46Young

Well put by you as well. Fire based EMS is generally unpopular by single minded prople for several valid reasons, but the truth is that, in most areas, you'll enjoy the best pay, benefits, and career advancement w/ fire based EMS. The bottom line, like you said, is to do what is best for you and your family, and to do what you can to change things if you're in a secure socioeconomic position to do so. Why martyr yourself? I say, educate yourself, move into admin, set policy, and effect change from a position of power.

Many good times with the ladies there, Bayside's best! Back in the day I would hit hit 97 then 98 right out of Jamaica to show in your area, and not get jobs out of Jamaica (it worked for anywhere, really), unless they were good, then we would buff them. I used that all the time to show at National/Roosevelt (46 Young) or Winchester/Union Tpke (53 Young). 97 would current you back in your batallion, and then you would right away hit 98 like you made a mistake by hitting 97, like you didn't know. I miss it. I've been tossing oround the idea of going per diem back at North Shore, even though I'm down in Virginia. Just for kicks and giggles. No one's mentioned "RMP" for a cop car. How's dispatcher 869, "Ed" doing? GOVAC! 93 signed and witnessed, music to my ears! Even better, 93 refused all! "My partner's using facilities."

If anyone is looking for work in NYC as a 911 prehospital EMS provider, this link may be of some use: http://nycems.blogspot.com/ On the right side of the page the 911 participating hospitals are broken down by borough. FDNY EMS is there as well, but they're easy to find regardless.

Like everyone else said, I always put down "negotiable." When discussing compensation during the interview, I like to leave that until the end, when they ask you if you have any (other) questions. My questions leading up to compensation will always be about company ops, schedules, basically everything about the company so you don't look like you're most interested about the money, whether you are or not. For pay scale, I'll simply ask "how do you determine compensation?" It's a pretty open ended question, and it's the smoothest way I can think of to ask the question. If they ask you for clarification, ask if it's step based, merit based, is there a contract, does everyone start at the same pay, or is your pay commensurate with experience? After that, you should ask if there's night diff, if all hours are compensated or paid on call after a certain hour in the evening.

If scheduling 50 firemedics for ambulance poses "logistical" problems, that can be easily solved by making everyone dual role. Just kidding Seriously, if ALS first response in a relatively densely populated area is unnecessary like Dr. Tober says, then can't EMS admin go above the fire admin to the Board of Supervisors (or whatever the local governing body is)? Having unnecessary ALS surely costs the county a pretty penny. Speak actual dollars and cents and you have a shot at cutting through the FD propaganda. Espacially if the county has implemented any tax hikes to cover basic services.

Some Pub Ed is in order as well. At least in the case of a 48 or 56 hour workweek with 24's, the public needs to realize that for every five 48 hour employees, they get a "free" worker regarding not having to pay for medical, training, admin, sick/personal/vacation time, equipment, retirement and such. Every five 56 hour employees save the expenses of two additional employees. In addition to that, for fire based employees, the FLSA thing has them getting paid straight time, plus a little supplemental comp, certainly well below time and a half. Regardless of a 16 or 24 hour shift, "safety naps" are beneficial to your health, pt care, and safety on the road. Besides, if we're idle, that means no one is in crisis at the present. Also, on the overnight, even for an 8 or 12 hour shift, any rest lessens the disruption to your circadian rhythms and makes it easier to return to baseline on your time off. Enjoy. If a supervisor knocks on your window, tell them that you didn't see them coming up, or that you were actually closing your eyes for a moment, in meditation to try to alleviate your "migraine." Or just say "amen" if your window is down and someone shakes or taps you awake. If you're urban, try and look for a city park, or the back of a strip shopping center to post. If you back into a loading dock ramp, the angle is quite comfortable for sleeping in the cab. I used to park out of sight in a playground at night behind the restrooms. I was only bothered once by a junkie beating my bus with a plastic sword, but that's a whole other story.

These jokers are amateurs. Everyone knows that you're supposed to wear dark sunglasses when you're trying to take a nap in the rig. No one can definitively prove that you were sleeping. If someone asks you why you're wearing sunglasses at night, simply reply that you suffer from migraines, that they're triggered by light, and yo've been successful in not having them by limiting your exposure to light in between calls when you're idle. Also, I used to sleep in the back of the bus. You throw a couple of blankets over the rails and the feet, one for your head, another to cover yourself, crank up the A/C, and you'll sleep like a baby.

If that were the case, then one could argue that having a mandatory, out of service meal break shouldn't be an issue since there's adequate coverage otherwise. It's desireable to work that into the contract earlier on, in case they fail to expand coverage and staffing in the future to keep pace with population/business growth.

We use the Phillips as well. When we used the LP12 (haven't seen the LP15 yet), it was set to II, III, aVF. It was explained to me that the inferior leads show first so that you can quickly go into diagnostic mode to accurately view any ST changes in case you were considering giving nitro. If those leads are clean, you can give nitro before setting up the whole 12 lead. The thing is, it's desireable to record a quick 12 in the house before initiating ntg, in case the ischemic changes return to baseline before you can record them. The absence of such evidence can negatively affect their in-hospital Tx course.

When I worked in Charleston SC they had a "no need for EMS" protocol where the crew could refuse txp. The thing is, no one wanted the potential liability, so no one used it. Anyway, it's the best when we're called for BS and the family follows the cabulance to the hospital in their car. In the time they called us, we responded, evaluated and transported, they could've been to the hospital two or three times over by car.

Interesting. Was this decision based on the city's own cardiac arrest data? Or was it from studies from other regions? Would you be able to provide the names or links to such studies if that is the case?

Thanks for the reply, that's what I figured after googling Contra Costa EMS. I know that the FD has a strong union there, but they're currently facing brownouts, possibly layoffs and other issues. If AMR has the contract for another few years, then there should be no problem, as long as the partnership with the county remains profitable.

8-11 an hour in Pittsburgh may be equivalent to 15 an hour in a large city like Boston or NYC. 15 an hour in these cities won't get you very far. I made 32/hr in NY as a medic and that was barely enough to pay the bills without OT or side work.

We have the same EMD issues over here. The 80 y/o male who's dizzy while sitting is low priority "BLS" while the 32 y/o female with a H/A is a higher priority "ALS". ( as an aside, I understand Kiwi's position on the antiquated concept of BLS and ALS; it's still our current system, however) Our dispatchers are not required to have any EMS training. Blindly following the EMS protocol cookbook makes for poor pt care, and blindly following the EMD cookbook makes for equally poor dispatching. Each day an agency uses SSM, Jesus kills a kitten.

Asst Chief Daryl Louder of the Fairfax County FRD has been named the new Contra Costa (CA) Fire Chief. As I've mentioned before, Fairfax County Fire does all 911 EMS txps. I noticed that the CCFPD has engine medics and no txp services. I'm wondering how the county's EMS txp is run. Is it all private? Third service? Some fire txp? If you're working there at a private agency, or know someone that is, I would get a plan B, a contingency plan in place, in case "you know what" happens. I'm sure that Chief Louder will strongly consider the prospect of absorbing EMS txp duties. He's our Asst Chief in charge of Business Services, after all.

I hear you, but the OP was comparing apples to apples with FDNY EMS vs the NYPD and the FDNY. The cops weren't getting paid jack until this last contract. Rookies were getting around a 25k/yr rate out of the academy and not much over 30k as the first raise. At least their salary is somewhat liveable if your spouse works, or if you're single. The NYPD couldn't hire anybody with those wages, so they had to sweeten the pot. The problem with EMS is that there are a ridiculous amount of EMT's and medics coming out of school on a regular basis. The hospitals pay the best, with the best working conditions, so many will apply to FDNY EMS for the benefits and pension, as a better alternative to the privates, to gain experience to qualify for a hospital spot, or to backdoor into FDNY as a FF. The supply and lack of strength in their union is keeping wages down. FDNY EMS only gained uniform status recently as well. My understanding of the pay structure is that rookies and employees with < 5 years OTJ are paid at a much lower rate so that the tenured employees can enjoy higher wages. Attrition typically happens in the first five years. Cops were/are leaving the NYPD for Nassau, Suffolk, or better jobs with state or county police in other parts of the country. FDNY keeps theirs because it's simply the most desireable place to work. We've lost FF's here to FDNY that took a 30-50% pay cut to get on. Many here despise unions, but offer no effective and realistic plan for EMS organization otherwise. Look what the UFA has done for the FDNY throughout the years: http://www.ufanyc.or..._us/history.php Compare that to some podunk FD in the Deep South ("the war's not over, it's only halftime, boy!"....... whatever) in a right to work state. Compare those results to your EMS agency. You'll need the protection if a FD attempts a merger. You even have fire attempting to gain market share in Lee County FL! No region or agency is immune. But most here think that all unions are evil,and that their agency will always do right by them based on past history. I'll bet that your union would see to it that fire would never have a chance at gaining EMS market share in your country. I'm liking your meal break provision here as well. Most over here don't have that, and just have to deal with whatever the agency says, for lack of effective opposition. It's a shame. If FDNY EMS was more on point with salary, conditions and all, like fire and the hospitals, I would have accepted the medic position back in '06 and been happy. My two cousins left FDNY EMS for NSLIJ so they could be paid better and be able to raise families with less issues. One of their husbands is a FDNY EMS Capt. He's had lucrative admin offers in other states, but his wife doesn't want to relocate. I don't get why you guys could never get the 20 and out like other depts.

+1 on the comments from Bushy and Jonas following this post. Also, kudos to Kiwi's system for doing right by the employee. "Mr or MRS I need t o fill my face," huh? Food taster jobs? I don't get hungry or have the need to relieve myself while running for hours on end? Are you kidding me? Your piss poor attitude makes EMS admin as a whole look bad and uncaring. Along with low pay and lack of career advancement, major factors that cause burnout and otherwise make EMS unsustainable as a career are long work hours without breaks, having frequently interrupted meals, and mandatory holdover. What is your agency's policy on forced OT? Speaking of holdover, why is it right to keep someone working a 24 hour shift for an additional 12 or 24? I can see doing it in rare circumstances, but not carte blanche. Or even 8 more on top of an 8 hour, 4 on 12, or whatever. My third service experience for Charleston County EMS included frequent 12-24 hour mandations within the 24/48. My schedule resembled a 36/36 or 48/24 on a regular basis. In addition to that, they used the toughbook e-PCR, so reports could be signed at the ED and faxed within 24 hours when completed. Because of this, we would often get another call U/A at the ED, or only a couple of minutes inside. You have to take it. Forget breaks, we would often be moved for coverage at night like SSM. No official breaks, mandatory holdover OT/mandatory recall, dispatch before availability at the ED and constant call volume for hours on end are all proof that a service doesn't provide enough units to handle the volume. If you stop trying to do more with less (at the employee's expense) and properly staff, these issues will no longer be issues. Sure, if you don't like it you can quit. I did my time in hosp based EMS and county third service EMS. I kept quiet and did my job well, waiting for the opportunity to leave, as do others who are unwilling to tolerate poor working conditions, pay, and benefits. Where I am now, we have a mandatory no hold/recall list that we fill out to be exempt if we have travel plans, need to care for a sick relative/spouse/child, or have a doctor's appointment (thanks local 2068!). We also cannot be assigned a call while showing at the ED completing documentation. You probably think that SSM is the best thing since sliced bread.

The solution my old hospital came up with was to pay 37.5 hours on 40, with 1/2 hour meal break on every eight hours. For in hospital personnel, it was easy to do. For EMS, it was obviously different. We're given 30 mins on an 8 hour, 45 min on 12, and 1 hour (can broken into 1/2 hour x 2) on 16. You must monitor the radio on break. You can also be pulled off break for an emergent call. The thing is, if you're pulled off your break and don't get another, or work straight through your shift, you're paid time and a half for that 30 mins, 45 mins, or hour. Fair enough, I think. These aren't 24's and it's a busy system with fairly constant call volume. Richard B will tell you, in NYC 911 you can request a 10-100 or "facilities", for two ten minute breaks on eight hours. My understanding is that on a 100 you're less recommended but can still be given a job in certain circumstances. For facilities, they'll call you, and you must answer, but can refuse the job by saying "My partner is still using facilities." Richard B could give us the most accurate info.

Oxygen needs Chuck Norris to live. Mr. Rogers wouldn't stand a chance.

When I worked in NYC we affectionately referred to the FDNY CFR's as "The Circle of Death".

One of my EMS LT's clued me in to this site. It's primary focus is for emergency services in the Greater Tri-State Area, NYC and it's surrounding areas, although topics from around the country and beyond can be discussed. http://www.emtbravo.net/index.php?act=idx What stands out to me is that the site has dedicated sections for firefighting, EMS, law enforcement, communications and explorers, and even a section for general emergency services discussion. It's toward the bottom. I've only looked at the NYC section under local forums so far, and I haven't seen much in the way of EMS vs fire tensions. There are as many fire topics as there are EMS, and nobody's trippin'. I admit, though, that this can be explained by the fact that there are no dual role jobs in the area. I've seen some ask about FDNY EMS and NYC 911 EMS in general. This would be the place to explore.

The OP'er wants to be a FF/medic. Here's my advice: Keep your day job, go to EMT school in the evenings, and work per diem afterward as an EMT. If you're willing to take a 30k/yr pay cut, that means that you could potentially save 20k cash each year, in addition to any EMT side work. 40k in two years, 60k for three years. The Frito Lay benefits will likely be much better than any private EMS service, and jobs are scarce nowadays. I highly recommend getting your medic trough an EMS AAS degree. It'll make you a more proficient medic than most in regards to book smarts. Also, the fire service values highly those with degrees nowadays. Promotions either require degrees or give weight towards promotional list scores to put you near the top. If you have a degree coming in, you'll climb the ranks all the quicker. The sky's the limit, and there's so many directions you can go. You'll need to decide if you want to do the EMS degree where you are, or out of state. In either event, you can knock out all the pre reqs and fluff classes (gen electives, psych, soc, etc) before you enroll so you can hold down FT work hours if you need to. You can use the 40-60k savings to live on if you can't find FT work. The Frito Lay job may not jive with the medic school schedule, unless you run your own route and can structure your route around school. I used to work on a snapple route in my early 20's as a driver and also preselling before I got my EMT. That 40-60k will also make a great down payment for a house after you get through your rookie year. You could also invest that money in deferred comp and have hundreds of thousands in retirement. Ask me how. CA, OH, and FL are oversaturated with medics from what I hear. The Carolinas don't pay much for the most part. Forget about getting on in NJ and NY. You can apply back home regardless of where you move, but you'll have a fairly easy time getting on in the MD/DC/ Northern VA area. Don't confuse getting on with passing the recruit process, though. My dept as well as others have an ALS ambulance internship process that must be passed in order to be released into the field. Fail and you're out of a job. I hope you're generally interested in EMS, because you'll be riding a txp unit at least as much as a suppression piece, no matter how long you're on the job. If you're just using EMS as a free pass onto the dept, you'll be miserable. We take EMS seriously here. You can't drop your medic unless you promote out of it. You'll be let go if you do. Don't forget that you need to pass the entrance exam, CPAT, medical, poly, and psych. You could have your medic by the time you're 26 or 27, and be hired before you're 28 if you do it the way I suggested.

http://www.nytimes.c...n/02mental.html Thoughts?

One thing I forgot - try taking in a deep breath, hold it, and bear down while lifting. It gives you an extra measure of protection, and the momentary increase in BP hasn't shown any advserse effects to my knowledge.

I had to use those one man stretchers for the first two years of my career. The toughest part was lining up the cot with the pins. If you miss, you're manipulating the cot from the bottom again. With four people, we would cross our grips over, forming an "X" with our near arms. I still use that technique to lift pts from the cot to a hospital bed. Anyways, the average EMS worker isn't exactly the picture of health. Long hours, frequent OT, interrupted sleep, sitting for extended periods of time, lifting the obese in awkward, mechanically disadvantageous positions and eating fast food and 7-11 due to lack of options takes it's toll. For the OP, to do the job and hopefully remain injury free, you need to realize a few things: A&P will teach you that the various muscles in your midsection run at all different angles. This is effective for protection if you train these muscles properly. Do prone planks, side planks, hanging toes to bar, ab wheel rollouts, turkish get upss and olympic style front squats (OSFS) to name a few things. Your posterior chain is where your strength from, and glute activation is the key to knee stability among other things. Deadlifts and romanian deadlifts are obvious, as well as glute ham raises, hyperextensions, bulgarian split squats, lunges, and snatch grip deadlifts. Most lifting in EMS is front loaded. Deadlifts, OSFS's, rows, renegade rows, sandbag carries and farmer's walks will get the job done . Moving a pt from cot to bed requires a strong pull in addition to a solid core. Pullups, rows, cable rows, and one arm DB unsupported (standing with free arm not resting on anything) will do. Don't forget shoulder health. Face pulls, the waiter's walk, power wheel/frisbee walks, scapular pushups, YTWL, scapular wall slides, and "reverse" shrugs while hanging from a pullup bar should bulletproof your shoulders. Most if not all lifting should be done from a standing or kneeling position just like on the job.