Why is EMS a 3rd Class Party? The Forgotten Child

[ems-buff 81]

As I was reading X635's post on Why should EMS be left out in the cold. It got me thinking. Why should we as EMS professional settle for being treated as "Ambulance Drivers". Now I am not ranting or raving, I'm am looking for input. Seth brings up some great points here. Here are some of his quotes in the above mentioned topic.

So why is it acceptable for EMS to operate without stations to change in from street clothes to uniform, rest and eat during downtime, decon, restock, etc.

Why is it? Just because we are not civil service, doesn't mean we shouldn't be treated like human beings. From personal experience sitting in an ambulance for 12hr's at a time twice a week, IS UNHEALTHY!! Yes we all know that it's not for the whole 12hrs. We do a job or 13 lol, but it's not fair. Not to mention how much you eat. Now I can't speak for everyone, but I know from at lest my point of view. I was 130lbs went I first started at where I work. In a two (2) year span I am now 218lbs. I Don't look it (Thank God), but that's unhealthy. With an EMS station, I would be able to work out possibly, Walk around, Possible play basketball, Watch TV, In other words keep my self preoccupied enough to not eat every time I'm bored. Most PD's and FD's take it for granted that they have a nice warm, and even comfortable place to stay. So what are some way's that EMS agencies that don't have a stations and have to do the "post shuffle" can fix this and possibly get what EMS needs.....

Next

I feel there are many reasons for this. First, EMS isn't a civil service, separate municipal agency. EMS workers are very complacent with their environments, and while many young people come in with energy and want things to change, after several years they burnout and don't care anymore. It seems in many systems no one wants to band together and fight for better working conditions.

Why would us as an EMS community not want to better ourselves by combine our passion of helping our fellow man, into help one another. Just like Fire and Police, We are a brotherhood. We have made the choose of helping someone in need, yet we wont help ourselves in get recognition that we are just as important as Fire or PD. It's true what people say. No one knows about EMS until they need us. WHY IS THAT?? Yes I know I am still very young in a profession that is still growing, but the saying "nip it in the bud" comes to mind with the whole morale issue. How come we can't going to a Local government and say make EMS a civil service. How hard is it ?

Next

Also, another huge part of this is EMS provided by for-profit agencies. Often, their is no money to invest in the system infastructure, nor a reason to. Othertimes, EMS is often spread thin and has to cover such a large area, and roams around to where they are needed. Often, EMS is too busy to fully utilize the station. But the biggest factor is many communities aren't even aware of "EMS", what they do, how they do it, or where they "live". Ask a kid where a fire truck comes from, and an adult where the nearest fire or police station is.

I know this Idea as been toss around and around, but how hard would it be to start a county wide EMS system like Boston. It seems to work alot better, why wouldn't it be able to be done here? And once you answer that question ask yourself if something is stop it from coming true, How can you fix that?

Now these are my thoughts on this problem, I am open to any other solutions

Edited February 23, 2008 by ems-buff

[ny10570 745]

Its the same root issue. First off EMS is a relatively new service. Fire and PD have been around as long as the community they protect. Fire is extremely devastating. A little bit of fire does a lot of damage, nothing like watching your neighbors home go up in flames to remind you how much you need fire protection. Fire is also a great headline grabber. It can take time to kill resulting in great video of people being rescued. Fire can also kill innocents very quickly making for compelling tragedy. One the most pervasive fears in the average person is crime.

A few headlines about home invasions, robbery, or murder and people begin clamoring for more police protection. Just about any headline you see on the nightly news PD will be involved in. They're at the accidents, they handle the crime, the standoff, the major weatehr event, the missing child, they're friggin everywhere. PD is the one service that everyone will call upon at one point or another.

EMS on the other is seen as unnecessary. People think they can get themselves or their loved one to the hospital. Its not like if you get robbed you just need to run down to the community gun depot pick one up and go catch the guy. House catches on fire, if you're garden hose doesn't cut it you have no recourse other than to call the FD. We're are never going to catch much real press coverage because half our job is getting off scene quickly. The incidents that are specifically EMS only affect one person.

So now taking all of that in account the general image is going to be that EMS is less important. With an economy that isn't so hot any more budget tightening has begun and its only going to get worse. Fire and PD are facing budget cuts in every big city across the country. With this new economic pressure how much traction is the new kid on the block going to get when they start asking for money.

If you want to fix the system, its going to take the efforts of the grunts on the ground. If your vac is failing start hiring people. Don't contract out to a paid service. Then as volleys drop there is a slow transition to paid that if the day comes that the volleys can't do the job any more there will be a system in place to create a municipal service. Be professional. Do the job right and take pride in your apperance. Your uniform, no matter what it is should always be clean, in good shape, and FIT RIGHT. Wash you bus once in while even if you just hose off the salt and sand in the winter it makes a big difference.

Having a station is not the solution to our problems. Our unhealthy habits will follow us to the couch in front of the TV just as easily as they do to the bus. If you want to pick a fight, fight for pensions, better salaries, LODI benefits, and better training. Find a union and get one in there. Once we stop letting the management kick us around we'll all be better off.

EMSBUFF, its not the 12 hour tours that are unhealthy. You're killing yourself. You're carrying around 70% more of you than there was 2 years ago, there's no way it doesn't show. Stop kidding yourself and fix this before you do some real damage. Most jobs don't let you work out while on the clock, so don't use that as an excuse. If you want to make some changes in the job we're going to need you to be around to make them.

[jcoppola 52]

EMS Buff,

I feel the need to address some of your very good comments. First, let me say that I appreciate what you guys do for a living. You put up with an inordinate amount of bull!#$% and receive little pay for doing so. Every single EMS call I go on, I think of how tough it must be to have EVERY call be an EMS call.

However, speaking only as a member of a FD, I can tell you that no one that I know in a Fire Service career takes the warm, clean confines of a station for granted. It is the very heart of what we do. The kitchen of the FD is the nerve center of the department. We discuss work stuff, training stuff, difficult or fun calls and when appropriate, personal stuff. After a long and drawn-out call, every FF longs to get back to the station to rehab, eat, shower, maybe sleep, and banter. I cannot understand why it is not a custom to provide the same for EMS services, as they, more than anyone, need that very precious rehab after a particularly hairy call.

Second, and I can tell you this from experience...you can have a whole firehouse full of exercise equipment, an awesome coffee maker, an XBOX 360, a great shift of guys, all the new movies you can ask for, an HDTV and a basketball hoop, but its not going to keep your face out of the fridge. Boredom is relative. What we need is more action, more fires etc. to keep us busy.

Addressing the union-joining issue, I agree 100%, Getting these people into organized labor would help out tremendously. Most services are huge conglomerates like AMR and those that are not are hospital-attached. Who better to assist in getting and keeping job security and benefits for workers than a Labor Union who has experience in doing just that. I can remember a few years ago the Norwalk Hospital medics were possibly on the brink of joining our union, IAFF Local 830, and it was squashed at some level and I am not sure which one, but...I never understood why. Please don't interpret this as me just spewing pro-union stuff, they are facts, we work in an industry that needs to protect members that are in the business of protecting others. We also work in an era where we are getting faught tooth and nail about keeping the very benefits our forefathers got for us. Negotiate a union contract and you will see what I mean.

Oh man, I have got carpal tunnel now...

JVC

[ems-buff 81]

Its the same root issue. First off EMS is a relatively new service. Fire and PD have been around as long as the community they protect. Fire is extremely devastating. A little bit of fire does a lot of damage, nothing like watching your neighbors home go up in flames to remind you how much you need fire protection. Fire is also a great headline grabber. It can take time to kill resulting in great video of people being rescued. Fire can also kill innocents very quickly making for compelling tragedy. One the most pervasive fears in the average person is crime.

A few headlines about home invasions, robbery, or murder and people begin clamoring for more police protection. Just about any headline you see on the nightly news PD will be involved in. They're at the accidents, they handle the crime, the standoff, the major weatehr event, the missing child, they're friggin everywhere. PD is the one service that everyone will call upon at one point or another.

EMS on the other is seen as unnecessary. People think they can get themselves or their loved one to the hospital. Its not like if you get robbed you just need to run down to the community gun depot pick one up and go catch the guy. House catches on fire, if you're garden hose doesn't cut it you have no recourse other than to call the FD. We're are never going to catch much real press coverage because half our job is getting off scene quickly. The incidents that are specifically EMS only affect one person.

I understand where you are coming from, but there is no excuse as to why a newspaper can take a picture of an EMS crew on scene of a working fire, or a picture of a crew standing by at a SWAT team opps. 1 example comes to mind with this discussion, The lake Mohegan fire at a Vet's hospital. Where members of Lake Mohegan Vac where seen taking care of sick and injured animals, That was news worthy, was it not?? Yet I never saw anything but great photo's by JT camp and a incident alert by Remember585 here on EMTbravo. It's just sad on it seems we are frowned upon by the general public.

So now taking all of that in account the general image is going to be that EMS is less important. With an economy that isn't so hot any more budget tightening has begun and its only going to get worse. Fire and PD are facing budget cuts in every big city across the country. With this new economic pressure how much traction is the new kid on the block going to get when they start asking for money.

Now With this next statement, I AM IN NO WAY, SHAPE, OR FORM bashing any FD or PD. With that said. Why is it acceptable the there are budgets for brand new fire trucks, and new police cars, new scott packs, NEW stations?!? Yet it's possible for a VAC to buy an ambulance on it's own ONLY thru donations. Or a commerals ambulance to buy the cheapest one's the got going out there. Minis safety of it crew so that the big bosses can live high and mighty??

(this is all hear say there is no actual evidence that such a thing goes on)---->

However, speaking only as a member of a FD, I can tell you that no one that I know in a Fire Service career takes the warm, clean confines of a station for granted. It is the very heart of what we do. The kitchen of the FD is the nerve center of the department. We discuss work stuff, training stuff, difficult or fun calls and when appropriate, personal stuff. After a long and drawn-out call, every FF longs to get back to the station to rehab, eat, shower, maybe sleep, and banter. I cannot understand why it is not a custom to provide the same for EMS services, as they, more than anyone, need that very precious rehab after a particularly hairy call.

I thank you for those nice words, and I know that you understand that sometimes just putting your head down on a pillow and laying in a bed, is sometimes the best thing any of us can do to help each other, but only thing is. How can we get the public involved to show the we are just as important as Fire, Police, DPW, ect.... How did we as EMS professionals let the public's perception of us get so distorted.

Second, and I can tell you this from experience...you can have a whole firehouse full of exercise equipment, an awesome coffee maker, an XBOX 360, a great shift of guys, all the new movies you can ask for, an HDTV and a basketball hoop, but its not going to keep your face out of the fridge. Boredom is relative. What we need is more action, more fires etc. to keep us busy.

I agree, but we can't just start fire or hurt people, and if we do....... enought said. But in all honesty, Working fire, MVA-Rollover, Floods don't happen as often as we hope, So how can we still get the same feeling we get when we are at a working fire, or a "hot job" but just not a real incident????

Addressing the union-joining issue, I agree 100%, Getting these people into organized labor would help out tremendously. Most services are huge conglomerates like AMR and those that are not are hospital-attached. Who better to assist in getting and keeping job security and benefits for workers than a Labor Union who has experience in doing just that. I can remember a few years ago the Norwalk Hospital medics were possibly on the brink of joining our union, IAFF Local 830, and it was squashed at some level and I am not sure which one, but...I never understood why. Please don't interpret this as me just spewing pro-union stuff, they are facts, we work in an industry that needs to protect members that are in the business of protecting others. We also work in an era where we are getting faught tooth and nail about keeping the very benefits our forefathers got for us. Negotiate a union contract and you will see what I mean.

There is a union for EMT's and Paramedics out there, and it is really big, They have atlest on local in every state, it's called The International Association of EMTs and Paramedics (IAEP) it's a division of the National Association of Government

Employees (NAGE). The more people come to realize that Unions are the way to go. The more right's EMS will have..

(I am pro- union, but as a member of this forum, anyone has the right to say a union sucks, We are all adults here your thoughts are just that, YOUR THOUGHTS. And I respect them.)

Oh man, I have got carpal tunnel now...

(sorry about the carpal tunnel JVC )

[Guest]

maybe making it a civil service job is the answer

[AFS1970 504]

I think one of the key issues, other than the relative age of the service, is the fact that EMS is dominated by private, profit making corporations. I know that there are alot of members of this board that work for commercial Ambulance Services, which have no equivilent in the Fire or Police worldss.

Even in the towns where the local Fire Department is a private corporation, they are non-profit, and have no competition. We usually do not put our fire services out to bid, like we do with EMS. One would never see this in Law Enforcement. Yet we take it as the normal state of things in EMS.

As for unions, I think the reason they have not taken off in EMS the way they have in Fire & Police departments is related to the above. Profit making corporations are notoriously anti-union, much more so that any branch of government. Union wages and benefits will cut into profit, as will stations, better uniforms, better ambulances.

EMS is often seen as little more than a Taxi service, and a free one at that. The system abusers certainly feel that way, some EMT's complain about being that way, and everytime an article appears about the need for more units, it brings up the high number of non-priority calls, that strain the system. Yet we wonder why people do not consider EMS to be essential.

As for News coverage, This handles itself in the PD's, because the media is always looking for info. FD's over the years have begun to embrace this trhough the use of PIO's. What has EMS done? How many EMS agencies actively talk with the media? How many issue press releases after major incidents? EMS usually hides behind HIPPA or other confidentiality laws, but in truth there is much that could be released with the specifics edited out, that would show the true nature of EMS to the public, and might help with all the other issues that have lead to the "Third Service" designation.

[ONEEYEDMIC 68]

Making EMS a CIVIL SERVICE JOB will do nothing but hurt EMS in my opinion. But if it is going to be done make the process the same as becoming a LEO or FF. I want a written test to be given, then the same agility that everyone has to take to get into an academy. That means full medical and psycological.

Let's face it, as we have said in the past look at some EMS workers. They are DISGUSTING. I am not saying the PD or FD's don't have overweight people but EMS probably triples the other services. I remember when it was hard to get into MEDIC SCHOOL. Now it seems that they take anybody and it shows in the quality of their skills. So for now it has to stay as it is.

And just because you sit in an ambulance for 12hrs shifts doesn't mean that you have to gain weight by eating the whole time. You can get out and walk around. You can take a meal and work out. You can eat healthy. Boo Hoo.

[x635 4,066]

Making EMS a CIVIL SERVICE JOB will do nothing but hurt EMS in my opinion.

Why would it hurt EMS? EMS, as it currently stands, has a huge problem. You have commercial, for profit ambulance medical transportation companies calling themselves EMS agencies, and real Emergency Medical Services agencies. The whole line between the two is blurred.

EMS SHOULD be a Civil Service job. EMS is just as important and is just as much a part of an emergency response as PD or FD. There's absolutely no reason why Paramedic's and EMT's shouldn't be afforded the oppurtunity for job security, reasonable pay, good benefits, and a pension.

Also, if you made EMS a Civil Service job, with a competitive test including a physical agility component, I'm sure you'll get higher quality people. Also, if you put these same people through an EMS Academy, just like the PD and FD academy, they'd come out better for it.

Take Boston EMS and Austin-Travis County EMS. Both are third service, municipal agencies. Both have strict and comprehensive hiring standards. It's a competitve process. Both have comprehensive academies, and high standards to meet both clinically and operationally once you hit the street. Both offer excellent pay, benefits, and equipment. Why can't we do the same here in Metro NY?

Also, about the Medic School comment. There are still some Medic Schools around that do the right thing. The Medic School I attended REQUIRED mandatory GPA's, etc etc. However, some schools nowadays are more interested in the money that the administration is forcing them to take in, then the product they put out on the street. Again, just like a FF or PD Officer starts fresh into an academy, the same should be done for EMS to ensure consistent quality providers that are all on the same level.

Don't lump every EMS provider into the same category, or stereotype everyone based on certain individuals.

[ONEEYEDMIC 68]

Let's just take Westchester County right now and say they were going to give a Civil Service test to all CURRENT PAID EMS WORKERS and others that want to start an EMS CAREER. You give all the tests that go along to get a CIVIL SERVICE JOB. How many do you think would fail? I would say more than 50%. That hurts EMS. If you gave them a year to pass the tests, I think that number would go down.

I don't know about other EMS AGENCIES and how the hire. I know where I worked and the people that I worked with. I know that all MEDIC SCHOOLS aren't the same. The point I was trying to make is that the skills I see now aren't that great. I don't know why that is but I would have to say that it reflects on the CLASS. I am not picking on one particular class either. I don't know where anyone takes their classes.

I am all for EMS making money so that they can live. I was in that boat bouncing around to different jobs to make ends meet so don't think I am bashing EMS. People are scared to mention the WORD UNION at their places. We always come on here and talk about EMS and how to change it. Do you really think it is going to change in the next 5, 10, or 20 years? I don't, but I would like to meet the person that does it.

[x635 4,066]

I know that all MEDIC SCHOOLS aren't the same. The point I was trying to make is that the skills I see now aren't that great. I don't know why that is but I would have to say that it reflects on the CLASS. I am not picking on one particular class either. I don't know where anyone takes their classes.

But that's not just the Medic School's fault. Again, I blame a lot of it on the agencies, and the "you have a pulse, we'll hire you" syndrome.

A for-profit agency, or agency with limited funding or high turnover, isn't going to invest a lot in their employees. EVERY system needs FIELD Supervisors/Evaluators, training staff, mandatory in-house training and skill recertification, and other tools so they can BUILD or REPAIR on what the Medic School taught or didn't teach...which is also where the academy would come in. Just like you're not going to have a perfect firefighter or cop right out of the gate....you're not going to have a perfect medic. However, PD and FD oversight of new employees is a LOT stricter and more comprehensive then 95% of EMS Agencies.

[Guest]

Let's just take Westchester County right now and say they were going to give a Civil Service test to all CURRENT PAID EMS WORKERS and others that want to start an EMS CAREER. You give all the tests that go along to get a CIVIL SERVICE JOB. How many do you think would fail? I would say more than 50%. That hurts EMS. If you gave them a year to pass the tests, I think that number would go down.

granted it would give some people the boot, but don't you think that would actually help ems? weeding out the qualified vs. the not so qualified? i've seen some vollies and paid guys looking like friggin slobs (boots untied/unlaced, untucked shirt, uniform collars "popped!") when they go on calls and when they get out of their rigs at hospitals. i have never seen a cop, ff, or even a mailman for that matter looking like a mess. to me looking like a professional makes you a professional and a civil service job you are held to look the part.

i know a certain company that had a certain employee who was recently fired, who came in unannounced to various er's and would tell people to fix themselves up. that wasn't his job, but he made his sloppy employees look respectable.

[helicopper 1,050]

Let's just take Westchester County right now and say they were going to give a Civil Service test to all CURRENT PAID EMS WORKERS and others that want to start an EMS CAREER. You give all the tests that go along to get a CIVIL SERVICE JOB. How many do you think would fail? I would say more than 50%. That hurts EMS. If you gave them a year to pass the tests, I think that number would go down.

I don't know about other EMS AGENCIES and how the hire. I know where I worked and the people that I worked with. I know that all MEDIC SCHOOLS aren't the same. The point I was trying to make is that the skills I see now aren't that great. I don't know why that is but I would have to say that it reflects on the CLASS. I am not picking on one particular class either. I don't know where anyone takes their classes.

I am all for EMS making money so that they can live. I was in that boat bouncing around to different jobs to make ends meet so don't think I am bashing EMS. People are scared to mention the WORD UNION at their places. We always come on here and talk about EMS and how to change it. Do you really think it is going to change in the next 5, 10, or 20 years? I don't, but I would like to meet the person that does it.

Frankly, if that many people failed a civil service exam for EMT or paramedic I think it would be a great service to the industry! If a person can't pass a basic test focused on the job and certification that they already hold they don't deserve the job! It also serves to reinforce the point you made about the quality of EMS professionals varying greatly due to the vastly different training programs out there. I also think your estimate is off - way off - but since you are spitballing with 50%, I won't spitball back.

EMS definitely needs a change and maybe a county or regional approach would be better than the patchwork nonsense we've had for the past 30 years.

It is time for EMS to be recognized for what it is and treated that way!

Considering you bailed out to go to one of the other emergency services, that is civil service, does provide better pay, benefits, and incentives (like a 20 year retirement), you of all people should be more supportive of this effort and not simply bashing it because it would be laborious.

[Bnechis 3,961]

As I was reading X635's post on Why should EMS be left out in the cold. It got me thinking. Why should we as EMS professional settle for being treated as "Ambulance Drivers". Now I am not ranting or raving,....

Great Question. Maybe the reason that EMS in general and EMT's in particular are treated as "Ambulance Drivers" is due to lack of training, supervision and leadership.

Lets look at these 3 issues:

Training: HS Diplomia and approx 160 hrs of EMT training or 4 weeks and most commercial and vol. services will send you out on calls with minimal additional training, including driver training. To cut my hair you need over 1,000 hrs training to get licensed. When DES & DOH offers additional training only a very small % show up. In the 1980's & 1990's many of the vol. agencies fought hard against ALS because "we do not need paramedics telling our EMT's what to do". Also new EMT's are often paired with other newbies doing NH runs, so they do not get good training reinforcement.

Career FF's recieve 12 - 16 weeks of training plus in many depts EMT. Then they are assigned to other members or officers with more experience to learn the job. Police go to the accademy for 6+ months then are assigned to a training officer.

Supervision: What does it take to be a supervisor? In EMS this varies from election, to company preference, to nobody wanted it, and on occassion to the perfect candidate. In my PD you need to have a associates degree to even take the sargents test, BA/BS for Lt. and a masters for Capt., The FD does competitive testing for promotion and mandated state officer training.

How often does an EMS supervisor show up to evaluate or supervise personel? How about PD (often) & FD (most calls).

How often is the head of EMS selected by the Mayor, Supervisor, Board, etc. What about FD? PD? And do they have a seat at the government table?

Why is it? Just because we are not civil service, doesn't mean we shouldn't be treated like human beings. From personal experience sitting in an ambulance for 12hr's at a time twice a week, IS UNHEALTHY!! Yes we all know that it's not for the whole 12hrs. We do a job or 13 lol, but it's not fair. Not to mention how much you eat. Now I can't speak for everyone, but I know from at lest my point of view. I was 130lbs went I first started at where I work. In a two (2) year span I am now 218lbs. I Don't look it (Thank God), but that's unhealthy. With an EMS station, I would be able to work out possibly, Walk around, Possible play basketball, Watch TV, In other words keep my self preoccupied enough to not eat every time I'm bored. Most PD's and FD's take it for granted that they have a nice warm, and even comfortable place to stay. So what are some way's that EMS agencies that don't have a stations and have to do the "post shuffle" can fix this and possibly get what EMS needs.....

Lots of issues here.

1) Lots of other jobs require you to be in your vehicle all day: PD, DPW, truckers, taxi's, Bus drivers, USPS, UPS, FedEx, Construction, etc. etc. Being in the vehicle alone is not unhealthy. "Not fair".......my father always told me life is unfair.....bitching here does not change that.

2) Stop Eating in the Bus. Read, work on your education, get out and walk. Gaining that much is unhealthy. We see people sleeping and eating all day in EMS stations....and gaining just as much weight.

3) FD does not take it for granted, we constantly have to fight to even maintain what we have. The majority of FD Career stations in Westchester are at least 50 yrs old, many built for horse drawn fire apparatus. I know of at least 12 that are in danger of collapse and we have to fight to keep them open.

Why would us as an EMS community not want to better ourselves by combine our passion of helping our fellow man, into help one another. Just like Fire and Police, We are a brotherhood. We have made the choose of helping someone in need, yet we wont help ourselves in get recognition that we are just as important as Fire or PD. It's true what people say. No one knows about EMS until they need us. WHY IS THAT?? Yes I know I am still very young in a profession that is still growing, but the saying "nip it in the bud" comes to mind with the whole morale issue. How come we can't going to a Local government and say make EMS a civil service. How hard is it ?

Most local governments want nothing to due with EMS. Most governments do not wat to pay for it and i may of the commercial contracts they prove it with $0 cotracts. Others provide minimal levels. In the communities with VAC's or VFD's the local gov's have gotten away with providing minimal if any support, with the EMS agency going for decades proudly not even asking for help.

Next

I know this Idea as been toss around and around, but how hard would it be to start a county wide EMS system like Boston. It seems to work alot better, why wouldn't it be able to be done here? And once you answer that question ask yourself if something is stop it from coming true, How can you fix that?

Boston is a City not a county. If you look at the communities around Boston its similar to Westchester with lots of different agencies.

The problem with starting a county system is convincing each existing agency to give up its kingdom. You also have a problem with paying for it. i.e. Yonkers is Fee for service, which means no property tax is spent on service, if you start a county system you will have at a minimum start up costs, which the county will most likely use property tax to cover. Why would any taxpayer that currently does not pay for EMS want to pay for it?

[Bnechis 3,961]

If your vac is failing start hiring people. Don't contract out to a paid service. Then as volleys drop there is a slow transition to paid that if the day comes that the volleys can't do the job any more there will be a system in place to create a municipal service.

This is the reason we have 20-30 agencies with part time people, almost none are big enought or busy enough to propertly function this way and will always be short of funds to run properly or provide any benefits.

If your failing, consider merging with the other EMS agencies in your area. Then when you hire, you have a large enough base to do it right.

Be professional. Do the job right and take pride in your apperance. Your uniform, no matter what it is should always be clean, in good shape, and FIT RIGHT. Wash you bus once in while even if you just hose off the salt and sand in the winter it makes a big difference.

Well said.

[Bnechis 3,961]

Why is it acceptable the there are budgets for brand new fire trucks, and new police cars, new scott packs, NEW stations?!? Yet it's possible for a VAC to buy an ambulance on it's own ONLY thru donations. Or a commerals ambulance to buy the cheapest one's the got going out there. Minis safety of it crew so that the big bosses can live high and mighty??

New Stations? Our stations were built in

1902, 1904, 1922, 1962, & 1962. Ad our scott packs were replaced in 2005 with a grant. Our new trucks replace 20 y/o ones that we sell for scrap metal.

The VAC's spent 20-40 years proudly claiming that they only needed donations, many even refused till recently to bill 3rd party insurance.

If you watch the commercial industry on a national level you will find many go out of biz, because the amount they can bill is below the cost of providing the service.

[Goose 188]

Training: HS Diplomia and approx 160 hrs of EMT training or 4 weeks and most commercial and vol. services will send you out on calls with minimal additional training, including driver training. To cut my hair you need over 1,000 hrs training to get licensed. When DES & DOH offers additional training only a very small % show up. In the 1980's & 1990's many of the vol. agencies fought hard against ALS because "we do not need paramedics telling our EMT's what to do". Also new EMT's are often paired with other newbies doing NH runs, so they do not get good training reinforcement.

Career FF's recieve 12 - 16 weeks of training plus in many depts EMT. Then they are assigned to other members or officers with more experience to learn the job. Police go to the accademy for 6+ months then are assigned to a training officer.

Thanks for highlighting this MAJOR issue. I think it takes at least one certification cycle of full-time EMS experience to really get yourself grounded in the field. One of the biggest issues is, if you double or triple the training hours, the volunteers are going to raise hell. Now, these aren't fighting words at all, but the argument will be made - and has been made to me in personal conversation - that volunteers already take time out of their lives to respond to calls (which is a noble cause) and to train (however little it may be) now you expect them to go through a course thats 300+ hours that requires more a more advanced knowledge bank and skill set, your putting an unreasonable burden on the system.

Now, this I'm not saying volunteer agencies are solely to blame. This issue is very complex and multifaceted, but they contribute their fair share to the problem.

I can't tell you how many times I've done meet and assists with volunteer agencies (who have a full crew and bus o/s) only to have them turf over a BLS call to us because "were going back towards the hospital anyway" or because they don't feel like transporting patients from the adult home. But they would be the first to kick and scream and ring their local politicians the second the state were to hand down more rigorous standards or more training requirements claiming the state was trying to drown or shut down the volunteers in the interests of commercials/municipal systems.

Edited February 24, 2008 by Goose

[Bnechis 3,961]

Also, if you made EMS a Civil Service job, with a competitive test including a physical agility component, I'm sure you'll get higher quality people. Also, if you put these same people through an EMS Academy, just like the PD and FD academy, they'd come out better for it.

You will only get the higher quality if you invest the money into the system.

Take Boston EMS and Austin-Travis County EMS. Both are third service, municipal agencies. Both have strict and comprehensive hiring standards. It's a competitve process. Both have comprehensive academies, and high standards to meet both clinically and operationally once you hit the street. Both offer excellent pay, benefits, and equipment. Why can't we do the same here in Metro NY?

It could be done all it would take is $$$$ and all the individual services to agree to disband......good luck.

Also, about the Medic School comment. There are still some Medic Schools around that do the right thing. The Medic School I attended REQUIRED mandatory GPA's, etc etc. However, some schools nowadays are more interested in the money that the administration is forcing them to take in, then the product they put out on the street. Again, just like a FF or PD Officer starts fresh into an academy, the same should be done for EMS to ensure consistent quality providers that are all on the same level.

25 yrs ago you had to have 1 year of ALS experience (as an EMT) and take a competative test to get in to the medic class. You had more people interested than total seats in class. Now the state has moved all the programs to "accredited schools". And the law no longer allows the same level of presceening, also the number of students coming in is so low that the schools need everyone to cover the costs.

[JJB531 652]

This is and issue that has been discussed NUMEROUS times on this site. It makes for good discussion, but as long as we continue to just talk about it, that's all it's going to stay... a good discussion.

There are so many problems with EMS that one doesn't know where to start. If we were able to narrow down the problem to one or two things, then it would be considerably easier to possibly correct these things and bring EMS "up to speed" with other parts of the country.

There is a considerable shortage of EMS providers, especially experienced providers who are respected practicioners in the field of prehospital emergency medicine. Many of the respected EMT's and Paramedics out there end up leaving the field to further their careers, or leave to join fire or police departments where there is more stability, room for advancement, and opportunity. So what ends up happening? Agencies (paid and volunteer) end up placing individuals, whose ink is still wet on their EMT and Paramedic cards, out there to learn on their own. There is no standard for field training, and many agencies don't even have any type of field training program in place for new EMT's and Paramedics. So do we blame the agency?

The same problem is being encountered with EMT and Paramedic Programs. Unlike a Fire or Police Academy, where the goal is to graduate "competent" police officers or firefighters, who will then go to their respective agencies and endure some kind of field training program, EMS programs are about making money. EMS programs receive funding from the State depending on the number of students they graduate. The more students who graduate, the more funding the program receives. So do we blame the program coordinators/instructors?

What about EMT's and Paramedics. In any emergency service, there are those individuals who are dedicated and promote professionalism within their respective field. Unfortunately though, in the field of EMS, there is a general lack of self-respect by EMS personnel. Paid personnel (especially in the field of private-for-profit) who walk around shirts untucked, stained, baseball hats on backwards, unnecessary/excessive jewelry... I can go on and on. And volunteer agencies where providers go on calls in jeans, shorts, sandals, tank tops, etc. etc. We should have some self-respect to look in the mirror before we go out in the public's eye, and the agency should be enforcing a dress code. So, are we to blame for our own misery?

What about our EMS Advisory Council, Department of Emergency Services, or NYS Bureau of EMS. What do they do for EMS? No training except for the occasional CME topic, protocols that are outdated, having to attend call audits that are, IMHO, a complete waste of my personal time, no public education to promote EMS, the one dinner they do a year to honor EMS where only a few people from each agency are permitted to attend, and the barbecue they do every year at Rye Playland. While it is a nice gesture, I personally think it is a little ridiculous that you're honoring EMS providers for saving a life while people are looking on slobbing down cheesburgers and keg beer. I personally think it's a disgrace. I would rather see our Westchester EMS Region coordinate with the local villages, towns, and cities, and do something in conjuction with the municipalities to honor EMS workers for their service. We have an EMS Advisory Council that is headed up by a Police Chief.... not a Paramedic. I still haven't seen one thing the Advisory Council has done to promote EMS... the last time the minutes on their website were updated was in 2003. So do we blame those who basically have EMS oversight in Westchester County?

Is a union the answer... maybe. I wouldn't mind seeing a local association made up of EMS providers to speak on behalf of EMS providers. To go to the media to promote EMS and the things EMS providers do every day. To go to the Council and our Medical Advisory Committee to get the protocols that we want. To unify all of the EMS agencies in Westchester County, to provide training (why should I have to pay 200 dollars out of my own pocket for ACLS and PALS?), to establish standards for field training, maybe establish a county-wide EMS Honor Guard, to set standards for EMS agencies, to learn to work together instead of all the home rule garbage that's out there. I think for EMS to begin to advance, the first thing that has to happen is that EMS providers themselves have to learn to stand and work together. The agency patches may be different, but the State certification patches are all the same.

[ny10570 745]

Turning EMS into a civil service position tomorrow would be great, but who is going to give up their and control and who is going to cough up the cash for this? Lets be real. This is going to take an effort from the bottom up. The only way I see this happening in the short term is through a union. I am far from neing one of those rah rah union guys, but EMS needs a common thread and a strong union could be it.

Bnechis, you're right just hiring a few part timers isn't the solution. What's important is that it establishes a precedent where agencies don't have to sell out to privates to fill their staffing needs. Mt. Pleasant is in a unique position where they really could lead the way. Two of the three agencies all ready are paying for part time EMTs, they share the same ALS service, and they could easily be organized under one municipality.

[Bnechis 3,961]

So what ends up happening? Agencies (paid and volunteer) end up placing individuals, whose ink is still wet on their EMT and Paramedic cards, out there to learn on their own. There is no standard for field training, and many agencies don't even have any type of field training program in place for new EMT's and Paramedics. So do we blame the agency?

Yes. If a PD or FD does not have field training and something goes wrong we blame the agency (and its leadership). Since EMS agencies are certified by DOH based on standards, if they dont meet the standards then its the agecies fault.

The same problem is being encountered with EMT and Paramedic Programs. Unlike a Fire or Police Academy, where the goal is to graduate "competent" police officers or firefighters, who will then go to their respective agencies and endure some kind of field training program, EMS programs are about making money. EMS programs receive funding from the State depending on the number of students they graduate. The more students who graduate, the more funding the program receives. So do we blame the program coordinators/instructors?

Thats not completely true. EMS students must prove "competence" (the state exam) or the state does not reimburse for the training. When I teach (Phelps) students are required to sign a contract that they are responsible to pay for the course. If they are eligible for State Fuding, they do not pay, unless they do not complete the course and the state wont pay. These policies are to cover the cost of training.

What about EMT's and Paramedics. In any emergency service, there are those individuals who are dedicated and promote professionalism within their respective field. Unfortunately though, in the field of EMS, there is a general lack of self-respect by EMS personnel. Paid personnel (especially in the field of private-for-profit) who walk around shirts untucked, stained, baseball hats on backwards, unnecessary/excessive jewelry... I can go on and on. And volunteer agencies where providers go on calls in jeans, shorts, sandals, tank tops, etc. etc. We should have some self-respect to look in the mirror before we go out in the public's eye, and the agency should be enforcing a dress code. So, are we to blame for our own misery?

agreed

What about our EMS Advisory Council, Department of Emergency Services, or NYS Bureau of EMS. What do they do for EMS? No training except for the occasional CME topic, protocols that are outdated, having to attend call audits that are, IMHO, a complete waste of my personal time, no public education to promote EMS, the one dinner they do a year to honor EMS where only a few people from each agency are permitted to attend, and the barbecue they do every year at Rye Playland. While it is a nice gesture, I personally think it is a little ridiculous that you're honoring EMS providers for saving a life while people are looking on slobbing down cheesburgers and keg beer. I personally think it's a disgrace. I would rather see our Westchester EMS Region coordinate with the local villages, towns, and cities, and do something in conjuction with the municipalities to honor EMS workers for their service. We have an EMS Advisory Council that is headed up by a Police Chief.... not a Paramedic. I still haven't seen one thing the Advisory Council has done to promote EMS... the last time the minutes on their website were updated was in 2003. So do we blame those who basically have EMS oversight in Westchester County?

Lots of issues,

What do you (or any individual or agecy) do for EMS.

Call audits are conducted by individual MD's representing the ER's. Some are very good, others are not. But that has nothing to do with the agency's you listed. In other states agencies PAY the Medical Directors for this service. In westchester we expect them to do it for free.

"only a few are permitted"....are you kidding? Maybe if you want your agency to foot the bill.

Is a union the answer... maybe. I wouldn't mind seeing a local association made up of EMS providers to speak on behalf of EMS providers. To go to the media to promote EMS and the things EMS providers do every day. To go to the Council and our Medical Advisory Committee to get the protocols that we want. To unify all of the EMS agencies in Westchester County, to provide training (why should I have to pay 200 dollars out of my own pocket for ACLS and PALS?), to establish standards for field training, maybe establish a county-wide EMS Honor Guard, to set standards for EMS agencies, to learn to work together instead of all the home rule garbage that's out there. I think for EMS to begin to advance, the first thing that has to happen is that EMS providers themselves have to learn to stand and work together. The agency patches may be different, but the State certification patches are all the same.

To speak on behalf of EMS providers....Have you or anyone you know made any effort to attend the council meetings. Half the agencies in the county have never sent a sole. There are about 50 people who have been or are active over the last 20 years.....you want change....show up!

Have you ever been to a MAC meeting. You want protocols....ASK!!!!

NRFD wanted AED's (long before it was an EMT skill)...we ASKED.

We ASKED for EPI Pens....1st BLS Agency in Westchester

We ASKED for Albuterol....1st BLS Agency in Westchester

We ASKED for Mark I Kits....1st BLS Agency in Westchester

CO moitoring.......

STOP COMPLAINING ABOUT MAC and ASK for the protocols you want.

You pay for ACLS & PALS for the same reason the RN's & MD's have to pay. Its not funded.

To set Standards......We Have a County Mutual Aid Plan.....but we still have 20% of the agencies/muicipalities still have not signed onto it.

You are correct, EMS needs to stand up and participate.

[JJB531 652]

So to address a few of your comments to my post.

Yes EMS providers must show "competence" in order to pass the state exam... yet so many who graduate are GROSSLY INCOMPETENT. I've seen individuals who have been EMT's for YEARS and still cannot perform an adequate patient assessment or even take a blood pressure for that matter. Just because someone has book smarts to pass a written exam and the cookbook scenarios given during the practical exam, in my opinion, is not enough. EMT students should be doing more time on an ambulance, practicing their skills, until an experienced (and competent) EMT or Paramedic says they are competent to sit for the state exam. Maybe Phelps doesn't push people through the state exam to get their share of money from the state, but there are programs out there that do.

What do I do for EMS? I act professional. I make sure my uniforms are always in order. I attend as much training as I can, even if I have to pay for it out of my own pocket. I take as many train-the-trainer courses as I can so I can offer these courses to other EMS providers FREE OF CHARGE. I have taken a very active role in a number of progressive programs the agency I work for provides to the community. I have written articles for trade magazines, and written editorials that have been published in newspapers promoting EMS. I have done numerous public education programs at schools and career fairs. If you would like me to keep going, I'll be happy to PM you my resume and portfolio.

I understand nurses and doctors have to pay for ACLS and PALS, but this discussion is how EMS compares to other emergency services. If a police officer wants to get radar qualified, do they have to pay for it out of pocket? If a firefighter wants to take any of the courses offered at the DES, do they have to pay for it out of pocket? NO! So why does an EMS provider have to pay out of pocket for ACLS, PALS, NALS, PHTLS or any of the other courses traditionally available to EMS providers?

In case I studdered, yes, I said only a few are permitted to the EMS dinner. Each agency is permitted a certain number of slots. At least that was the reasoning I was given when I was bumped off the list of attendees for the last dinner. With the exception of award recepients, the majority of people attending the dinner are upper level management (Line Officer, Supervisors, Managers, etc.).

I would love to attend MAC meetings and Advisory Council meetings, but I unfortunately can not afford to take off of work to attend such things, so I try to make up for it in other ways. I've spoken with regional faculty... I've talked about RSI, CPAP, hemostatic agents, expanded scope of practice for specialized paramedics (i.e. TEMS providers), clearing C-Spines in the field, etc. I'm asking for it, personally, and am still waiting to get it.

[Bnechis 3,961]

I'm merely stating the things that I see going on. So to address a few of your comments to my post.

Sorry you feel that way. It sounded like it to me.

Yes EMS providers must show "competence" in order to pass the state exam... yet so many who graduate are GROSSLY INCOMPETANT. I've seen individuals who have been EMT's for YEARS and still cannot perform and adequate patient assessment or even take a blood pressure for that matter. Just because someone has book smarts to pass a written exam and the cookbook scenarios given during the practical exam, in my opinion, is not a measure of competance. EMT students should be doing more time on an ambulance, practicing their skills, until an experienced EMT or Paramedic says they are competent to sit for the state exam. Maybe Phelps doesn't push people through the state exam to get their share of money from the state, but there are programs out there that do.

So the real issue is that the EMT program (in general) is not adequate. These are format issues that I agree need adressing, but they also mean more hours and everytime anyone suggests adding training time, everyone freaks out.

What do I do for EMS? I act professional. I make sure my uniforms are always in order. I attend as much training as I can, even if I have to pay for it out of my own pocket. I take as many train-the-trainer courses as I can so I can offer these courses to other EMS providers FREE OF CHARGE. I have taken a very active role in a number of progressive programs the agency I work for provides to the community. I have written articles for trade magazines, and written editorials that have been published in newspapers promoting EMS. I have done numerous public education programs at schools and career fairs. If you would like me to keep going, I'll be happy to PM you my resume and portfolio.

No need to keep going. Its clear that you do a lot to improve your EMS world. My point was you were commenting about other entities and what they should be or should not be doing. My point was everyone is willing to comment about these entities, but very few are willing to participate.

I understand nurses and doctors have to pay for ACLS and PALS, but this discussion is how EMS compares to other emergency services. If a police officer wants to get radar qualified, do they have to pay for it out of pocket? If a firefighter wants to take any of the courses offered at the DES, do they have to pay for it out of pocket? NO! So why does an EMS provider have to pay out of pocket for ACLS, PALS, NALS, PHTLS or any of the other courses traditionally available to EMS providers?

I've paid for many fire and rescue courses over the years. Its oly been the last 10 years that NYS provided Technical rescue training. Before that if you wanted it, you paid for it. What about the career fire accademy? Paid for by the local dept., Many agencies are willing to pay for courses, others are not.

In case I studdered, yes, I said only a few are permitted to the EMS dinner. Each agency is permitted a certain number of slots. At least that was the reasoning I was given when I was bumped off the list of attendees for the last dinner. With the exception of award recepients, the majority of people attending the dinner are upper level management (Line Officer, Supervisors, Managers, etc.).

Not true. No agency is given any slots. Its always been you sign up and pay. The last few years its continued to get bigger, but they would love to keep growing. Who bumped you...WCREMSCO or your agency?

I would love to attend MAC meetings and Advisory Council meetings, but I unfortunately can not afford to take off of work to attend such things, so I try to make up for it in other ways. I've spoken with regional faculty... I've talked about RSI, CPAP, hemostatic agents, expanded scope of practice for specialized paramedics (i.e. TEMS providers), clearing C-Spines in the field, etc. I'm asking for it, personally, and am still waiting to get it.

While I attend less MAC than I would like, I still rarely hear anyone requesting these items at the meetings. The MD's need a proposal that covers all issues before they are willing to risk their license on it and if it is not proposed by anyone, we will never see it. CPAP last year was proposed ad a trial was done and the agency that did it felt it was of marginal use.

An additional issue, if we have trouble now with substandard training, how do we add additional skills and expect those that are already below where they should be to be competent?

[JJB531 652]

I don't necessarily think that the EMT program itself is inadequate. I would like to see EMT students spending more time doing field rotation hours than the 8 or 16 hours they're doing now. My initial comment regarding EMT programs was the fact that there are programs out there that are a little too generous with graduating students.

I don't feel I'm improving "my EMS world" (as you put it), because very little of what I do benefits myself. In fact, nothing that I do really benefits myself. The stuff I do within the agency that I work for benefits the agency and the community that we serve... the benefits certainly aren't reflected in my paycheck.

You are right, if we already have substandard training, how do we justify extended the scope of practice... I agree 100%. But unfortunately it's been done. Especially at the BLS level with the introduction of albuterol administration. I will not go into specific stories of the number of times I've seen albuterol given to patients clearly in CHF with no ashtma history. I guess when I refer to expanded scope of practice, I'm thinking of all the great paramedics I've had the pleasure of working with, and how this expanded scope could benefit our patients. I've heard rave reviews from other systems on the use of CPAP, and I've seen other agencies that are extremely progressive and are even using field-induced hypothermia of post-cardiac arrest patients. Obviously medicine is not an exact science (just look at how many times the AHA BCLS and ACLS protocols change), and years of studies go into such procedures and protocols.

I was informed by my agency that they contacted the WREMSCO for extra slots to this event and were denied. Obviously they could have been blowing smoke up my you know where, so if I am mistaken in my initial statement I will retract it.

[Bnechis 3,961]

I don't necessarily think that the EMT program itself is inadequate. I would like to see EMT students spending more time doing field rotation hours than the 8 or 16 hours they're doing now. My initial comment regarding EMT programs was the fact that there are programs out there that are a little too generous with graduating students.

Agreed, the time frame is set by Fed DOT and NYS DOH

I don't feel I'm improving "my EMS world" (as you put it), because very little of what I do benefits myself. In fact, nothing that I do really benefits myself. The stuff I do within the agency that I work for benefits the agency and the community that we serve... the benefits certainly aren't reflected in my paycheck.

I'm sorry I ment, both your individual and your agency as opposed to a more regional improvement.

You are right, if we already have substandard training, how do we justify extended the scope of practice... I agree 100%. But unfortunately it's been done. Especially at the BLS level with the introduction of albuterol administration. I will not go into specific stories of the number of times I've seen albuterol given to patients clearly in CHF with no ashtma history. I guess when I refer to expanded scope of practice, I'm thinking of all the great paramedics I've had the pleasure of working with, and how this expanded scope could benefit our patients. I've heard rave reviews from other systems on the use of CPAP, and I've seen other agencies that are extremely progressive and are even using field-induced hypothermia of post-cardiac arrest patients. Obviously medicine is not an exact science (just look at how many times the AHA BCLS and ACLS protocols change), and years of studies go into such procedures and protocols.

Sounds like, training, leadership, suppervision issues again. i understand how you feel, but consider this, If you could hire all the medics in a system, offer them $200,000/yr plus bennies. You can hire 40 medics, national search, you hire the best 40 i the US, one of them will still be your worst medic and the system must address that.

We can not add new things if the current things have not been mastered, even if its the "right thing"

I was informed by my agency that they contacted the WREMSCO for extra slots to this event and were denied. Obviously they could have been blowing smoke up my you know where, so if I am mistaken in my initial statement I will retract it.

Where there is smoke there's fire........Only way they would have been denied is if after the deadline for submission.

[JJB531 652]

I wish there was ways I could single-handedly create regional improvement, but I do what I can. I'm sure it's been said here before, and I think you even addressed it, that EMS in this area as a whole needs to step up to the plate in order for regional changes to take place. More people need to get involved, more people need to attend meetings, more people need to have the desire to work towards change.

I'm not trying to bash the MAC or WREMSCO or Advisory Committee... they do what they can do. Do I wish they could do more, absolutely. I think that there are some very dedicated individuals there who are already overworked and they too can only do so much.

This is why I suggested maybe some form of Association made up of regional providers who are willing to take the time to assist the MAC and WREMSCO. Similiar to how there are law enforcement associations (i.e. NTOA, NYS Tactical Officers Association, etc.) who promote training and provide discounted or free training to it's members, they improve view of the service in the eyes of the public, etc. Another example is while it may be difficult for an individual agency to train, equip, and maintain an Honor Guard for LOD deaths or active-duty deaths of members, perhaps an association could pool resources to have a county-wide honor guard that can do funerals for EMS personnel or other functions. I'm just using these as examples from looking at what types of details are typically seen with Police and Fire.

If providers want to bring EMS up to the level that FD and PD are, I think that this might be a start. While the whole system does need serious overhaul, I think that any improvements that we could start now would be a step in the right direction. To improve the way we're seen by not just the public, but also how we are perceived by members of other emergency services.

Edited February 25, 2008 by JJB531

[ONEEYEDMIC 68]

Frankly, if that many people failed a civil service exam for EMT or paramedic I think it would be a great service to the industry! If a person can't pass a basic test focused on the job and certification that they already hold they don't deserve the job! It also serves to reinforce the point you made about the quality of EMS professionals varying greatly due to the vastly different training programs out there. I also think your estimate is off - way off - but since you are spitballing with 50%, I won't spitball back.

EMS definitely needs a change and maybe a county or regional approach would be better than the patchwork nonsense we've had for the past 30 years.

It is time for EMS to be recognized for what it is and treated that way!

Considering you bailed out to go to one of the other emergency services, that is civil service, does provide better pay, benefits, and incentives (like a 20 year retirement), you of all people should be more supportive of this effort and not simply bashing it because it would be laborious.

Your right I bailed out and I don't regret any second of it. I did my time in EMS. I worked my 80+hrs a week in different places to make ends meet. I left for a CAREER that I LOVE and ALWAYS WANTED TO DO. The fact that I have the option to retire in 20 years with a pension and medical benefits is awesome as well. I would never have had that if I did EMS FOR LIFE. I actually still love EMS as well. I just don't have any desire to do it anymore. That doesn't mean that I can't state a fact that I believe or what I saw when I worked EMS. That doesn't mean I am not bashing EMS. I made a point that if a test was given tomorrow, 50% of CAREER EMS PROFESSIONALS would FAIL either a written or agiltiy portion of the test. Maybe I'm wrong, maybe I'm not. I guess we will never know.

[helicopper 1,050]

granted it would give some people the boot, but don't you think that would actually help ems? weeding out the qualified vs. the not so qualified? i've seen some vollies and paid guys looking like friggin slobs (boots untied/unlaced, untucked shirt, uniform collars "popped!") when they go on calls and when they get out of their rigs at hospitals. i have never seen a cop, ff, or even a mailman for that matter looking like a mess. to me looking like a professional makes you a professional and a civil service job you are held to look the part.

i know a certain company that had a certain employee who was recently fired, who came in unannounced to various er's and would tell people to fix themselves up. that wasn't his job, but he made his sloppy employees look respectable.

Sloppy appearances and poor attitudes are not products of EMT/medic schools - they're from the lack of discipline at the agency. If you allow people to walk around with unlaced boots, untucked shirts, etc. that's the image they're going to present.

If line officers, supervisors, or whatever mechanism exists in the organization went out and told these responders that their attire is inappropriate or conduct was not professional, it would either be fixed or the failure to change would give them cause to remove the person from the agency. VAC's don't have captains just to wear shiny collar brass. They're the operations supervisors! Don't say "we need this EMT or that driver" either - bad apples are bad apples. Get rid of them and replace them!

[JJB531 652]

Sloppy appearances and poor attitudes are not products of EMT/medic schools - they're from the lack of discipline at the agency. If you allow people to walk around with unlaced boots, untucked shirts, etc. that's the image they're going to present.

I absolutely agree that sloppy appearances and poor attitudes are not the products of EMT/medic schools.... but I think that it partly does stem from lack of discipline while in the training stage.

For example, when new recruits enter the police academy or fire academy, what would happen if they showed up to their academy class with a dissheveled uniform or unshaven? They would be running laps until they pass out. Their uniforms are expected to be clean and pressed, they are to be properly groomed (haircut, clean shaven, etc.), and so on. This is how police and fire academies promote professionalism and a professional appearance, from the first day of the academy.

I could show up at my EMT or medic class wearing sandals, shorts, a tank top, and it's perfectly acceptable. You can't build a house without a strong foundation, and I just don't think that EMS programs really build that strong foundation. They may turn out some good or even great EMT's and Paramedics here and there, but they do not instill any type of discipline, and there are some people out there who need it. So what happens, students graduate and then go to their respective agencies with the mindset that it's okay to go out on jobs in shorts and a tank top, and unless the agency follows a strict uniform code (which most of them don't, and now we can start to shift the blame to the agency), the EMS community will continue to be viewed the way it is now in the eyes of the public. Then again we are talking about grown adults who are State certified medical providers. An agency shouldn't have to tell them to tuck in their shirt, shine your boots, shave, or even take a shower for that matter.

I'm not blaming EMS instructors or any programs out there, because this is just the way it is. I also understand that you can't have EMT or medic students out there running laps, but I think if EMS providers were trained in an Academy-like atmosphere, maybe we would be turning out providers who did have a little more discipline than what we're seeing now.

[ny10570 745]

JJB, lets compare apples to apples. Volunteer fire, while not the gold standard of physical specimens appear much better than your average VAC. In both cases training is done on your own time in a non academy environment, yet why does one look different from the other? Commercial EMS, compared to just about any other corporate enterprise has stricter standards of appearance. Hell even UPS requires vehicles to be washed on a regular basis. Its the people in charge and the senior members who are responsible for setting the standard. This once again comes down to the rank and file stepping up and demanding more from their co-workers and employers.

[Guest]

JJB, lets compare apples to apples. Volunteer fire, while not the gold standard of physical specimens appear much better than your average VAC.

i don't see where apples meet apples. from my experiances, vfd people and vac people are of a very, very different breed.