Volunteerism in Rural EMS

[rescue25]

R1, I don't want to derail this thread any further and I certainly didn't mean my response to come off as picking on you, because it wasn't intended that way!

... but what self-respecting individual who is already a Paramedic, WANTS to be a firefighter? I'm sure there ARE some out there, albeit probably very few. No slight against FireMedics, btw. I just can't imagine doing it myself.

I can't either. In fact, one of the reasons I'm doing EMS as a volunteer right now is because there aren't any career opportunities nearby where I wouldn't have to pretend to be a firefighter on the side. Richmond City is an exception, but I have no desire to burn out in a year and get paid sh!t for the pleasure. I can assure you I'd rather be making money doing EMS, but vollying is the only way to get solid experience without the hassles of Fire or the inner city.

I'd imagine the call volume is high enough to support volunteer and fire medics at the same time? Educate me on this point, if you're familiar with it, please.

Henrico's call volume is pretty good. I can't find the fire department's call stats page off-hand, but my volunteer station alone ran just over 6,000 calls last year, and we only cover a small portion of the county as our first due area. That area is getting smaller all the time due to the increasing number of fire medics -- which, while that may not be great for our volunteer recruitment and retention, is certainly the prudent thing for the county to be doing in order to maintain an adequate system. Our situation is certainly different from a rural area where one (or a few) volunteer agencies are the only real game in town.

I agree with this 100%, and fully support it. I'm not going to hold my breath, however.

I hope not, unless you enjoy syncopal episodes! :shock:

I'm inclined to agree with this statement, because of the edu properties of it...but even if it was accomplished for Paramedics, you know how Virginia is. I feel the OEMS would still maintain the other certs, which would continue to enable the half-assed providers out there (in Va anyway) to continue to practice half-assed EMS.

Yeah, I love how Virginia phased out the Shock-Trauma and Cardiac Tech levels only to replace them with essentially the same thing: Enhanced and Intermediate. I won't pretend to understand the supposed advantages of having the Enhanced level, since I don't ride in a rural area. I've been told the value of an IV and a handful of drugs is beneficial in these areas (never mind the frighteningly lack of accompanying education/training), although I really think we need to shift our collective mindset toward making sure that "real" ALS providers are available, even in rural areas, instead of making up new "in-between" levels to accommodate volunteers who either don't have the time or willingness to go farther. Which, let's face it, is why they exist in the first place.

[mediccjh]

Yes, so far we have the "Dean" (Dean Martin) the "Duke" (John "The Duke" Wayne), and the "Princess" (Princess Leia) of EMT City. I am surprised that nobody has adopted these other titles:

• King of EMT City (Don King, Rodney King, or Elvis photo avatar)

Queen of EMT City (Queen Elizabeth, Freddy Mercury, or Liberace' photo avatar)

Prince of EMT City (Prince or Will Smith, or any royal prince photo avatar)

Don of EMT City (Don Ameche, Don Knotts, or Don Corleone photo avatar)

Dick of EMT City (Dick Van Dyke or Dick Van Patten photo avatar)

Captain of EMT City (Captain Kirk photo avatar)

Sargeant of EMT City (Dick Sargent photo avatar)

Sheikh of EMT City (anybody with a schmagh [checkered Arabic headscarf] photo avatar)

Shah Of EMT CIty (Shah Mohammad Reza Pahlavi of Iran [RIP] photo avatar)

Ayatollah of EMT City (Ruhollah Khomeini photo avatar)

• Anyhow, back to the topic at hand... those who keep trotting out the tired old argument of how individual volunteer providers can be just as good as individual paid providers are -- and I suspect intentionally so -- missing the point. This is not about individual providers. This is about THE PROFESSION! The fact is that the state of the profession itself is our prime concern here. If the profession fails to progress, so does care at the lowest level. And so long as the profession is viewed as nothing more than a hobby that is not worthy of your full-time devotion, then the profession will indeed continue to fail to progress. It simply does not matter that you, as a volunteer, are personally devote yourself fully to your education and personal professionalism. If you are giving your services away for free, further cheapening our services and our image, you may be helping your individual patients, one at a time, but you are hurting the profession as a whole. That harm affects those who are working full time to make this a respected profession (which benefits YOU TOO!), as well as hurting the citizens who deserve better a better service.

Spin it any way you like. But once you pull away the blinders and look at the big picture, not just your current patient, there is no way that an intelligent person cannot see that volunteerism is seriously detrimental to EMS. Period.

I want to be the Slum Lord. My avatar can be Joe Pesci from "The Super."

[becksdad]

As for the titles - who wants to be the "Dick of EMTCity"? We could have elections.....

[Asysin2leads]

Actually, Dick of EMTCity should be Richard Nixon, hands down.

Anyway, you what I was reading about the other day? In Germany, in some areas, local communities get together and get little roving bands together who go out and pick up garbage off the streets, to keep things tidy. So, next time a volunteer starts running his mouth about how its all about serving the community, ask them how come they don't do like the Germans do and have volunteer trash collection squads. I'm guessing it has something to do with lack or flashing lights and T-shirts. I mean, in America, despite the fact that picking up litter has tremendous benefit for the ecology, property values, and overall hygiene of a community, if you are on the side of the road picking up garbage, then usually you have a bright orange jumpsuit on.

Any "Its all about the community" types out there want to jump in on this?

[JonathanGennick]

I mean, in America, despite the fact that picking up litter has tremendous benefit for the ecology, property values, and overall hygiene of a community, if you are on the side of the road picking up garbage, then usually you have a bright orange jumpsuit on.

Any "Its all about the community" types out there want to jump in on this?

It's actually quite common in Michigan to see family groups, clubs, and such out on the highways picking up trash. One local church school has adopted a stretch of county highway. And the state has an official program whereby any interested group can adopt a mile or two or three of state highway to maintain. If you pick up the litter a few times a year, the state will put up a sign plugging your group. You see these signs all over the place now. I suppose you could argue that volunteers are putting professional trash-pickers out of work :-).

And shortly, in my city you will see a group of volunteers hard at work digging up contaminated soil, replacing that soil, and then planting flowers by the roadside and in a traffic island. I guess the professional landscapers are out of luck.

I am too new at EMS to have a solid opinion yet on the volunteer versus professional issue. The one issue that I do have an opinion on though, is that of coverage. If by "volunteer" we mean that a call might come in only to have no crew show up, because everyone happens to be busy or out of town, or too tired to care, then that is just not right. I pretty strongly believe that there needs to be an on-call crew at all times. That's the way it is where I live. Michigan might require it--I'm not sure--but our service has a scheduled, on-call crew at all times, 24 hours a day, seven days a week, 365 days a year. (And we get paid for that too).

[rescue25]

Well, we do have "adopt-a-road" litter pickup volunteers.

(Edit: JonathanGennick beat me to it!)

[AZCEP]

And if not for the strength of the Teamsters, sanitation workers nationwide would be just as threatened by the proposition of someone doing their job for nothing.

The comparison is a stretch, at best. Compare yourself to professional healthcare providers. Stop with the claims of other departments being paid. All of the ones that are mentioned are paid for the work they do. Sanitation, public works, etc. do not work similar schedules, their job functions are vastly different, and yet we continue to hold to the claims of equality.

Educated, healthcare professionals need to be paid for their time and effort. There is little acceptability in the notion of providing voluntary service with the increases that you will all see in call volumes, and criticality of the patients. We worry ever so briefly about not having enough providers, then wonder how this is possible with the numbers that are still certified/licensed but do not want to give their time for free.

Why would anyone wish to jump through the hoops that are required, knowing full well that the only work is going to be for little to nothing? Every system is obviously different, but on the whole the volunteer system is facing it's own collapse. If professional organizations do not take the steps now to prepare for this eventuality, what happens when it does?

[Asysin2leads]

Everyone, look, quick! It's my point! It's right over there! Look quick! Oh, I guess you missed it. Anyway, to reiterate, anyone who says they are a volunteer EMT because they want to serve their community can also be out there picking up trash, which has a much greater affect on the community overall. Anyway, when someone shows up wearing a T-shirt that says "TOOLS OF THE TRADE" and has like a litter bag and one of them sticks with the nail on it, then we can start talking comparisons

[Dustdevil]

Actually, Dick of EMTCity should be Richard Nixon, hands down.

Oh dude! You totally nailed that one! I bow to you on this! :thumbright:

I mean, in America, despite the fact that picking up litter has tremendous benefit for the ecology, property values, and overall hygiene of a community, if you are on the side of the road picking up garbage, then usually you have a bright orange jumpsuit on.

Any "Its all about the community" types out there want to jump in on this?

Hey, why don't we reverse the formula? How about we take convicts and make them run EMS? After all, apparently there is this huge shortage of rural providers, and we can't afford to pay them. These guys have nothing better to do and are a captive audience (like firemonkeys). We can make EMTs out of them in about two weeks of 12 hour a day classes in prison. They will be providing a valuable service to the community and maybe even working towards early parole or even a pardon. It's better than no EMS at all, isn't it (which is the volunteers' argument)?

The funny thing is, everywhere I have ever seen them eliminate volunteers in EMS and the fire service, I never saw all those people rush to find some other way to fill that need to serve their community. Not once. Never saw them organise a trash squad. Never saw them go drive school buses for free. Never saw them go feed prisoners for free. Never saw them cut the courthouse lawn for free. They just disappear. So much for that total BS about their need to serve the community.

[Ridryder 911]

I have purposefully not read or posted in this area, due to the same lame excuses and non humble replies. I do understand the need of volunteers in small remote areas that will never be able to support a professional EMS on its own, however; majority of volunteer EMS is because the " need of self proclamation"and in lieu of paid EMS. I usually can identify one by the arm extension and double joint, from patting themselves on the back.

I have a simple way to find out true volunteerism. Require them to obtain the minimal level of an associate degree in EMS to perform, remove all identification labels, emergency lights, stethoscope around the mirror, multiple patches, etc. from their personal vehicles and persons. Require monthly in-services at the appropriate level, with failure requiring them to leave the service. As well as require clinical exposures for patient contact. After that, they would be able to maintain their certification level and volunteer as much as they want to.

Sorry. but this debate is futile. The way to remove volunteerism is education. Requiring an academic level and continuous education at this level in lieu of "training courses" will separate those that desire to provide care and those that want to provide a community service because it is fun, and meeting their personal needs.

R/r 911