The problem with Rural EMS

[crotchitymedic1986]

And isnt EMS already under federal control -- yes the DOT has done a fine job ?

[JakeEMTP]

Jake, what kind of shifts do you operate though? Some locations, mine included, work 6 days on 3 days off for some staff, 7 on 7 off for others, every shift is 24 hour on call. Would you be satisfied with your job if you had to stay at the base for 2/3 of your life, of being able to spend quality time with your family, even though you are getting paid for it? Rural services can rarely afford to pay staff for 12 hour shifts and even if they can, finding enough qualified staff is often the greater challenge. We have 2 ambulances and 7 full time employees and have a half million dollar annual budget. We are required to be in the ambulance within 6 minutes of a call out, day or night. We've become masters of the quick dress and dash.

You might be required to stay at the base, that doesn't make you a better medic or more capable to provide patient care. All it means is that you don't have to be on call 24/7 for most of your career.

I work a 24/72 schedule. Sorry you have to be on call , that sucks and needs to change. Seriously, not having money to pay staff is BS. If the town wants professional EMS they'll find a way to pay for it. There are many threads here at EmtCity that address this subject. I recommend a search.

I never said I was a better medic, I said I was a professional.

[CTXMEDIC]

Most of this garbage and criticism is coming from a paid agency member who wants to move into our station. Our residents don't want your service. You don't care. You do it for a paycheck. I've witnessed it for years, and although I do my best to judge it on a case by case basis, I've been in EMS too long to think otherwise.

Try getting out of bed at 2:00am, rushing to the station, then the scene when you aren't getting paid...then talk to me about response times...you condescending a-hole.

Because we do it for a paycheck doesnt mean we dont care. As for your residents not wanting a professional EMS service that doesnt take 5min to get to the ambulance, Im sure a civil war soldier didnt want a XBox either. If youve never been exposed to it, how do you know if you dont want it? BTW, im not in bed at 2 am while on shift, im sitting in a running ambulance waiting for a call to bail out a wanker volly squad. Its the volly squad first responders that drag EMS down to the level it is today.

Support your local volly squad:

[Arctickat]

I work a 24/72 schedule. Sorry you have to be on call , that sucks and needs to change. Seriously, not having money to pay staff is BS. If the town wants professional EMS they'll find a way to pay for it. There are many threads here at EmtCity that address this subject. I recommend a search.

I never said I was a better medic, I said I was a professional.

Don't be sorry that I work on call hours, for our system it is a model that suits our needs and we enjoy it.

First of all, the town doesn't pay or operate EMS here. It is a privately owned service that is contracted to the health region. Income is generated from provincial grants as well as user fees. Our wage scale is determined by the union agreement. I laugh out loud at those who think that every single EMS operation should have 12 hour shifts and staff staying at a base. I laugh when I read people comment that "someone should put up the money" so that every EMS service conforms to what they think is proper. I find it condescending of you to state that you are a professional because you stay at the base while on shift, yet only work 1 out of every 4 days while I work 2 of every 3 and am quite content.

Sure, we could work it so that I work 24 on and 72 off, if I want to kiss my $60,000 plus annual pay check goodbye. Just because I get to sleep in my own bed at night doesn't make me less of a professional than you. To insinuate that I don't care about my patients because we don't sit in our ambulance 24/7 to make sure we can respond within seconds to the 350 or so calls we get every year is simply egotistical and shows a definite lack of respect to a fellow professional. Simply put, your comments offend me.

That said, I do believe Chris' comment was also over the top and rather rude.

[sirduke]

You people work some odd shifts in my humble opinion. I work for a small rural county, our service is owned by the county government, we are funded by the county, ie taxes, all revenue generated by our service goes back into the general county fund, and we are allocated a budget each year. It often gets slashed towards the end of the year, but there it is.

Our shifts are 24 on 48 off, no "on call" luckily, we run two trucks and a extrication unit.

We hope in the very near future to add another ambulance as our call volume is sufficient to justify it, however the county commissioners have yet to allocate the funds. What chaps my butt is seeing the sheriff's depts budget get increased each year, and at the same time they keep taking money from us.

We are centrally located in the county, but due to the size, some points in the county are at least 15 minutes away on a good clear day, and those on the dirt roads, depends on if it rains.

Until the county administration decides to do something to improve it, and that will be when the citizens raise enough hell, it won't get much better. We have many volly fire depts that will respond on scene and assist us, and we are trying to get them all certified as NREMT First Responders, which will perhaps give the patient a little better chance.

That probably just set me up for a flame as I support vollies, in the proper context. Extra hands are nice sometimes, and I haven't seen my paycheck suffer because they rolled out. Granted they don't have ambulances, but there have been several calls that went a hell of a lot better due to the assistance. Having a pair of eyes on scene, assessing the patient as I roll hell bent for leather to them, can give me a much better idea of what I might find on scene, than the scant bit I get from a bored dispatcher sitting at the control desk doing her nails.

There is a lot that needs improvement in EMS, but the first thing we can do about it is to be the best we can, and keep advocating change.

Just one man's opinion.

[Arctickat]

We've also got volunteer first responders in our area as well, and I love having them available. We work very closely with them and conduct their con-ed for them. Sir Duke, how many calls a year does your company do?

[CTXMEDIC]

my first ems job was in a rural area with 20min response times to the far western edge. every FD in the county was a volly unit. our county seats department could tear apart a car better than any i have ever seen. its nice having the man power and I can recall a time while working at the service i do now that i was begging the county to re-tone the volly department over and over until we got a response, never did get them on that call. guess they were all at work....

Problem is that we cannot command a competitive wage when we have people doing the job for free. we have MD's that volunteer their time but are not volunteer doctors, same as nurses, dentists etc. on average the vollies dont have the training we do, the call volume to maintain proficiency, an adequate response time, continuing education opportunities etc. i am NOT saying that there aren't some very good volly agencies out there. im just saying ive never seen one in person. when i get guys responding to a call in their POV's with all the whacker lights goin, in sandals and a tanktop with a beer logo and a Skoal trucker hat on telling my patients that they're 'EMT's', whats that telling the public? its no wonder that some of the public abuses the 911 system or calls us and then tells us 'dont touch me, i want a real doctor'.

[crotchitymedic1986]

I dont see why people see rural as a problem. I purposefully chose to live in a rural area, and I knew when i moved there that i wouldnt have cable tv, delivery pizza, trash collection, or a fast response time from public safety.

[sirduke]

We ran 4104 calls last year, about the same the year before, some days, though few are extremely slow, others you never see the station all day and half the night, seems lately we are slow through the day, then come night fall, fun all damn night.

We too have no paid fire service in the county, and depend completely on vollie units, and to be fair, they are great about responding, and do their job well. I agree with the statement about the whackers, they do give us a bad name, but fortunate for us, all the vollies here are quick to let it be known that they are FIRE and not EMS, so that helps. The county volunteer units are well organized by the head firefighter or Cheif as he prefers, and he is strict about training and conduct on scene. I've seen him send more than one off and told not to return till he got his head out of his ass. And, he will boot someone out of the dept quick if they fail to maintain their certs and meet his standards of preformance. He's pretty damn squared away.

I have zero experience with vollie EMS services, so I can't comment on them except that I think they should be paid services, and that we need a national standard that really has teeth, unlike the frigging NREMT.

I guess my opinion would be more adamant if I was affected by the vollie EMS and seeing it cut my paycheck, but the ultimate goal is patient care.

As for vollie fire, well, let the firemonkeys sort that one out.

[JakeEMTP]

Sure, we could work it so that I work 24 on and 72 off, if I want to kiss my $60,000 plus annual pay check goodbye. Just because I get to sleep in my own bed at night doesn't make me less of a professional than you. To insinuate that I don't care about my patients because we don't sit in our ambulance 24/7 to make sure we can respond within seconds to the 350 or so calls we get every year is simply egotistical and shows a definite lack of respect to a fellow professional. Simply put, your comments offend me.

It was not intended to be offensive and I'm sorry you took it that way. But Kat, you called me out when you stated being stationed based doesn't make me a better medic. I agreed and said I was a professional. Meaning this is my sole Profession ie: I get paid for what I do. Nothing more, nothing less.

The rest of your response confused me. I think you misunderstood what I was saying. My response was to the Vollie. He is less than professional than me.