The local news does a hatchet job on EMS

[Lone Star]

AMR comes to town, companies either get folded up, consolidated or just plain destroyed; then when the municipalities realize what a mistake they made, it's too late.

After AMR is driven from the area, there is nothing to take it's place.

In Michigan, AMR moved in and all but destroyed the previously established private carriers by either driving them out of business (jumping their calls, etc) or just swallowing the company. At one point they had 12 different labor unions in MI alone.

After the State of MI got tired of AMR's way of doing things, they suspended AMR's priveliges in almost every county in the state. Needless to say, alot of the counties were scrambling to establish new services to fill the void.

[HERBIE1]

AMR comes to town, companies either get folded up, consolidated or just plain destroyed; then when the municipalities realize what a mistake they made, it's too late.

After AMR is driven from the area, there is nothing to take it's place.

In Michigan, AMR moved in and all but destroyed the previously established private carriers by either driving them out of business (jumping their calls, etc) or just swallowing the company. At one point they had 12 different labor unions in MI alone.

After the State of MI got tired of AMR's way of doing things, they suspended AMR's priveliges in almost every county in the state. Needless to say, alot of the counties were scrambling to establish new services to fill the void.

I think it's rather amusing that AMR's parent company-Laidlaw- is also known for it's waste hauling business.

(I'll refrain from using a too easy joke here...)

[fiznat]

I didn't say AMR isn't deserving of criticism. Of course it is. Start a thread on that topic and I will happily contribute.

All I'm saying is that the company is not relevant in *this* thread. We all stage for PD at violent scenes, what does the fact that it was an AMR ambulance matter? Unless we are just looking for another excuse for ad hominem attacks....

[Richard B the EMT]

I will always refer back to a drill I witnessed, not as an active participant, at the "Pulse Check" Convention of the New York State Volunteer ambulance and Rescue Association, some years ago.

Scenario: Several persons shot in a courtyard between 2 buildings, the LEOs are on scene, VAC EMS already treating and packaging on the scene. The scene is supposed to be secure.

Suddenly, a man wearing camo makeup and Battle Dress Uniform busts out of the door of one of the 2 buildings facing the courtyard, firing an Uzi at all the patients, LEOs, EMTs, Paramedics, and us spectators!

Turns out the gun toting maniac was the original shooter!

OK, real time, again. The weapon was one of the "motorized" water guns designed to look like an actual Uzi submachine gun, popular over a decade ago, until LEOs started firing their Glocks at kids carrying the realistic looking toys. The gunman was an actor within the scenario.

Point being, even when the LEOs are on the scene, and declare it "Safe", the scene may not be: it will be in flux until you get off the scene, and even then, the bad guys may follow you to "complete the job" at, or even IN, the ER. Yes, this is kind of a Television or Movie scenario, but it definately can happen.

As already covered in this string, AMR's crew did follow protocols in that they staged, but staged too near the initial incident, making themselves potential targets. Then, they compounded the error by initially withholding treatment when the patient was physically brought to them, potentially setting themselves up for retribution from those with the patient for withholding that treatment.

As I see it, the AMR crew ended up in a lose/lose situation. There was no right thing from the moment the vehicle was seen by those on the scene.

[Kaisu]

No wonder AMR is having to import medics from across the country to run that system.

Dammit Dust... do not diss the company or the system without direct knowledge of it. (and the rest of you doing it on this thread too...) I looked up the stats on Jacksonville and it is 80% black and the 24th most violent city in the country. These EMTs (B and P) are dealing with a situation that we really don't appreciate without being there. It is like the backseat quarterbacks bemoaning the treatment of the enemy by our troops.

As far as big bad nasty corporate ambo shoving out the moms and pops... the operation I work for is miles better under the corporate umbrella than it was under mom and pop in terms of standardization and improvement of delivery of services for the patient.

Are there valid criticism and room for improvement? - of course there is... Know any piece of EMS that isn't like that?

I love you to death Dust.. and admire you tremendously. I can hardly wait to get a feet on the ground look at what is going on and you can be damn sure I will approach it with an open mind. I look forward to posting my impressions.

(do you see another suspension lurking ? )

edited to add the and the rest of you bit....

Edited April 17, 2010 by CrapMagnet

[Lone Star]

Dammit Dust... do not diss the company or the system without direct knowledge of it. (and the rest of you doing it on this thread too...) I looked up the stats on Jacksonville and it is 80% black and the 24th most violent city in the country. These EMTs (B and P) are dealing with a situation that we really don't appreciate without being there. It is like the backseat quarterbacks bemoaning the treatment of the enemy by our troops.

As far as big bad nasty corporate ambo shoving out the moms and pops... the operation I work for is miles better under the corporate umbrella than it was under mom and pop in terms of standardization and improvement of delivery of services for the patient.

Are there valid criticism and room for improvement? - of course there is... Know any piece of EMS that isn't like that?

I love you to death Dust.. and admire you tremendously. I can hardly wait to get a feet on the ground look at what is going on and you can be damn sure I will approach it with an open mind. I look forward to posting my impressions.

(do you see another suspension lurking ? )

edited to add the and the rest of you bit....

Considering I lived in MI and was 'in EMS' prior to, during and after the whole 'AMR presence', I believe I AM speaking with direct knowledge.

I can name at least 3 counties in Michigan that didn't have the Laidlaw or AMR logos anywhere in that town..., and suddenly at least 3 companies started sporting Laidlaw then AMR logos. Not long after that, all those logos just magically 'disappeared'.

When they 'disappeard', the void left behind meant that very few had ambulance service outside of the fire departments that provided such services.

Those companies that somehow resisted the takeovers, assimilations or outright closings lost a big chunk of their business to AMR jumping calls. (Which was one reason that the State pulled their priveliges). Patient complaints was another reason.

[Kaisu]

I was addressing myself specifically to the situation in Jackson Miss. as portrayed in the disinformative media and the comments precipitated by that. If I were to attack your experience of the situation in your neck of the woods based on ideological grounds, or heaven forbid.. an attempt to be right at all costs, then I would be doing the very thing I object to in those posts.

The comment regarding the improvement in EMS here in my neck of the woods subsequent to the corporate takeover is for this specific situation only.

[Dustdevil]

Dammit Dust... do not diss the company or the system without direct knowledge of it.

I didn't diss the company. I'm the last one here who would do that. I merely intimated that there are obviously some problems at that specific location that may result in an unstable workforce, as well as efforts by the company to shore up their image there.

[HERBIE1]

I'll stand by my original comments and also did not "dis" the company- except for the snide waste hauler joke.

My point was, and still remains- that large businesses are all about profit- even ones tasked with providing a health care service. A business puts out feelers and attempts to expand and take over an area. AMR is no different than Starbucks, McDonalds, or any other large chain in that regard. That's how it works. As long as the quality of their service or product isn't an issue, they have every right to do so. If the company cannot deliver on their promise to uphold standards, provide a quality service, then they are gone. Similarly, if they cannot generate enough profit to justify their presence in an area, they are also gone. Simple business.

This story was about a screw up by the crew. In order to learn exactly what happened, and how to keep it from happening again, some questions need to be asked and honestly answered.

What was the company's policy regarding responses to shootings and other potentially violent scenes? What was the experience, training of the crew? Where exactly was the ambo supposed to stage? How would the crew know who to contact to ensure the scene was secure? Ultimately, the company is responsible for their employees- for training and their actions. In a civil suit, the company is held liable under the legal concept of "respondeat superior". Even if the company does have an established policy for such situations, it's still their responsibility to ensure all employees are aware of it and comply with it.

The problem is, situations like these are fluid, and Richard B alluded to another issue- secondary incidents are very likely. Often times- especially when the responses are short, a supposedly "secure" scene is anything but. The shooter is still in the area, another situation develops, retaliation occurs- anything is possible and the crew needs to be acutely aware of their surroundings, the possibility of a sudden change in the scenario, and be able to react appropriately.

[Kaisu]

And I suppose mom and pop run the company out of the goodness of their hearts. Mom and pop were about the money too.. they made a killing when it was sold. Its the American way.

What mom and pop had was resources limited to what they had accumulated and were willing to spend (two very different things).

If mom and pop were running the store in Jackson, they would not have the ability to deploy personnel from all parts of the country (with pay equivalent to what the macho medics make in the war zones) to fix it.

There is no doubt a large company is all about the money. When they have deep pockets, they HAVE to watch the Ps and Qs. They are a target, and are watched very closely by the regulators and the industry. A lot of stuff that slides with mom and pop does not fly with corpo. Standard of care is the watchword and corp knows that deviations from that will make things very expensive.

A large company allows me avenues to address deficiencies. I have had safety issues dealt with in a matter of hours after bringing them to the attention of the chain of command, said deficiencies being left overs from when mom and pop ran the show.

A large company provides me with medical, dental, EAP, 401K, educational opportunities as well as cool shots at deployments like the one in Miss.

Do not for one minute think I am an apologist for the company. I get into very deep water at times for my big mouth and there are things that are wrong for sure. What I have experienced is complete support for my efforts to provide the best care I can.

My initial reason for posting was to defend the field staff in Jackson. We all know that the media gets it wrong a lot. We also know that we all screw up from time to time. I love the discussion about the issue. Its how we learn and grow, but also be aware the uniformed and unbalanced opinions help no one, especially the holder of them.

Edited April 18, 2010 by CrapMagnet