Combining EMS and fire to be able to afford full-time professionals

[HERBIE1]

Apparently I'm in the minority here, but can someone explain to me why so many feel threatened by volunteer prehospital providers?

When I started as an EMT B nearly 30 years ago, for awhile I worked with the Red Cross as a volunteer in a rural area, providing medical care for special events as well as disaster assessment and even did some tornado spotting. The people I worked with were some of the most dedicated, hard working folks I have ever met in the business. They improvised, used their own time, resources, and money to get the job done and were well respected in the communities they served. People appreciated ANY help they could get.

I simply fail to see what the problem is with volunteers. There's a time and place for them- in areas where paid personnel are simply not possible, isn't it better to have ANY provider vs none at all? There are just as many lousy full time professionals as volunteers so I reject the premise that because they are volunteers, their abilities or dedication is somehow suspect.

Maybe I am missing something here, but if we're supposed to be about helping people, then limiting or putting restrictions on that help seems counter intuitive to me.

Please educate me on this- I am honestly looking to understand this attitude.

[Eydawn]

Do us a favor. Search "Paid vs volunteer" in the forum search (not the quick search, but the actual search) and spend about 6 hours reading through the back and forth.

I'll distill the bottom line for you however. My grandmother always used to caution my mother and her sisters that "A man won't buy the cow if he can get the milk for free." AKA: You'll be used, not given the best treatment, and left by the wayside if you give your "services" away for free.

There *ARE* very good, dedicated volunteers out there who provide EMS to communities who would otherwise have nothing. Many of them are in the minority if you look at the polled responses of people in the threads that exist all over the forum on this topic. Volunteer systems do not have the same checks and balances and emphasis on education that many paid departments do (and paid departments struggle with that as well, so imagine how much worse it can be in a good ol' boy run VFD.)

Also, by providing EMS for free, people reinforce to their local town/city/county/state governments that EMS is not an essential service that *must* be provided to the citizens, same as trash, sewer, etc. Therefore, whatever provider level the vollies deem appropriate to respond with is OK-DOKEY by the local governments, holding block parties to raise funds for new equipment (which they might not get) is A-OK rather than ensuring that services are provided with the best tools possible to care for their patients, and many patients who would benefit GREATLY from ALS care will never receive it.

Rural areas, where transport times are long and resources are scarce, are the areas that can most benefit from ALS response.

So guess what reinforcing that minimum standards are acceptable does for our wages and our esteem in the medical community? We already struggle as a hybrid between public safety, transportation and medical care. If we allow this hodge-podge system where volunteers set the "norm" for those responsible for setting our wages and our licensure/certification in each state, we show that EMS really IS nothing more than people with spare time on their hands with some first aid training, and we make it that much more difficult for those who want to see EMS established as a respected medical profession with education comparable to other fields, like nursing or respiratory therapy.

EMS is bass-ackwards right now as far as education goes; you get turned out with half the picture and a few physical skills (if you're lucky) and you're expected to learn medicine with that half-full tool-bag before you're allowed to go and learn the clinical medical side of things, by which time you've already picked up habits that are going to be darn difficult to drop.

Education levels and pay rates in the medical field often correspond. If you're an educated provider, who can provide holistic care rather than "I see wheezing, I give this drug" then you are worth more, and your salary increases. But if you have people fighting that on all sides saying "I did EMS because I suck at school, I'm doing this because I have free weekends but I don't have time to go get an associate's degree" then the whole field gets dragged down along with wages and our image as a whole.

I feel you. Good providers, volunteer or paid, are good providers. But the fact is that the volunteer system is a big part of our fragmented, education-stunted low-wage system and is part of what is keeping the status quo alive (at the expense of patients who deserve better.)

Happy reading.

As a response to Kristo: I'd say that paid EMS/Fire as long as everyone plays nice is better than VFD, volley EMS. As long as no-one from either side is forced into a role they're not capable of or interested in enough to perform well.

Wendy

CO EMT-B

Edited March 28, 2009 by Eydawn

[aussiephil]

2 Things.

Abandon paid fire in favour of paid EMS. Dont combine them. It doesnt work. Fire will always try to justify their existance by trying to do more of everyone elses work cause there isnt enough fires (their core business) to put out. If they struggle, make them volly, or put them on a retained system where they are paid by the call. That way you will have more than enough money to pay for EMS.

Secondly, volly v paid ems. Community first responders should be volly. But that is anyone with a damn first aid certificate. If we expect people to undertake further education, then expect them to use those qualifications to benefit others, should they not be paid for that? Would you expect your local town planner to work for nothing? He has lots of qualifications & he expects to be paid well for them & maintaining them. Isnt pre hospital medicine the same? So why should we have vollies in EMS Herbie, you tell me.