checkersfire

i'm just wondering if there is a law in most states against 911 abuse?? if not THERE SHOULD BE. that way in these cases the p.d. could be notified and citations issued. i know it's different for some private services, it they think they'll make a buck they will haul anyone AMR/ABBOTT etc.

Although we've have had some do things close to this, I would almost transport just thinking he was a nut because of calling the rig for this! I would have to assume something is not right with this person. But ultimately, I would contact medical controll. My company would want me to transport (dont' want to lose the revenue). The other concern is if you leave and he walks out into traffic or drops dead on the sidewalk after you leave THERE MAY JUST BE A LIABLITY ISSUE THERE I have had them waiting at the curb with their suitcase waiting on us to transport them to hospital as direct admit cause medicaid won't pay for a cab

i've seen it, never got to use one, the medic that has it loves it. i think there is two of them, one for adults and one for peds. i do know their somewhat expensive though.

nobody is trying to make you their whipping boy, ryder is stating facts. i have my share disagreements with some nursing staff memebers at certain er's and snf's. i am licensed and it's my ass in a sling. like he said your under their wing right now. you may not think so, but you come across here as if you have an attitude, maybe you don't mean to, maybe your expressing yourself the wrong way? i help adjunct medic students in the classroom and for some reason, alot of students especially in the 1st tier or semester seem to have an attitude problem, they have a "know it all" attitude, i've had some that would interfere with my pt care when i was doing my medic runs and the were the emt on the truck and the preceptor had to put them in their place. please take my advise, be humble, do it their way, when you graduate, you can take a chance and do what you want. when your on your own out there, it's another world and it's real humbling when your on your own the first time in the truck and don't have a preceptor there holding your hand. enjoy the experience while you can.

i have been told that the "bevel down" idea works for going thru valves. i have also had an older medic tell me the he has sprayed a shot of nitro on the preferred site and that will make some harder veins appear. i would be careful when and where i tried this technique, i don't think your preceptors would like it very much. as far as your clinical sites. your going to run into alot of asshole rn's, lpn's and md's along the way. you just have to bite your tongue and deal with it until you get your license. once there, you can put them in their place, but make sure your RIGHT 100% or you will completely lose respect and have a hard time almost everywere you go. it seems like everyone knows everybody in this field. your not going to get every iv, intubation in the field. so don't expect to, and ANYBODY on here who says they do is a DAMN LIAR!!!! most medics get an iv around 80-85% of the time and it seems to come in spurts, some weeks you can't miss and other weeks you won't hit even the biggest vein.

No, the starting base pay for emt for example is 8.90 an hour, if you achieve "b" rate its 9.90 and "a" rates is 10.90. If you and your partner are dual licensed (illinois and missouri) you get an extra 65 cents an hour. Only if your on the Illinois side though, the Missouri employees don't have that option. The reason I'm complaining is the fact that they start you out at "a" rate automatically then if you mess up it feels like your being punished, when in reality they should start you at the lower rate and you earn your "a" rate and maybe it would seem different, I don't know. I figure it won't change anytime soon. My main reason for posting on here was to let the other amr employees across the country know what they are trying to implement all over!

They are not technically "withholding pay" they say your base pay is actually $2 dollars less an hour, so its considered a "bonus" if you do everything right.

I can tell you how they stay at "a" rate, they cheat their times!!! They will call en route then sit on scene another 10 minutes or drop the pt off at the er and have their partner go outside and put them "back in service" so their times stop. Like I said, I don't have so much of a problem with the paperwork portion, we can control that. Like mshow stated above, there are some substandard people here where we are that never get in any kind of trouble. I can't understand why? they seem to have the worst bedside manner, are the rudest to the staff at er's and snf's. They shuffle pt's in and out like cattle to keep their times good, to me that's not good pt care at all. Unfortunately, when these ass clowns do this, it makes us ALL look bad and incompetent. I have known people who have done some pretty stupid, I mean REALLY stupid things and still have a job and are at "a" rate and still have their job. I guarantee if I went in tomorrow and even mentioned I might call a union to talk to them, I would be gone by Thursday, and that's no joke, and I have a very clean record except for some absences for when I had skin cancer and missed 2 months last year. The plan looks good on paper, and may sound good to those on the outside, but when you really look into it, the way it's set up here, it stinks. I was asked a couple years ago what I would do different if I were mgt, my reply was do away with the performance plan, and if someone can't maintain an acceptable performance then they would be going bye bye lol. The paperwork issue is just an add on to the total plan, if you can't figure out the paperwork in a couple days, the you really shouldn't be touching a patient they have changed some things, used to, 911 (code 3) calls counted on your times, so if your on-scene at a mvc and waiting 35 or 40 minutes for the fire dept do exticate, your times counted. Now, at least if your call is dispatched code 3, your times don't count. If your called to a snf or mutual aid with a fire dept, it's considered "prior care on scene" which is a code 2 call (lights and sirens) but your times count, even though your doing the same treatment. Also, wait and returns to the dr's office used to count on your times, or if you were waiting for another crew to help you lift a pt, your times counted. At least they changed it so, code 3, wait and returns and lift assists don't count anymore so that's one positive.

I agree, but I would rather lose the instance program in trade for the "times" I also, can fix my times sometimes. But I refuse to be fraudenlant about it, and sometimes that would be the only way to stay at "a" rate. I also agree that they don't get rid of the "dead weight" they need to. I don't understand why, but its' been that way for years. It seems the worse you are, the easier it is to keep your job?

Let Let me tell you something junior, I've been here ALOT longer than you have!! I have seen alot of bs at Abbott/AMR and have heard from people on the Missouri side that have worked for AMR in other regions. They loved it, there was no pp plan, they had excellent equipment etc. The person trying to implement this plan at other places is our own executives from here that have been promoted to the region level! How do you figure a union would bring more trouble? What, with better benefits, higher wages, no more pp plan? I don't even care about the pay raise, IF, they did away with the pay for performance plan and left us at "a" rate. Actually, I don't mind if they left it there for the paperwork, we can control our paperwork, we CAN'T control our times, unless you want to do like the Missouri crews and cheat your times one way or another. I refuse to cheat, I also refuse to give substandard care to meet a time quota! Like I've said here before, when I get tired of it I will leave, then you'll be even more short handed and you can run even more! lol

How far are you from Seattle? I have an old boss/friend that is a cop there and I have been considering coming up that way.

I don't know either. The rumor going around here is that it is over whether to sign 3 yr contract or 4 yr. I believe it has to be more than that. Who sponsors your union? Here the only ambulance private service that is union is Gateway and that is backed by the teamsters. They do have it pretty good. Their previous owners almost lost the company by some misconduct, but they were just bought out and making a come back. Their emt's start out at $14 an hour and medics at either $19 or $20 an hour. Thats why amr is losing alot of people here to them!

My apologies to the snf nurses on here. If your a snf nurse that was prior ems then I wasn't referring to you at all. The snf nurses with prior ems experience and er nurses are the ones that will give you the decent pt care report when picking up a pt and will listen when you are dropping off a pt. You can always tell the difference. I'm not joking when I say though that around here there are some idiot nurses in our snf's in the st louis area, I don't know if its that way in the rest of the country? I know we have some morons in this field also. I get disgusted when I go to pick a pt up on a serious call (they have advised dispatch that its non-urgent) when it clearly should have been an "emergency" call, then when you arrive, they are at the desk and the pt needs to be intubated (I had that actually happen recently) the nurse was at the desk, handed me the paperwork and says "the pt is in room 108 and ready to go" I get there and they are breathing 40 times a minute and labored. I wasn't a happy camper, but you can't say anything to them, they complain and then you get in trouble for pissing off a customer. Again, my apologies to the "good" nurses on here I may have offended.

Some of you seem to be confusing the issue here, or at least not getting it!!!! Example: I explained about the times, 31 minutes bls and 42 als. If I am waiting at the p/u for 35 to 40 minutes for the facility to get the pt ready for me to transport (I'm talking about non-emergent calls), and I get to the destination and have to wait another 15-20 minutes for an rn to sign and take over pt care or just waiting on a bed, then my times are shot and I just lost a dollar an hour, or if my truck breaks down while your still on scene your times keep running (I know because it has happened to me before) I was considered to be on-scene90 minutes waiting on the tow truck. These things are BEYOND my control, has nothing to do with my skills as a medic, but I still lose just the same. I don't have a problem with them docking my pay for substandard paperwork nor anyone else's. Paperwork and pt care you CAN control, just not your times. They don't count your driving times because frankly if a crew was in an accident and told the court they would be punished for driving times, I think there would be a nice little lawsuit there? Many times we are dispatched to p/u at a snf or hosp when we are 5 minutes away, normally there is a 30 dispatch time. I can't justify taking 30 minutes to get to a location when I'm posted less than a mile from there. But when I call on scene, my times start rolling and if the pt isn't ready, there is nothing I can do about it. Now and then you will get a dispatcher who will tell you in advance a call is coming out at a certain time so you can time it right, but that's not the "norm". So I have heard people on here praising this plan, who doesn't really understand the whole idea!! Yes, there is a 60 day grace period as a new hire, and you stay at the higher rate of pay from the start until you mess up, so basically everyone expects it. The thing that really pisses me off (pardon the french) is that a couple yrs ago, I was in financial trouble, had to file bankruptcy. They called to verify income, they gave them my "a" rate of pay, not based on "c" rate. I filed the chapter 13 payback plan were your payments are based on your income. The company denied the different rates of pay when the lawyers questioned them during the bankruptcy. If your ashamed of your policy, then don't have it. If your not ashamed up then why are you denying it? Still havn't got a straight answer on that one and probably never will lol.

Thanks Dwayne, that's exactly what I was trying to say. The only thing is, they don't care so much about the pt care part of it. If you mishandle a pt, some misconduct etc, depending on who you are, you might get corrective counseling, a day or two suspension. If, you happen to be someone they want to get rid if, then you will be terminated for fairly minor offenses. I don't think the company sucks, just some of the mgt. I have been with them many years and have seen some good emt's and medics come and go. What I have been trying to tell people on here (mostly the amr folks) that may end up with this plan, because I hear that amr actually likes the idea, is that you may end up with the same plan and it stinks. Our morale is at an all time low and it's because of the "a", "b" and "c" rates. Another change was implemented, now if you can't have the pt sign the back of the form, you must get a proxy (which has always been the case) but now you have to document in the "objective" section why the pt can't sign the report, and if it isn't an rn proxy at the snf or er/destination, then you have to also put in their address and if you don't you drop in pay again. I just think our pt care should come FIRST and all this other crap second. I guess also what I'm trying to say is, it does affect the way our people do pt care. I have been at "b" rate because of my times, I refuse to lower my standards and like I've even told mgt, eventually, I will become tired of losing my pay and I will leave and go somewere else to work. I do know crews (both emt's and medics) who have/will give poor patient care to stay at the "a" or "a" plus rate, will commit fraud, forgery, cheat their times etc. We have an excellant Medical Director, he told me he didn't even realize this plan until a few weeks ago, no one had brought it to his attention. He knew their was a plan, but the way it was explained to him it wasn't punishment, but reward. Our employees have heard the last 8 months or so (since we were bought out by amr) that there was going to be a big change in April. My point is, I know of about 4 medics and 6 emt's that are leaving in a couple weeks if it doesn't change. We can't afford to lose anymore people, we are so short handed now, I could work my 16 hours a day x7 days if I wanted because of the staffing now. emt's aren't so in demand right now, but it only takes approx. 4 months to train them, it's a little longer to get a medic through. Maybe someday, someone in this company will wake up and change things for the better here and we can keep people.