Should Volunteer Squads Be Eliminated ?

[rescue25]

Again, I have not seen any professional describe to eliminate the volunteer, rather change the role of the volunteer to a first responder role. This has been performed in my area and has been very successful.

Can you describe how this works in your system? In my county, all fire personnel are EMT-B as a minimum, and the engines first respond to all ALS/priority calls. So I'm not sure there would be much use for volunteer first responders here. But it is an interesting idea.

[JakeEMTP]

Rescue25, can you explain why a Fire engine, with as stated, an EMT Basic on board is responding to an ALS call?

[rescue25]

I just want to say, too, that I find it unfortunate that there are a lot of people here that are equating volunteer with:

• All I can say is that none of these are the case with the volunteer system in my area. We staff a station 24/7 and make it to the vast majority of calls in our first due in under 8 minutes, we don't respond from home (unless it's a truly rare circumstance/MCI/etc. that requires a large number of providers), and we stay busy and have regular training opportunities, so skill retention isn't that much of an issue.

I know there are plenty of agencies out there that resemble the bullet points, but let's not paint with such a large brush?

That said, I agree that volunteer agencies will slowly die off. And I agree that there are probably many areas of the country that would benefit from a full time, paid EMS service -- and they're not getting it largely due to tradition and a good 'ole boy network of self-important volunteers.

[rescue25]

Rescue25, can you explain why a Fire engine, with as stated, an EMT Basic on board is responding to an ALS call?

Because every fire station has an engine, which is composed entirely of FF/EMT-Bs. Therefore, the theory is that they can get on scene more quickly than the paid fire ALS (or volunteer ALS) unit that is responding with them, because not every fire station has an ambulance. It's the first responder concept, and that's why I was asking about how the vollie first responders work in Rid's system, because it probably wouldn't make much sense here, given the system we have right now. But it's an interesting "compromise" so to speak should we ever not have the first due engine responding on EMS calls.

[Ace844]

Because every fire station has an engine, which is composed entirely of FF/EMT-Bs. Therefore, the theory is that they can get on scene more quickly than the paid fire ALS (or volunteer ALS) unit that is responding with them, because not every fire station has an ambulance. It's the first responder concept, and that's why I was asking about how the vollie first responders work in Rid's system, because it probably wouldn't make much sense here, given the system we have right now. But it's an interesting "compromise" so to speak should we ever not have the first due engine responding on EMS calls.

"rescue25,"

Or your system could just staff an appropriate amount of Ambulances to cover your EMS call volume, then you wouldn't have "a dilution of Fire suppression resources"; and your patients would recieve adequate and timely access to professional medical care. For more on this see here: http://www.cityofmemphis.org/pdf_forms/assessmentOfEMSS.pdf

Hope this helps,

ACE844

[rescue25]

I will read that tonight, thanks.

Also, I completely agree, but unfortunately I have no sway over the fire department and the county's thinking on the issue. I know that recruitment has been an issue... fire just can't seem to keep ALS providers. Either the pay is too low, or FF's don't want to run EMS and paramedics don't want to fight fires. The cross-training does scare off a lot of folks, myself included. But try telling the FD that...

What would also help is a better dispatch system. The majority of the calls dispatched as ALS/Code 3 (priority 1) could easily be handled by a BLS crew and without a hot response. Talk about a dilution of resources... but that's an issue for another thread.

[Ridryder 911]

We do not have volunteer EMS in my area. The volunteer EMS agencies was changed into paid systems, and now most that did volunteer is now within the volunteer fire departments. By doing such, they can respond as first responders as such role and provide initial care and assist the professional EMS. We are in the works of continuing our relations with the volunteers. I believe they are an asset, especially in rural areas that are not protected by paid professionals, and definitely can be an asset in aiding us in EMS.

We are considering starting once a month or quarterly pizza night, by providing free food and CEU's to volunteers. This does not just provide us with good working relationship, but will also allow them to get CEU's , get familiar with our equipment and procedures as well. Like I described, most volunteers are having to spend more time away from home, and thus decreasing memberships and activities. There are very few members that want to work two professions and not get some compensation. By having a paid full time ALS EMS and having the responders assisting have decreased their time awaiting calls and at the scene. Hence, they go home faster...

We also provide most of the major medical equipment and restock as necessary, since we are the only EMS provider. Basically a trade out situation... this has also decreased the costs of small local town city budgets... some of the responses are even 30 -35 miles away, so we depend on these responders to make initial contact and treatment. A dual Paramedic unit responds for further treatment and transport.

Again, it would be foolish for cities to compete, and try to provide duplicate systems. By re-duplicating services, several things fail... the EMS system, the patient (because lack of funding/education/level of care), and personnel.

As America has learned, each city, community cannot have or afford a hospital and they are soon finding out the same is true in EMS. Developing and improvising systems will have to occur. The predicted demand will be too much for most volunteer agencies. It will be better to have a first response system and utilize volunteers appropriately than to loose all help. I do believe volunteer agencies should be looking toward the future, and instead of trying to compete due to tradition, ego's, etc.. assist in developing funding for paid professional regional services with Paramedic capabilities. The end result would be better for the patient, the community, and even the volunteer agencies.

R/R 911

[Parapup]

I totally see a need for volunteers. The only thing I have to add is this. Everyone (including me) is always moaning and griping about not gettin paid enough. My question is why would the general public want to pay us more when there seems to be people standing in line to do this job for free. I love my job. It would just be very nice to make wages that compare to a nurses'. There are definitely areas of the country that can't afford to have paid ems services, It seems like it's like everything else...people don't appreciate you or take you seriously if you don't charge them. LOL

[temsp40]

Rid -- you bring up an interesting theory.

Has there been an impact type of study, specifically in a rural area, done on the removal of volunteer EMS systems and replacing them with a paid, regional EMS system?

I ask this because I am curious, I have just finished reading the thread since I threw in my theory of the disappearing volunteer, and I am glad to see that ACE is still alive and kickin'! I am curious about this. I have to agree with the overall gist of what has been being said, volunteers do have their position with EMS, but the time that they have is potentially limited by the demands of the evolving EMS system.

Is the future of volunteer EMS in jeopardy? Most likely. Is it going to be gone forever? Probably not, we will always see Explorer posts that start doing fire/police/ems things that will volunteer for the local service to gain experience and an insight to the realities of this job. There will always be some super-rural place in the back woods of Montana that the closest ambulance is 30 minutes away and the volunteer service is going to go out and help out until the paid guys arrive. Does that make the paid guys better than the volunteers? Absolutely not. Especially if you get volunteers with an interest and desire to do the best thing for the patient and paid guys (and gals) that are interested in working with these vollies to keep them on top of their game and to have a continued interest in being an EMS provider.

Again, however, I still see the volunteer services dwindle into the sunset. With training requirements to keep your certification current, the additional skills required to be an EMT and the overall time away from your family is going to get old. Those that volunteer should be praised and rewarded for their efforts. Those that volunteer and pay for furthering their education should get a tax break on this education. I cannot express my appreciation enough for the volunteers.

Quick aside on the post comparing the US Military with EMS -- simply no comparison. Military Service is something that you volunteer to do, the US is not like other countries that require young men and women to serve their country for a set time. The Army life was not the life for me, I did volunteer to join and was then PAID for joining.

Keep it shiny side up!

P40

[Nate]

So I guess the paid folks only do it for a paycheck, not to help anyone. I do do it to help.

Yeah, because that paycheck means we don't care. :roll: You sound like you have a hero complex, last time I checked we were all in EMS on this site; you can put that complex to rest.