46Young

To make any appreciable amount of money, you'll need to work in NYC. BLS pays around 10/hr for privates, maybe 15-22 for 911 participating hospitals. ER techs can make 15-20/hr as well. Working conditions are poor in the privates, but are decent at the hospitals. It's easy to get hired by a private, but difficult to get hired by a hosp. (except North Shore LIJ CEMS) without any prior 911 experience, or an "in". CNA's make anywhere from 10-15/hr, check openings at the hospitals. 1 BR in a decent area runs 1000-1200/month. 2BR maybe 1500-1900. Car insurance is oppresively high. Also, I would focus my energy on an ER tech or CNA position at the hospital. If you want to break into 911, apply to a hospital system that has an EMS agency, such as NSLIJ or NY Presbyterian, so you can focus on getting hired from the inside. Working conditions in the hospital will trump that of the street, and is way more school friendly. If you want to go RN (challenge the medic afterwards) there are many schools available, and plenty of employment available post graduation, unlike elsewhere in the country. The city did have a program that gave aid for those wishing to pursue LPN school. you can look into that, also. Medics make around 20-22 in the privates, and 22-32 in the hospitals. It's typically been easy to get hired with FDNY EMS. The working conditions are horrible, though. http://nyc.gov/html/...ts_042607.shtml When you park your car, lock your steering wheel with the club lock facing the dash. This makes it way more difficult for the perp to pick the lock.

Unfortunately, we live in the age of entitlement. The vast majority of minors nowadays are raised in an extremely lax environment. Is it due to the single parent not spending enough time at home, and therefore feels guilty to give discipline? Are both parents working so much that someone else (or the streets) are raising their kids? Do the kids threaten to call the cops when corporal punishment is attempted? Are the parents just soft? Are the parents too afraid that their children won't love them if they don't buy them everything they want, and do everything for them at home? Who knows. I believe that children that are made to work a PT $hit job during the summer or a couple days a week while in school to pay for clothes, dates, a beater car, etc will build character, teach the value of a dollar - to include saving and investing, and also to appreciate a real job, a career quality job when they earn that right after much sacrifice. Entry into EMS is all to easy. Many that I've come across don't take the job particularly seriously, like they're doing the place a favor by showing up, as they're destined for bigger and better things, and the job is already beneath them. It shows in pt care, driving, appearance, timeliness, badmouthing the company (they don't pay me enough to do this the way they want), language, and disrespect for authority. Many who get their EMT and then go to work right away don't take the job that seriously. They are most likely single, living at home, with no overhead other than car insurance and clothing bills. If they get fired, it's no big deal. Professional pride should be an innate quality, or at least a function of a proper upbringing. However, this is the real world we're talking about. Generally speaking, the level of professional pride appears to be dependant on several factors - difficulty in getting hired, compensation/benefits, treatment by management, and proximity/availability of similar places of employment. When I started my EMS journey at hunter Ambulance-Ambulette, a fine pulse and a patch IFT operation (per diem, can't live on 9.50/hr), there were plenty of bottom feeders, including one medic who would routinely spend an hour on the floor (no exaggeration), and an hour at the drop-off, citing poor pay. NSLIJ CEMS was at once THE place to go, and still ranks high as an attractive employer. That place was run militant, very busy IFT, mandated L/L updates when greater than 20 mins onscene or at destination, strict uniform/grooming policy, shoe buffer in the hall, etc. It takes time to get hired there, and many are turned away. The pay is competitive for the area. You can also work 911 or IFT depending on the shift. The employees are expected to up their game as such, and for the most part do so. However, things like overbearing management, rearrangement of schedules every 9 months, lack of OT have resulted in turnover and disgruntled employees as of late. Charleston County EMS was also run quite strict, as they are the highest paying 911 EMS agency in the region. They eat their young with a ferocity not seen in other agencies. the employees there are forced to behave, but look to leave at the earliest opportunity. The hiring process for the Fairfax Co FRD is lengthy, including a polygraph. The pay is stellar, as well as working conditions and benefits. Completing a lengthy academy is required prior to going out into the field. Many regard it as a career, and therefore come correct. I know the last example is fire based, but you can use any quality "go to" third service agency to serve the same example. The higher the caliber of employer, the more selective they can be in hiring, and the more demanding they can be of their employees, to include education, so long as the employees are treated well regarding working conditions, schedule, forced OT, leave policy. If you're a slacker, they'll drop you like a hot pop tart. I've also noticed that those with a military background generally have a higher percentage of those who take pride in their job and do it well, even if it's a crappy stepping stone agency.

http://www.emsresponder.com/web/online/In-the-Line-of-Duty/NC-Responder-Killed-in-Ambulance-Crash/2$10835

Fire asses, huh? Funny that you haven't said jack about the AMR crew that "didn't notice" that traffic had stopped in front of them, then turned into the oncoming lane, and then hit that guy's car, killing them. Running over the homeless man was negligent sure, but it wasn't intentional, in that they didn't see him and then purposefully run him over. The AMR crew failed to scan the road ahead of them, which suggests in strong likelihood that the driver was distracted, perhaps talking/texting on the phone, maybe eating or drinking, or playing with the radio. The driver killed that man. The driver was also criminally charged as well. I don't see you jumping all over THAT story, calling for their jobs, their heads, whatever. Give it up already you hypocrite. http://www.emtcity.com/index.php/topic/16667-news-feed-man-dies-in-collision-with-florida-ambulance-jemscom/ I know you've seen this, as it's been on the main page when you've been online, don't feign ignorance by saying that you haven't seen this thread.

Hey NickD, I understand the importance of presenting yourself as a valuable potential asset to the company during the interview. However, prior to hire, matters such as salary, work schedule, benefits, leave policy, paid time off, selection procedures for promotions, deferred comp with match, etc. etc. need to be discussed. Several weeks or months into the job isn't the time to be learning these things, as they ought to be in writing prior to hire. So, if not at the interview, when and where should one address these concerns? All too often certain things are promised to the new employee (verbally, not in writing), and not delivered. "We've had a recent change in policy". "We never said that." "Where did you hear that we were giving (XYZ) benefits?"

Before half of the community barfs out hateful comments toward the fire service, let me say this - Entire too many individuals spend their energy complaining of perceived injustices. In this case it's about FD takeovers of EMS, or more specifically a thwarted attempt to gain back a littile ground on that front. In other cases, in the general population as well as EMS, many are complaining about those that receive pensions when their life savings took a dive. Instead of wasting energy venting frustrations, efforts would be more productively spent bringing your situation up to the level of which you envy, not trying to bring others down to a lower level. Look how this attempt at reversal was easily dismissed. Strong political organization (easier with unions) is the only short term solution to improving your situation. Look at the ease with which this attempt at a private takeover was squashed. The opposite tends to happen, all too often when a FD decides (decides, not really asking for, due to political connections) to take over EMS duties for their region. Strength in Solidarity isn't a simple catch phrase. Some unions are corrupt, unions won't always save your job or protect benefits/perks, but the likelihood of protecting and advancing your position is much greater with one than without, generally speaking. Fight fire with fire. You have to be in the game to win it. I don't see any other way.

I'm guessing that they weren't running hot. If you were, you would certainly notice any slowdowns/stoppages of traffic in front of you. Admitting that they didn't notice the stoppage is admitting that they were distracted in some manner and not paying attention to the road. Hence the citation.

No, the guy didn't jump out IFO the truck. He did lay down IFO the medic unit's bay, however, when he could have opted stand up and be seen. If he was only trying to get their attention, why would he reduce his profile so as to be less likely to actually be noticed, increasing the danger of being run over? An elderly person passing out at the bay is quite different than someone deliberately walking over to and then laying down at the same place. The call location would have actually been IFO their bay (or at least station) and not one down the block. Same thing for the businessman. The medics hold blame for not looking, no argument there. I'm assuming that there are no dept SOP's in regards to checking IFO the rig before responding, or these FF/medics would likely be out of a job or at least suspended or something. Actually, your post #22 provides an article that states that there wasn't an existing SOP to that end. Blame the dept for that one. Many SOP's, GOP's and operating manuals are devised to prevent recurrences of prior accidents and fatalities. This seems to be one such case. In the case of the businessman or the elderly person, they wouldn't be deserving of their fate. The victim in the article had an active role in the incident. He suffered the consequences of his actions. That preplanned course of action is what alters the assignment of blame in this case, apparently enough to absolve the crew. As far as the jumper up, if they end up a jumper down it was their decision. It doesn't mean that I won't try my best to dissuade them, but if they jump, it's out of my hands, and whatever injuries they incur was their own doing. I never said that the victim in the article has less of a value as a human being than the next person, just that I can't feel sorry for someone who intentionally puts themself in harm's way for no good reason and then succeeds in actually getting injured. What did you think would happen? Life isn't a cartoon where you get run over and in the next frame you're good as new.

No, the FF/medics were guilty of some level of negligence for failing to see the victim, but the victim DID lay down at that exact spot (not standing up, but lying down out of sight), at that exact time, for a specific reason, as he expressed suicidal ideations as motivating him to do what he did. He's as much to blame as the FF/medics. Maybe more so, as the law cleared the crew of any wrongdoing based largely on the victim's own account of the event. He made a conscious decision to do what he did. Alcohol may have been a factor, sure. He also made the decision to drink the amount of alcohol that he did. Darwininsm, just like the former EMS employee that was crushed to death by the bay door.

Regarding the first paragraph, a CCEMT-P with a bachelor's, such as EMTinEPA suggested earlier could have the sufficient knowledge base to do the home care thing. That's dependent on the course material, naturally. The CCEMT-P with a bachelor's ought to be able to perform well inn CC txp's, and perhaps NICU's and PICU's with specialty training. Ditto for flight. As far as needing college to have any credibility as a pro education spokesperson, how about cutting me some slack. I already have A&P and pharm. After medic school I worked OT frequently as well as per diem jobs for two years, to get out of debt, and then to fund investments to provide my family with some measure of financial security. I then moved to Charleston for 6 months. Then it was a 9 month internship/recruit ordeal with Fairfax. The Fairfax career is proving way more lucrative than having an ASN or BSN. I now have the option of pursuing those goals, already being financially secure. Now I'm completing my rookie year. I spent those 9 months prior making only 53k without incentives, so I've spent my time post academy working OT and a side job, as before. We plan to buy a house soon. It's all about priorities, what's most important at the present. Did I not start the thread "RT vs RN" to ask for educational advice? Those wheels are in motion for the spring semester. It just so happens, as I've come to find out during a conversation with a colleague at the ED today, that NOVA CC's paramedic program is an accredited assosciates. Why is this important? It's important because the Fairfax County FRD sends selected employees that submit a letter of interest to the FRD to NOVA to earn their paramedic cert. Fairfax sends their employees to college for a paramedic assosciates. No fast track medic mill here. The dept also seeks to upgrade all their I's to P's when economically feasable. Fairfax no longer hires I's to function as ALS providers, to my knowledge. Score one for the fire service. I knew that I came to the right place. I did a quick google search and found this: http://education-por...n_virginia.html Look to the Annandale campus, not Tidewater, which is down near the Va Beach/Norfolk area.

That's not a bad idea, just that you'd need to convince employers to get onboard with that. Tell them that they could stop using RN's to do CC txp's, and instead bill for the CC medic at a higher rate. Perhaps CCEMT-P's could muscle in on the RN home visit sector. Another income stream for the agency.

I've asked several times on this forum and others as to how this positive change will come about. I only get vague answers claiming that education will force change, education plus organization will force change, but no concrete plan of action. I've suggested that EMS learn from the IAFF's success and employ a similar strategy. Or form unions to better their deal at their particular agency. Just think, the union will demand higher wages, better retirement, working conditions, medical, so on and so forth. Management will scoff, of course. The union can come back with a suggestion that management meet them in the middle if they all up their education to a degree level in an agreed upon time frame, as a condition of continued employment. A higher quality provider deserving of this generous deal. Having successfully bargained for a better deal, other EMS professionals will seek employment there. They'll also need degrees to apply. Other agencies will lose their best employees to this one. Other employers will be forced to increase their salary, benefits, education requirements, etc. etc. to match. Just one possible scenario. At the present, I don't see many in EMS going the degree route solely for a career in EMS. Not without a federal mandate or a livable wage and decent retirement to attract the more highly educated. EMS missed the boat on increasing education. Many use the field for a quick way to make some cash without spending years in school. Since most that enter the field are doing so to earn a living without having to go to school for several years or so in the first place, then it's quite a stretch to believe that individuals in the future that enter EMS for the same reasons would voluntarily go the degree route without an immediate lucrative payoff for their efforts. RN's, RT's and others went the education route first, citing pt benefit, then increased insurance reimbursement, then salary/benefit increase, but the EMS workforce is of a different mentality.

http://www.firerescue1.com/fire-news/597966-fla-firefighters-cleared-after-running-over-homeless-man/# Thoughts?

+1. The idea sounds good on paper, but there are many who won't want the inconvenience of hanging around and mailing a voucher. They'll just reason that the next passerby would call. Those who would vote that into law would be unpopular and hurt their chances at re-election, especially if there is a large population of the socioeconomically disadvantaged in that city, who use 911 for EMS more frequently than other groups, statistically speaking. The media will eventually credit some death out in the street to a delay in calling 911 due to the new law. It would probably be good grounds for a lawsuit against the city as well.

At my dept the first promo to tech (EMS, Hazmat, Trot, Apparatus) gives 10% weight to education. For Lt's it's 20%. For Capt I and above, it's 25%. I'm suprised that more depts in this region don't require 2 years college. The FDNY dropped their requirement from 60 credits previously to now just one year or 6 months FT experience. FD's, PD's and EMS agencies alike are requiring education nowadays for promos, and rightfully so. The problem is, there's way more opportunity for advancement in a FRD or PD when compared to EMS. We just promoted 31 new Lt's this quarter. This is done through oral boards and objective exams, afterward being placed on a list. In EMS, there seems to be way fewer opportunities for upward mobility in the system. Fewer supervisor positions available, fewer specialty niches to shoot for. Additionally, the promo system may not be a competitive list, but frequently based on favoritism and cronyism. Hospital based systems do offer more of an opportunity for advancement to other areas of the health system, but typically no pension to speak of. So, take away the likelihood of your degree facilitating upward mobility, there's little motivation for many to go the degree route for the P-card, unless they want to parlay that into another healthcare related degree. But then, they're leaving the EMS field as their source of primary employment anyway. You'll need a large percentage of degreed paramedics to make effective any organization and lobbying. If the money's not there, many will go the path of least resistance, and the one's with degrees will look for a better deal before too long. Catch 22. The EMS profession started out strong enough, but then stalled out. sure FD's had a large hand in that, but they weren't the sole offenders by far from a political standpoint. As far as the existing workforce, each and every EMT and medic currently employed and not holding a paramedic assosciates is to blame for holding back the profession, myself included, opting for easier alternatives. Start assigning blame there.

For those that don't know, most units in NYC are staged on street corners, the "89". Go watch any unit in the city, any time of day, FDNY EMS or NYC 911 participating hospital alike, and watch when they get a job. It's a safe bet that no one gets out of the bus and does a lap before they go 63. Even if it's at night and they were passed out before being awakened for the job. I know that I never did. Nor did anyone else I've known. When I worked 46 Young T1 at the old 89 of National/Roosevelt, IFO the Walgreens there, there were quite a few drunks lurking about at all hours of the night. I've frequently observed them sleeping on a park bench, up against a building, on the corner, in the gutter, once on the double yellow in the middle of the street! I've gone 63 and noticed that someone fell off my back bumper. Twice. Some drunk decided to sleep on the back step. It's not a stretch to believe that one could go nite-nite IFO the front tire in the gutter. I've worked several "man under" jobs at a couple of 7 train elevated platforms. The drunk leanes over looking for the train, and falls in. Sometimes they're intact, sometimes we're searching down the block for body parts. Some people cross the street, slowly, in moving traffic, walking all hard and stuff, daring someone to hit them. Some teens think it's funny to jump out IFO our moving rig, saying to hit them so they could get rich and sue. Darwinism. I don't wish anyone dead, I don't know the whole story as to why this individual laid down IFO the bay door. was he AMS with head trauma? Was he so drunk that he had no clue? Or was he just plain stupid? Don't know. Can't say at this time. What I can say is that I don't feel sorry for someone who injures/kills themselves due to pure stupidity. I do submit that drinking yourself into such a stupor that you have no clue where you are or what you're doing qualifies as pure stupidity, though. If you're at a house party or have sober friends to look after you it's one thing. If you're walking around the neighborhood three sheets to the wind is a whole other thing entirely. It's why I don't entertain refusals from drunks. Get them to a hosp where they're safe until they sober up. If you secure a refusal and they get smacked by a car, guess who's to blame?

That's what I'm getting at. Someone with either prior law enforcement experience or 60 college credits in whatever can blow past many professions that require a Bachelors or a Masters regarding salary, low stress, retirement, incentives, job security, etc. I'd jump on it myself if I wasn't already hooked up. I imagine this position is highly competitive. Otherwise, they wouldn't care about the 60 credit requirement. Do you have a download for the step increase schedule? How are the higher positions compensated? Well over 100k as a top out I'm sure. Better than a PA or an attorney.

I attended the ABLS course today at my FRD, given by 3 RN's and an MD from MedStar. When we were reviewing for our practicals, the MD asked us what RSI med ought to be avoided for the burn pt. and why. Nothing but blank stares from the class. Here's the answer: http://www.medscape.com/viewarticle/452569 I also overheard a comment about how the course content doesn't really apply to 911 prehospital care (it certainly does). Knowledge of how a pt may be managed in a burn center will improve your assessment to look for what the burn surgeon may need to know, and will also allow you employ best practices when you go above your protocols when seeking authorization from OLMC. The 911 only medic is incomplete. Many cert programs place their main emphasis on the 911 side only, only giving token gestures towards IFT or in hospital considerations. A degree program should ensure that the medic has the knowledege base to see the big picture, how our actions affect the pt's in hospital Tx course. More importantly, it provides the base for a legitimate progression to CCEMT-P or flight.

My FRD has always considered I's and P's the same for all intents and purposes. The problem is with the difference in knowledge base between the two. There are many areas in the US where an EMT I-85 or I-99 many be the only game in town. Some say that if EMT-P becomes the entry level position, mandated by federal law, then these local Govt's will somehow find the money to compensate degreed medics. I'm not so sure. It's like trying to squeeze blood out of a rock.

The pay isn't the only factor to consider. Your retirement benefits and medical are as important if not more so. Many have become bankrupt due to medical costs. Many have exhausted their 401k/403b, not having a pension to rely on. Correct me if I'm wrong, but aren't federal employees vested with medical benefits for life after only 5 yeasr of service? Also remember, that 50k is only a starting salary. Municipal employers typically offer lower salary ranges when compared to the private sector. That's because the municipal employees are getting job security, pension, superior medical that they can take with them post retirement, so on and so forth. Judging a position solely on the basis of annual compensation is an extremely myopic view. Consider also that some employers, municipal or private alike, may offer a generous starting salary. This may serve to distract the prospective empolyee from any number of undesireable aspects to the position such as lousy schedules, forced OT, horrendous working conditions, prohibitive leave policy, lousy retirement, lousy medical, lack of career advancement, lack of tuition reimbursement, lack of a grievance process rather than favoritism from management, residency requirement in a region with a poor quality of life, lack of substantial raises after that initial generous starting salary, etc. etc. One needs to consider the big picture when looking for a place to work. Do your research.

SE DC can be rough, but there are planty of nice areas as well. I currently live in the Garrisonville area of Stafford Co VA, where starter homes are going for around 200k. Great schools and a large number of military, public service and Gov't employees living here. Maybe an hour from DC, maybe less. Just go in early and PT before your shift. Plenty of nice areas in MD as well. I got my experience in some rough areas Queens and Brooklyn, and I've lived in some pretty shady areas as well (Bushwick for one). It's a great place to be from, and I wouldn't trade the life experience and job experience that I'm fortunate to have for anything. It's given me the tools to face any situation that I may encounter in my travels. Many families are losing everything they own and worked for, and would be very fortunate to land a secure pensioned career such as this. 50k post academy (that's entry salary, mind you, not top out) is pretty good. I'm sure that you get much better experience than working (rotting) out in the sticks somewhere, running 2 calls a day if you're lucky.

Interesting. Although this pt seems like a case of "The boy who cried wolf" I don't put anything past anyone. full eval. Let the doctor decide whether they're faking it or not. Now that you mention it, I have worked a lot of 0400-0500 diff breather calls who advise onset upon waking for an hour or two prior to calling. We've all witnessed the 0600 NH shift change diff breathers with a "They were fine ten minutes ago when we checked" advisory per the morning crew, with the pt flat on their back full with audible rales upon entering the room. Sitting them up and giving more than the token 2 liters they're getting U/A works great while we get our interventions going.

Point taken. this was back in my BLS days, and we could set our watches to him, the call came in at 0630 whenever we were on during weekdays. This pt typically had good air exchange, no stridor, no acc. muscle use, reclining semi fowlers on the couch with his duffel bag packed, was able to walk up from his basement steps w/o coughing or any noticeable increase in resp. effort. I'm thinking that the albuterol neb we gave him probably took the place of his reg. scheduled neb in the morning. We always did a full assessment within our scope because, you just never know.

I wish that they would've done that in NY. I've had plenty of calls for BP checks, setting a pt up with a neb or two and then having the pt refuse further Tx/Txp, so on and so forth. NY could also use a better txp laws as well. We had a guy that would call each and every weekday, around 0630 (our shift ends at 0700), C/O asthma exac (clear L/S, no noticeable distress whatsoever), get a neb, and then request txp to a hospital several batallions across the borough. Queens Village area to Mary Immaculate Hosp for those in the know. We come to find out eventually that he worked as a security guard down the block from the hospital at a Rite Aid. He would use his medicaid card for a free ride to the hosp next to his job, leave the ED, and then go to work. Not a damn thing we could do about it. As long as the hosp is less than 10 minutes from the closest ED, and the pt isn't in extremis or requires specialty services, we have to go there. The easy way out for those who don't want to pay for a bill, txp or otherwise, would be to give a fake name, address, etc. Call from a pay phone at the corner store. Chronic callers figure that out pretty quick. My favorite is pts that sign out AMA from one ED and call 911 for txp to another, while standing IFO the first hosp! Even better when we were the ones to txp them there in the first place. Nothing we can do about it. No use getting upset over it.

I wish that they would've done that in NY. I've had plenty of calls for BP checks, setting a pt up with a neb or two and then having the pt refuse further Tx/Txp, so on and so forth. NY could also use a better txp laws as well. We had a guy that would call each and every weekday, around 0630 (our shift ends at 0700), C/O asthma exac (clear L/S, no noticeable distress whatsoever), get a neb, and then request txp to a hospital several batallions across the borough. Queens Village area to Mary Immaculate Hosp for those in the know. We come to find out eventually that he worked as a security guard down the block from the hospital at a Rite Aid. He would use his medicaid card for a free ride to the hosp next to his job, leave the ED, and then go to work. Not a damn thing we could do about it. As long as the hosp is less than 10 minutes from the closest ED, and the pt isn't in extremis or requires specialty services, we have to go there. The easy way out for those who don't want to pay for a bill, txp or otherwise, would be to give a fake name, address, etc. Call from a pay phone at the corner store. Chronic callers figure that out pretty quick. My favorite is pts that sign out AMA from one ED and call 911 for txp to another, while standing IFO the first hosp! Even better when we were the ones to txp them there in the first place. Nothing we can do about it. No use getting upset over it.