thing, but what is the adversity to moving US as a system in to the next phase, or as you put it: "EMS needs to focus on creating its own identity and stop with "just like them" stuff." Nursing is a field that comes from a long history of being held back by the MD if I'm not mistaken and has come a very long way to get where they are today, so why is it that if they have so much more education (which I will agree that they do) do they not push for EMS to get better educated and create our identity? Nurses have been there and know what it takes, but as I'm sure many medics here and out on the street will agree on, we are looked down upon much like nurses were by MDs of the past. Why is it that we can't do hospital triage? Is it because we are uneducated? Then teach us! I have never understood what the big mystery of knowledge is. If I can (as a paramedic) do something in the street to better a PTs outcome, then why is it the RNs and the MDs don't want to take the time to teach? Look at the history behind 12 leads in the field, what was the big hang up there? hell, even ER docs have to get them read by a cardiologist, but they still start care based off the 12 lead and Hx, don't they? As far as the attacks on Vent in regards to RN vs EMT-P. Vent is dead on the money here and really we as a profession need to take a closer look at our education. What are we going to do about it? Are we going to just continue to sit here and spout off at Vent, or get some progressive changes made to our career choice? RNs are being seen more out in the street in many different areas besides just special needs transports, and if we intend on surviving as EMTs and medics then WE need to figure ourselves out as stated. If things keep going the way they are, WE could easily be replaced by RNs.......have NO doubt!

My question to you is this then, What is wrong with getting an EMT license and better serving the community? What is wrong with getting more educated, and being more of a help to the EMS system your FD is riding the coat tails of (to increase their call volume, and increase grant money)? Do you have an issue with getting up at 3am to help lift a 600lb PT, because that "first responder" cert isn't going to change that at all!

Sleeping around is NOTHING new to EMS, period, and that alone could be another thread by itself.

Thats cute Rid, but having a CC in front of your EMT-P around here means NOTHING at all other than the billing department being able to charge more for the SAME service that I provide without the little CC before or after my title. It doesn't matter to ANY departments in this area much like a RN getting in to EMS around here. The highest "street" level recognized is EMT-P. There is NO extra pay, NO extra benefits (to the employee with the CC), NO change in PT care......only the billing is different. As I stated, it is a nice way to get some CEUs and good knowledge, but nothing around here changes other than BILLING.

http://www.stltoday.com/stltoday/news/stor...EF?OpenDocument Home News St. Louis City / County Story 'He was never alone' By Christine Byers ST. LOUIS POST-DISPATCH 07/27/2008 From the moment Maplewood firefighter Ryan Hummert died, firefighters were there. At first, it was his Maplewood crew, who, along with 22-year-old Hummert, had thought they were responding Monday to a routine car fire. Instead, they found themselves in the middle of a gunman's killing field. Before it was over, two police officers were shot, Hummert was killed and several other bullets barely missed their intended targets. Minutes that seemed like hours passed until police could safely remove Hummert's body. Then firefighters were there to carry him to an ambulance. Clayton firefighter Brian Zinanni knew it was time to begin a firefighter's tradition. "We need somebody to stay with Ryan," Zinanni told a visibly shaken crowd of firefighters. Rock Hill Fire Chief Kevin Halloran and Clayton firefighter Ted Destatte volunteered and boarded an ambulance for a somber ride to the hospital. "We wanted him to go in a fire department ambulance because it was the start of us taking care of him," Halloran said. When Hummert was pronounced dead at the hospital, firefighters were there. When the medical examiner autopsied the body, firefighters were there. Halloran and Destatte delivered Hummert to the funeral home, where other firefighters relieved them. Nearly 12 hours had passed since Halloran had boarded the ambulance to escort a firefighter he barely knew through the post-mortem motions. "I said I would do it not knowing fully what the day was going to entail," Halloran said. "It was one of the biggest honors I've had in my career." Many felt the same way. Within hours of Hummert's death, firefighters from across the country had called Zinanni to volunteer to stay with Hummert's body at the funeral home. "It's a process of healing for firefighters as well as considered an honor to sit with a fallen comrade," said Zinanni, team coordinator for the Missouri Fire Service Funeral Team. "And it's a comfort to the family to know he was never alone." When funeral directors placed Hummert's casket at the front of the funeral parlor, firefighters were there. Two firefighters stayed with the casket for two-hour shifts. Often, the group grew to six as some stayed past their allotted time, or others just showed up. Some came in T-shirts and jeans. Others wore their dress blues. They passed much of the time as they would at their respective firehouses, waiting for the next call. Talking shop. Sharing laughs. And sitting together. It was their way of bringing the firehouse Hummert loved so much to him for his final moments among them. Every once in a while, the group quieted. Their eyes turned to the casket. "So he was only 22?" asked Grovespring, Mo., firefighter Brandon Miller during a shift that lasted until midnight Wednesday. Maryland Heights firefighters nodded. "Wow, that's scary," Miller said. "I'm only 20." Maryland Heights firefighters got a kick out of Miller and his fellow Grovespring firefighter Robert McClanahan. Their stories about life in a rural volunteer district south of Lebanon, Mo., kept the mood light. They discussed donating equipment to the volunteer department. "Do you think we could come by for a tour of your station?" Miller asked. "I've never been in a paid fire department before." "Sure," replied firefighter Larry Tennison. Soon, Maryland Heights Capt. Bill Matzker's eyes drifted once more to Hummert's casket. "So who was this Knobbe guy anyway?" he asked of the alleged gunman, Mark Knobbe. The group shared what they knew: Knobbe was estranged from his family. He had worked for the Art Museum. He set his home on fire and shot himself in the head. "Just senseless," Matzker said. About seven more shifts passed before the informal casket vigil gave way to a formal honor guard. Firefighters in full dress blues stood at both ends of the casket for 10-minute shifts during the seven-hour visitation. Halloran took his post at 2 p.m. Wednesday at the foot of the casket. Brentwood firefighter Tim Hammer stood at the head. Hummert's tearful mother, father and sister were the first to visit. Firefighters were there. They stood rigid until the next pair relieved them. But once in the hallway, their tears flowed. The rotations continued until 10 p.m., even through a 40-minute procession of more than 600 firefighters, saluting the casket two by two. Once the formal honor guard retired for the night, the informal watch resumed. Funeral directors dimmed the lights and told the firefighters where to find the restrooms and coffee. When Hummert's family arrived the next morning for the closing of the casket, firefighters were there. Members of Hummert's Rockwood Summit High School football team carried the casket to the door. From there, firefighters bore their brother to a pumper and then to Immaculate Conception Church. Maplewood firefighters sat in the front rows to the right of the casket. The family sat to the left. Firefighters delivered many of the nine eulogies. Two nearby churches opened for the overflow. Firefighters from as far as New York, Nebraska, Tennessee, Kentucky and Indiana quickly filled more than 800 chairs and stood in the aisles. About 135 firetrucks escorted the casket to the cemetery. The family waited at the grave site as more than 1,000 firefighters marched behind the pumper carrying Hummert's casket. It's a tradition called "the Sea of Blue." An honor guard stood at attention while Maplewood firefighters delivered the casket to its final destination. More than a dozen firefighters on bagpipes played "Amazing Grace." And firefighters on bugles played taps. The Hummerts returned to a limousine, in awe of the firefighters' role in their son's final journey. "We could have taken months and never planned anything as beautiful as this," said Andy Hummert, Ryan Hummert's father. The limo pulled out, and the firetrucks lined up to exit. Cemetery workers prepared to lower the casket. They pushed a mound of earth over Hummert's grave. And a firefighter was there. cbyers@post-dispatch.com | 636-500-4106

I believe this is just a good way to get some CEUs and pick up some good knowledge, but the biggest bonus that I can see in this area is for billing purposes. The extra letters allow for high cost to the PTs....I may be way out of line here, but thats how I see things around my area.

I have definitely had a different experience with the Private sector having better access to equipment (back in the day). My time with the Private sector was 4 years of getting a truck with your choice of brakes, steering, or air conditioning not a combo of any of these items, but only 1! I always went with the steering so I could aim that bastard truck at a brick wall if I needed too. Most of the trucks had well over 500,000 miles on them and were put together with duct tape and any kind of wire the mechanic could find. It was not uncommon to have very minimal floor boards up front, and you better plan on getting wet if it was raining outside. We did upgrade to LP10 from a LP5 while I was there, and that was only about 10years ago. We still carried those HUGE tackle box type drug boxes in, and the list goes on and on. Barri truck? HA! This was one of the "premiere" private services in this area, and in all fairness they have changed and upgraded their equipment a decade later. This service and the Other "BIG ONE" around here both spent more time trying to make the "All mighty dollar" than worrying about Pt care or their employees. Safety? HA! I now work and have worked for the same tax based service for over 10 years, and will never look back. I do miss some of the calls and can never trade in my experiences with the private service, but good riddance. Where I work now we are spoiled little "primadonnas" who have just about anything that makes sense to have on an ambulance with a nice mixture of experienced medics to keep it real. The pay is 100x better along with the benefits, we have a great relationship with all 3 FDs that are in our district. FD responds on all "LIFE THREATS", and if a lift assist is needed......we just call or wave our magic wands (radio antennas....lol). Getting PD out there may take some time due to the size of the county, but the come at the drop of a dime. Yeah, I'm spoiled, so what?

JPINFV, thanks for your input, but my question was about the IAFF not the IAFC to wendy. I'm going to back out of this thread now as to not hijack it. Wendy sorry for the question that may have stirred up the caca, i was just wondering what info you had on the topic of the IAFF needing to be persuaded to increase training for EMS. Being a member in good standing for many years in a non-fire department I have never heard of this, although I will also admit that I haven't looked for it either. The paper sounds interesting as hell, and I would enjoy reading it in a later thread if possible.....your choice of course. sorry again for the interruption, please continue!

The math on the Paul McCartney-Heather Mills divorce is as follows: After 5 years of marriage, he paid heather $49 million. Assuming he got sex every night during their 5 year relationship (which would NOT have happened!) it ended up costing him $26,849 per time. On the other hand, Elliot Spitzer's call girl, Kristen, an absolute stunner with a body like no other, charges $4,000 an hour. For anything! Had Paul McCartney 'employed' Kristen for 5 years, he would have paid $7.3 million for an hour of sex every night for 5 years (a saving of $41.7 million). Value-added benefits are: a 22 year old hot babe, no begging, no coaxing, never a headache, plays all requests, ability to put BOTH legs around you (!!!), no bitching and complaining or 'to do' lists. Best of all, she leaves when you're done, and comes back when you ask her. All at 1/7th the cost, with no legal fees. Sometimes renting makes far more sense.

http://www.myfoxstl.com/myfox/MyFox/pages/...mp;locale=EN-US

Nothing in the world makes my blood boil worse than somebody/ anybody blaming society for the problems with our kids today. Happy, shame on you! It is not my fault that your child or the OP's child acts the way they do at this age, just as it is NOT your fault that my child acts the way she acts at this age. Blaming society for this behavior is a pure cop-out for being a lazy parent, end of story! There is nothing different from that and me being blamed for the slavery of the 19th century in American history based off my skin color. TAKE RESPONSIBLITY FOR YOUR OWN CHILDREN AMERICA!!!!!!!!!!!!!!

wendy, i'm confused about your reference to the IAFF....just curious! Christopher.Collins, was that a reference to "lumpy"? Gary Ludwig? I haven't heard that name in forever.....

This was written by a guy...it's pretty damn smart. Girls -- Please have a sense of humor! I never quite figured out why the sexual urge of men and women differ so much. And I never have figured out the whole Venus and Mars thing. I have never figured out why men think with their head and women with their heart. FOR EXAMPLE: One evening last week, my girlfriend and I were getting into bed. Well, the pass ion starts to heat up, and she eventually says, ' I don't feel like it, I just want you to hold me.' I said, 'WHAT??!! What was that?!' So she says the words that every boyfriend on the planet dreads to hear... 'You're just not in touch with my emotional needs as a woman enough for me to satisfy your physical needs as a man.' She responded to my puzzled look by saying, 'Can't you just love me for who I am and not what I do for you in the bedroom?' Realizing that nothing was going to happen that night, I went to sleep. The very next day I opted to take the day off of work to spend time with her. We went out to a nice lunch and then went shopping at a big, big unnamed department store. I walked around with her while she tried on several different very expensive outfits. She couldn't decide which one to take, so I told he r we'd just buy them all. She wanted new shoes to compliment her new clothes, so I said, 'Lets get a pair for each outfit.' We went on to the jewelry department where she picked out a pair of diamond earrings. Let me tell you... she was so excited. She must have thought I was one wave short of a shipwreck. I started to think she was testing me because she asked for a tennis bracelet when she doesn't even know how to play tennis I think I threw her for a loop when I said, 'That's fine, honey.' She was almost nearing sexual satisfaction from all of the excitement. Smiling with excited anticipation, she finally said, 'I think this is all dear, let's go to the cashier.' I could ha rdly contain myself when I blurted out, 'No honey, I don't feel like it.' Her face just went completely blank as her jaw dropped with a baffled, 'WHAT?' I then said, 'Honey! I just want you to HOLD this stuff for a while. You're just not in touch with my financial needs as a man enough for me to satisfy your shopping needs as a woman.' And just when she had this look like she was going to kill me, I added, 'Why can't you just love me for who I am and not for the things I buy you?' Apparently I'm not having sex tonight either....but at least that b*t*h knows I'm smarter than her.

Not at all, the same here.

I'm going to agree with Kaisu on this one. The statement put out there wasn't an insult to the OP. There may have been some misunderstanding on if the OP was verbalizing her feelings about the father in this situation, but the point (as I see it) that is trying to be made is that all the anger towards this "so-called father"/ "sperm donor" may be getting used incorrectly. The energy being used to hate this person should be focused on this child who sounds lost right now, both because he is a teenager and because he sounds to be very angry at someone or something. I also understand Kaisu to be saying that this child needs some "tough love". If this were my child and I got a text message stating FU in any form, the phone would no longer exist. It sounds to me that Kaisu's advice isn't to far off, blunt, yes, but refocusing the anger involved here (towards this childs father) in to a positive for your son may help! I didn't feel as if there was a finger being pointed, just some advice that was asked for.

Thank you Christopher.Collins, and I do agree that the coaches should be the ones in control of the sporting event and their teams, not the parents. My point about the parents is for them to be involved, informed, responsible for their child. Parents these days do waaaay to much pulling up to the doors and dropping off with a "see ya in an hour". The children in these activities need parents to be informed about the "sport", involved with their kids training (as far as making sure they get proper training both body and mind), and being responsible enough to say the dreaded "N" word......NO! I don't disagree with the fact that there is danger, but there is no more danger than in any other sport being played by our children today. Please let me expand! In every sport we have practice (training), we have precautions (helmets/ gloves/ padding/ ect), we have rules (run the bases counter clockwise/ stop at a tap out). I'm not trying to tell you that you or anyone else is wrong for disagreeing with this sport, but as long as the child and the parent work together the way they should....."communication", why is it wrong? The example of Beauty Pageants may be a little over the top for me, but I know what your trying to say, kids should want to do the sport they get involved in, at any age. MMA does look very violent, but it is a mixture of martial arts, and there is tons of training with this sport. These children are taught many lessons that they will carry through their lives, including honor and respect. My feeling about this subject is simple, let them continue without interruption and evolve as any other sport out there has done. If some stuffed shirt came down to watch your childs Tee-ball game, and saw one of them get hit in the face with the ball, would you be upset if he tried to regulate the game so that a "softer" ball would have to be used? We may not agree with it, but does that give anyone the right to step in and control it from the outside? Not in this great nation!!!!!!