The Private Ambulance Service Thread

[IBStacy2U]

I work for a private ambulance co. in CA and am strictly doing it to try and gain experience and pt. contact. It's the first job right out of EMT school and having no experience I thought it would be a good stepping stone.

There are ups and downs working with private ambulance co. UPS-Transfor granny to and from Dialysis or from Hosp. to Con home, 99% of pts. are stable, Get to network, learn working with all sorts of different personalities, if you don't know the area you can pick it up at a slower pace.

Downs- No respect from anyone, Feel like a glorified taxie, Can't run code 3 at all, FTO training consists of 3-4 days, Manager in my case has little experience in the field, Don't really get to see trauma or use your skills as much.

This is just my opinion. Thanks for listening.

[GulDukat]

Actually thank you for responding.

I have a couple of questions for you if you don't mind answering.

1. Do you not do any emergency work because your company chooses not to do this or because you are prohibited by some local law?

2. How long have you been out of class? The reason I ask is, how do you plan to keep your skills up after you have been away from class for awhile?

3. When you say you have no respect by anybody, can you elaborate a little on this? I just want to compare your feelings on this with others.

Thank you for what you do by the way. You have one of the roughest jobs in the business, I am not kidding when I say that either.

[IBStacy2U]

I don't mind answering your questions at all. Maybe you might have some better insight/advice for me.

1. My company does not have any emergency work because it is just strictly BLS Transport. We are prohibitied by county protocol from running code:3

2. I have been out of school since April 2007.

3. As far as respect goes you get the other companies like AMR who look at ya like you don't count in the EMS field, The nurse only likes you because you are taking a pt. out of her care and off to someone else, other than that she looks at you like ya ya we got this just give me a quick report and be on your way. You just really get the impression that your a peon, and people look down on you.

I was really nieve when I joined this industry, I had no clue as to how things worked and didn't have anyone in the field to talk to. I just thought an ambulance co is a ambulance co and they all do the same thing, some more than others but that's it.

I am considering putting in my app. for another agencie but wonder if it would be better to have at least 6mon of experience, right now I only have 4mon. :?

[JPINFV]

^

Just wondering, what county in CA do you work in?

[GulDukat]

I don't mind answering your questions at all. Maybe you might have some better insight/advice for me.

1. My company does not have any emergency work because it is just strictly BLS Transport. We are prohibitied by county protocol from running code:3

2. I have been out of school since April 2007.

3. As far as respect goes you get the other companies like AMR who look at ya like you don't count in the EMS field, The nurse only likes you because you are taking a pt. out of her care and off to someone else, other than that she looks at you like ya ya we got this just give me a quick report and be on your way. You just really get the impression that your a peon, and people look down on you.

I was really nieve when I joined this industry, I had no clue as to how things worked and didn't have anyone in the field to talk to. I just thought an ambulance co is a ambulance co and they all do the same thing, some more than others but that's it.

I am considering putting in my app. for another agencie but wonder if it would be better to have at least 6mon of experience, right now I only have 4mon. :?

Hello,

Thank you again for your reply. As to advice, I'm not sure how good mine would be because each geographical location has it's own set of values and priorities.

So what would make sense for where I am from may not make a lick of sense to someone in California.

Let me state this right now, the one thing that I believe is universal (in other words no matter what state you work in or country for that matter) continue your education.

Attend any and every In-service, class, pracitcal, etc., etc., that you can. Read text books, even if it means going back and reviewing your EMT text. You would be supprised how much you have forgotten since you left class even though you have only been out for a short period of time.

Here let me ask, when was the last time you applied a short spine device? I bet EMT class, maybe your state practical.

If you have down moments, I know the private world that is rare and precsious, take out some equipment and practice. Get a partner to practice with you.

Paramedic school is an option.

But no matter what you do don't stop learning.

Ok there is that part, now let's see if I have any suggestions for anything else.

I guess I am to assume that your county only allows Paramedic units to transport Emergent patients? I don't have an answer for that other than the obvious, you are going to have to be a Paramedic.

Did I mention yet that you should never stop learning?

Ok here is where I am going to vere off into some, well um...., let's just say that my next viewpoint may not be agreeable with everyone. :twisted:

Here goes.

You need to be PROFESSIONAL. PERIOD. END OF STATEMENT!!!!

Now before you freak out on me and think that I am calling you un-professional, that is as far from the truth as you can be.

Here is my point. At the end of the day the opinion of others doesn't really mean crud. As long as you and your patient, their family and the staff that you work with accept you for your professional skill that is all that really matters.

Now I know that is a lot easier for me to type than it is for you to live, trust me I've been there.

But if you want a different point of view on this from an old person, I'll give it to you.

No matter where you are, no matter what service you are with, no matter your skill level someone is going to look down on you.

That's right even if you are God's gift to Paramedicine there is a surgeon somewhere who will always consider you an Ambulance Driver.

If you work for the County 911 Provider there is a Fire Department Medic somewhere laughing at you because you don't have his pension plan.

Yes, I admit where you are at it is going to lead to almost every other person involved in EMS in your area (including the wonderful E.R. Nursing staff) to stick up their nose at you and pretty much show nothing but disdain for you.

However, as of now it is just because they are prejudice against who you are with and what you do. Not who you are.

Being professional will keep it that way.

Being un-professional will take their prejudice and turn it into justification.

Professionalism begins with continued education. Have I mentioned yet that you need to keep learning? Just making sure.

At the end of the day though there comes a point in time that transporting a walker patient to the Ortho clinic for a follow up of an ORIF of a hip may be detrimental to your long term career.

The biggest pitfall that any of us in this side of the field have to be cautious of is complacency.

At some point in time you just pick Bob up from the ECF and transport him while talking to him about the war he was in and you find yourself takeing fewer and fewer vital signs. Listening to fewer and fewer breath sounds.

Be on the look out for this behavior. This will be the beginning of the end of your EMS career.

One other piece of advice I would like to pass on. Don't just listen to one person and that includes me. Talk to everyone you know about this, you are to young and to new to be already doubting your career.

I'm not saying your doubting it, however I can tell by the way you have written this that you are already disillusioned with your lot in life.

Yours is one of the reasons I started this thread. I want people to talk about this entire lack of respect from both sides to see if it's real and if it is why is it and if there is anything that can be done about it.

Keep up the good fight, don't let anyone talk down to you and keep learning. We need good caring people in the field and far fewer hero's.

Oops the evil part of me came out there at then end.

[pampering patty]

Oh my where do I start. I work for a private service as well as a county 911 service. I started with the private service so I could learn the different areas of my state as well as the locations of the various trauma and burn centers etc..... I am a EMT-I and I always work with a paramedic. Depending on the call I work in the back on a transport,ie....non ACLS protocal. I also get great experience with pt personal skills,,,,listening to the patient you are transporting to a second level rehab, the pt who is going for a heart cath because of an abnormal EKG and is just looking for someone to talk to.

I enjoy the 911 service as well because I get to use and maintain my "medical" skills. I guess I might be one of the lucky ones. Both of my services are equally good and treat me with respect.

[HellsBells]

During my time in EMS, I've worked for two small private companies ( one good, the other... not so much). I'm now working for a large public service, that I'm more or less satisfied with. However, in a service with over 500 employees, its harder to develop those close personal friendships then, say with 10 other co-workers.

In my naive and callow youth I chose to work, for what was perhaps the worst of private operators, in terms of quality equipment, staff respect, and probably, one of overall incompetence in leadership. This was a BLS service with 3 units, we did 911, transfers, standbys, whatever made money, we did it. That said this was a service that did about 400-500 calls a year, so three units was actually quite generous (but of course only because the town was willing to pay).

The treatment of the staff was so unbearable for people that when I came on, the longest an employee had been on staff was 1 1/2 years, all the units were constantly in need of repair( One in particular had been in a roll-over, written off by insurance, our boss was paid out for it, he then bought it back, had it refurbished and put back in service). We were always on short supply for stock, one unit was stocked with these ancient wooden spine boards; which on one memorable occasion almost broke in half when used to lift a heavy dude off the ground. It ended up having a crack around the handle running down the edge of the board. When I tried to take it off the truck, the owners solution was to wrap the handle in tape and deem it fit for service. Can you dig it?

Anyways, after I was employed for about a year our owner lost the service due to his continued incompetence, as well as a few run ins with town council. The company that came in was a well established private operator, running services out of 4 other neighboring towns.

The change was quite welcome, we went to 2 ALS, one BLS unit, brand new ambulances and equipment, a new hall, plus the new owner transferred over about 95% of the former staff, we started having monthly in-services, paid vacation days, competent management.

Now I'm working in a municipal system and the union really dictates how were treated by management, but as I said earlier, I do miss the smaller more, close knit community aspect of the smaller service. But I suppose thats more an issue of rural vs urban at any rate.

[TLC EMS]

Private ambulance services are the "transfer" jockies of EMS. They cannot be considered part of the EMS system because the employer cares little about Emergency Medical Services. The goal with private services [at least where the boss is concerned] is taking transfers exclusively. Obviously the road crews feel different, but they don't make the rules.

I have seen "emergencies" take a back seat to transfers too many times to kid myself about private ambulance services and what they represent. That's why the turnover rate is so high in private services. No EMT or Paramedic feels good about making transfers their primary focus, thus many hate what they do and where they are at. Those of us who have over 20 years remember the days when medics and EMTs were all proud medical providers, now a chimp can do what private EMS does primarily. Sure "that's where the money is" [transfers] but it isn't and never will be where my heart is in feeling like part of the EMS system. I feel like a cab driver with skills.

Man you have issues My family ran and owned a private 911 service for over 30 years and 99.9 percet of the fire jocks had to get precepted by my dads service when they wanted to become medics I now run a small BLS service in ca and I think those of us who grew up in EMS and have 15 years as an EMT see it a little differently. just my .10 cents

[Dustdevil]

Man you have issues My family ran and owned a private 911 service for over 30 years and 99.9 percet of the fire jocks had to get precepted by my dads service when they wanted to become medics I now run a small BLS service in ca and I think those of us who grew up in EMS and have 15 years as an EMT see it a little differently. just my .10 cents

I am assuming you mean Kalifornia and not Canada, since no self-respecting Canadian would fail to capitalise "CA." And, of course, there haven't been paramedics in Alberta for "over 30 years."

But I would agree with you that Gerry apparently has some issues. It is beyond ignorant to assume that, because you have seen private providers who suck, all private providers suck. That is no more valid than the assumption that, because Detroit FD and LA County FD EMS suck, all public providers suck.

[Gerry314]

I am assuming you mean Kalifornia and not Canada, since no self-respecting Canadian would fail to capitalise "CA." And, of course, there haven't been paramedics in Alberta for "over 30 years."

But I would agree with you that Gerry apparently has some issues. It is beyond ignorant to assume that, because you have seen private providers who suck, all private providers suck. That is no more valid than the assumption that, because Detroit FD and LA County FD EMS suck, all public providers suck.

I never said they "all" suck, I said that the dynamics of commercial EMS are such that they cannot be considered part of the EMS system as I define it or as it is viewed by the general public. When your primary occupation is transfers and they take precedence over emergency calls, that affects the legitimacy of that service as an EMS service. I am certain there are services with a more balanced transfer to emergency call valuation, but in my service...that isn't the case. Yes I have issues, and those issues stem from a misdirected focus. I spend many hours and a lot of money to maintain my credentials only to van patients from doctors appointments to home and every other manner of non-vital transportation. I didn't write what I wrote to be victimized by others on this board. Granted OWNERS of EMS services see their services differently than those who actually do the work. You can say what you want about me, but if you are honest about the facts that exist in commercial services then you understand what I am saying is factually sound. Calling my thoughts ignorant is either an attempt to ignore the facts and realities or it is a testament to the intelligence or depth of information available to the reader. I really hate getting involved in these discussions for this reason, you attack me for my perception of 23 years of EMS evolution as just disgruntled rantings instead of a truth that can effect EMS personnel who have longevity. Maybe you just don't recall the early EMS system and that leads you to criticize the comments of someone who has been there and what exists for you is percieved as the "Norm". Who knows, but I am done with this.