My own personal rant....what are your opinions?

[STAT]

This is something that has been stirring in my head for a while and I was wondering what everyone elses opinions are out their in EMT-City Land.

In the GTA area I see many ambulances that belong to speciality "transfer companies" cruising around the city. These companies do a fantastic job at stable patient, non emergency transfer from hospital to hospital or hospital to home. Transfer companies are important because they do all the "Code 1" transfers so real MOH Ambulances dont have to. That means an Ambulance is available to respond to an emergency and is not tied up doing "taxi" work. The job they do and the service they provide is not in question. I understand how important it is and so should any paramedic out their whom would not want to do a code 1 at 3 in the morning.

My problem with it is how they go about doing their job. I see these pseudo ambulances EVERYWHERE. They look exaclty like real MOH ambulances. Most still have red emergency strobes that are still functional, and a working siren. Many companies seem to strive to make their transfer ambulances look as close to a real ambulance as possible. Some companies have opted to decal the sides of their trucks to give the feel that they are providing some type of medical care to patient. I see ambulances up and down our roads that have huge "star of life" decals. Many still have original decal work from the service that sold them (ofcourse without the services name) Some campanies have even went as far to call themselves "Critical Care Patient Transport" WOW! really? what the hell did I go through paramedic school for? I could have worked for you guys with only my standard first aid! And then the uniforms....These transfer people look exactly like REAL paramedics! They have navy uniforms with reflective striping and shoulder flashes. Some even carry stethoscopes and scissor packs, for what reason....I dont know.

My point....Paramedicine is the newest of all 3 emergency services. We are still to this day are in a fight to be recognized as professionals. Our industry is in a never ending fight for respect it seems. Respect that real, hard working paramedics have been earning for the last 30 years or more. It sickens me how these companies jump right in and present themselves as real ambulances/paramedics. They capitalize on the fact that the public cant tell the difference. I think that the whole transfer company industry should eat a huge slice of humble pie. Get rid of the ambulances (no need for them anyway) get vans that fit 35a's...get rid of navy paramedic uniforms and get golf shirts and khakis. As the rock would say...."know your role and shut your mouth" Im not a hater I just know that we have fought hard for the respect we have now and it can be so easily lost by people working for these companies that have nothing invested into it. I think that their needs to be a definitive line drawn that seperates the real from the fake...

Anyone else have anything to add? Am I wrong to think this way? I figure this should be an interesting debate....

[akroeze]

You say the transfer industry should do this... but what is in it for them?

They aren't breaking any laws and they already have a HUGE financial investment in their current inventory. So what reason do they have for making these changes?

[STAT]

Well thats not really the point im driving at...we can explore what they should do with old inventory in another thread. Im more or less wondering if anyone out their agrees with me or not....Do I have a valid point or am I off? Im open to whatever. But more then anything I want to know if Im the only one who thinks like this or not.

[Mastabattas]

I can't speak to how things are done where you are, but here in Edmonton we have a transfer service as well.

Interhopsital Ambulance (Edm) is a private ambulance service which runs ALS and BLS units, responds to emerg and non-emerg calls, and employs a full range of EQUALLY TRAINED and QUALIFIED EMT's and PARAMEDICS in addition to their EMR-staffed Specialized Transportation Service (STS) service.

The units are ambulances...period. With fully qualified practitioners on board, if an already sick patient being transported to another facility starts to circle the drain would you prefer that they did not have the resources to intervene? Would you prefer that they weren't able to step up priority with L&S (according to protocol of course) and get the patient to a hospital faster?

I know plenty of reputable practitioners who work for both the transfer service as well as an emerg service and enjoy both. In some cases, while doing long distance transfers these same practitioners have come upon real emergencies more often then with their other employers. And if you are working for the transfer service, but come across an accident or anything...you are required to stop and assist until another unit arrives to take over.

Our transfer service staff wear uniforms like any other practitioner... and why shouldn't they? They are identified the same as anyone else... by the shoulder flash. They are registered EMTs and Paramedics. They have gone to school the same as anyone, they have worked the same as anyone, and most importantly they provide patient care just like we all do.

[STAT]

Lets get this straight, Im talking about Ontario, not Edmonton. If that was the case, it wouldnt be an issue but in Ontario it is much different. If it is like you say in Alberta good! thats a step in the right direction. but please read carefully, I am speaking about the GTA (Greater Toronto Area) and the transfer companies surrounding it. The minimum qualification to be hired is Standard First Aid and an F class licence. You also have to pass a lift test. After that you go to it. Now I know for a fact that some Paramedics do work for transfer services while waiting for full time hours at their MOH service. that is also good, however most (if not all) of these transfer ambulances dont have ANY medical supplies on board. No symptom relief or even Defibs (too expensive) It seems these companies want to look and act like ambulances but dont want to have to put out the money to stock them or hire qualified people. Alberta and Ontario EMS systems are very different and from what you said so are the Trasnfer systems. you cant compare apples to oranges.

[unknown]

I don't work the field, I don't live in a big metropolitian area where these Transport services operate..... I DO however work in an area where we feel the sting of Not having these transport services available. If we have a cardiac patient that is stable, and needs to go to definitive care for surgery.... they can go by ground or by a transport service but what happens at that one moments notice that they go south? I do think having medical personnel staff those units is viable to the patients health. If that patient crashes for any given reason those care givers need to be able to provide ACLS.......... So what do you do when you are called to fly a stable patient who CAN go by ground, but the local EMS agency only has one ALS crew, and its a 4 hour round trip to transport this patient to the big City? BLS wouldn't be able to help this patient if they Crashed and then you as a flight service are going to be called out to assist for that patient on a scene flight basis. SO IF a credible transport service was available, they could play taxi, provide needed care should the occasion present its self, ALS crew stays local for the REAL emergencies and the Helicopter is poised and waiting for the Real critical patients needing definitive care..........

Not saying this cardiac patient isn't a Real emergency but I do hope every one understands what I am trying to say here.......

[STAT]

Good point....Transprt services are important, I have stated this....however, and I again repeat myself I am talking strictly about the system in place in Ontario.

Anyone out their from Ontario...that works as a REAL paramedic have anything to say about this? I think the issues are getting a little too clouded by everyone else thinking they have something really important to say but missing my point altogether.

[akroeze]

I am an Ontario medic. The local transfer company dress just like medics but they drive sprinter vehicles without flashers or sirens or anything.

I HAVE seen some of the vehicles you refer to when I'm in GTA but usually they seem to have the front red flashers removed and just the side and back ones remain. I see no problem with this as this removes their ability to use them.

[STAT]

ya Ive seen the sprinter vans as well I think they are a great idea...lots of space for patient, and easy to repair. Also better on gas. I think the transport industry should make a shift in this direction. Instead of trying to look and act like real ambulances/Paramedics they should set their own style.

[Mastabattas]

Our industry is in a never ending fight for respect it seems.

This is true. However it has to do with how we portray ourselves... There is a lack of professionalism, integrity...and even just comprehension of what either of those are within our industry in North America. I am embarrassed to be associated in the mind of the public with some of the practitioners that have tainted our image. However I have two choices when I contemplate how to deal with it: 1. Whine and complain and seek sympathy where I can get it, and criticize everyone else for their part in it... or 2. I can suck it up, and try and educate my colleagues and the public each and every day with each and every encounter I have.

I opt for the second. And as such, I strive with my imperfect human abilities, to refrain from participating in any of the negative behaviours which are the very reason for the struggle we face as an industry. This includes no childish criticisms or tantrums, discouraging gossip, and behaving with as much professionalism both on the job and off as I can.

...get rid of navy paramedic uniforms and get golf shirts and khakis. As the rock would say...."know your role and shut your mouth"

Do you really feel that it's these things that are confusing the public? It's a lack of recognition from the government, a lack of public education, inconsistencies within each province as well as between provinces, and a generally immature unprofessional population which unfortunately portrays the industry to the public.

Did you know... CMA tow truck drivers (and other companies that I've seen) ALSO where navy clothes with reflective striping? Did you know that there are locksmith trucks that are old ambulances converted, and mobile soup kitchen trucks that are old ambulances, as well as private recreational vehicles that are old ambulances...

It's not our vehicles, or our clothing which will gain us respect in the eyes of Joe Public. It is our colleagues, our behaviour, our professionalism, and our integrity both on duty and off.

We have a transfer service similar to what you describe... affiliated with the same service I already mentioned. Because they are employed by the same company they wear the same uniforms, albeit with slightly different patches. Their units are similar to the BLS vans. In addition the office staff with this service also wear the same uniforms. I don't see anything wrong with any of this.

There are much bigger battles to be fought. How about national reciprocity for starters?

I will add though, if the vehicles are as you describe them (ambulance style decals, star of life, lights)...could they be in violation of regulations? I'm not overly familiar with this side of things, but here in Alberta we have provincial regulations which set the standard for our units to a bare minimum. I believe it might pertain to just the equipment but are there bodies that regulate the exterior appearance of vehicles... and if so would the examples you listed be in violation? Perhaps that would be an appropriate avenue to pursue to effect change.