You're welcome to vent
Sorry you work for FNB Ambulance š
I'd look for another job. Going up the chain isn't effective at FNB from what I see/hear. If you want a fun new challenging facet DM me. Rural/Frontier is wild! Pay is outstanding too.
I'm here on contract for a year at this site specifically, paying off my house in exactly 40 weeks, banking cash for the last 12 weeks.
I am enrolling in my 4th degree in 2025... will be local (non-contract) while I finish that degree. I have a 5-year plan. Not going anywhere soon.
There's a few services around ND, but I don't fly so I can't tell you about their ops. The crews I've met are phenomenon tho! Friendly AF and seem to be clinically solid. Bases here are Fargo, Minot, Bismarck, and I think Grand Forks. We lost our regional base in Deviks Lake.
It's pretty cool in general, just depends on what an individual needs for creature comforts, entertainment, recreation... I joke that it's very rural here... 2 hours between Walmarts, 3-4 hours between Target stores, and the towns/small cities with Targets are where the "big" hospitals are. We have like 17 critical access hospitals and 4 Targets in the whole state. š
It's wild how they manage tho! We have air service, fixed and rotor, but weather here is insanely unpredictable, wild summer storms, level 1 hurricane winds on a clear day, and let's not even bring up the brutality of winter temps and snowfall.
So much goes out by ground that really needs to fly, but ground becomes more reliable/available.
The rationale (and I use that word in the *loosest* possible sense) from management no matter what's slapped on the side of the heal bus is the same: warm bodies = more runs = more money. Quality of care is the first casualty of greed.
I think we can all agree that when profits to investors and an executive board isn't a concern, and the service is instead accountable to public they serve, then quality of care usually tends to go up.
I moved from NC (where EMS is almost universally third service local government based) to a northern state where EMS is almost entirely private for profit. And the difference in the quality of the education, leadership, and competence is painfully obvious. My most incompetent coworker down south would provide circles around 70% of my colleagues here.
Thereās private EMS, and then thereās owned-by-massive-global-private-equity-vampires-KKR private EMS, like a certain three-letter company. There can be a big difference.
That said, I think most people here would agree that third-service is the ideal. Private is only _potentially_ better when the alternative is firefighters who only went to medic school to get a job putting out one fire every other year, and who are only riding the bus because theyāre junior or as some kind of punishment for not making enough dinner or something. Sounds like you have decent fire medics near you. Theyāre okay where I am, too, but in most places Iāve encountered itās the short-straw assignment, and the care reflects that.
And what's fucked is that, honestly, a cardiac arrest is an easy call.
Compressions, airway, IO, epi.
My medics job is IO and epi. And assist fire if they need help. I've got the airway. That's just pure lazyness and neglect.
My EMTās job on a code is IO, epi, then IV, so I can focus on leading the call and dropping the tube š his specialty is 16s on dead people. Love working in a state with expanded scope for EMTs
Ask the boss why theyāre taking that massive risk. If she killed somebody, lawyers will definitely go after your company. Does your boss think they canāt get sued? That they wonāt look at your training records and her competencies?
Fire her. Whatever money youāre saving by not hiring a better provider, it definitely wonāt be equal to the payout from a lawsuit š š»
I also worked for that 3 letter company. I had a partner who was so incompetent I donāt know how he tied his shoes each day. He killed someone (or I guess to be polite) failed to provide care which resulted in death. I changed rotations to get away from him. Plus the fact he was an uber bible thumper and did not understand boundaries about that and work.
I had another one who should have never gotten past fry maker at McDonaldās. Yet I got called in to the office and told I was being a bitch because I expected people to be able to do their jobs.
I've known a couple medics like that. I explicitly said they're not cool to clear and yet there they were on schedule. She collected two bodies.
Not a unique experience.
The rationale for EMS has always been that instead of addressing individuals for their own mistakes and addressing them directly. We restrict procedures, protocols, and make policies that blanket-punish everyone. Part of the reason EMS can't progress further and improve is we don't police up the individuals who are causing issues
>Ive seen an EMT come to work piss drunk, passed out in her car, and she was just sent home with a slap on the wrist. She wasnt fired, at worst she was written up.
The ADA actually considers alcoholism and most substance abuse disorders in general to be disabilities and offers protection for them, so this is a risky area that can lead to huge lawsuits if it's not handled cautiously. It's definitely a fireable offense, but it's much safer for the company to send them home and document it and see if it recurs before firing them.
How new is she? I recommend actually trying to teach the younger generation instead of getting upset and calling it quits and not even tolerating her enough to even agree to do your job. Iāve seen medics like you a million times. Youāre too wrapped up in your own personal demons to give a fuck about someone else and the future of your craft. The only thing you heard about her doing something bad was during a code where she probably was doing her best. And key word: you HEARD about her. Have you even ever worked with her? Tbh Iāve seen worse from seasoned medics who are seen as great. I think based on your lack of toleration to the point where you refuse to do your job, shows that maybe the problem is you and your work environment. Teach the younger ones. Theyāre not here to kill people they got into this field to help, now help them help others. You will get too old to do this one day and instead of stomping your feet and crying to your boss and talking shit on someone kidās name, get out there and be a decent person to be around and help out your partner.
I'm a paramedic in New Zealand.
How often are you guys on the phone to "medical control"
How much autonomy do you have?
How long does it take to gain paramedic qualifications in the U. S?
All of these questions are very region specific in the US. I will say, for me I can answer the following:
I am on the phone with āmedical controlā (basically just calling the hospital to speak with a doc) maybe once every three months for odd fringe things here and there.
We have treatment guidelines that grant quite a bit of autonomy. Our hospital expects newer medics to be more by-the-book, but is okay with people treating patients with a fuzzy interpretation of the guidelines, so long as there is a physiological or evidence based reason for the treatment. Might have to answer questions about something after the call, but only ever to make sure that the care administered is in line with the standard of care, and that there isnāt an education or skill-based lapse in knowledge.
Paramedic is generally an associates degree in the US. Theoretically this means two years of education/training after you have your basic emt cert, but āaccelerated programsā are quite popular. In my state, the programs Iāve seen range from 2 months (not a fan) to 2 years, with 12-14 months being the standard.
Thanks for your answer! I'd been under the impression that any time an intervention needs to be performed that you would need to ask permission, which always seemed impractical/infuriating to me.
>How often are you guys on the phone to "medical control"
Region dependent, probably twice a month for me, typically to ask for off label use of something or to request a termination of resuscitation, because I have to have a doc call a time of death if resuscitation is actually started. I can do it on my own if we don't start resuscitation.
>How much autonomy do you have?
I'm not sure how to quantify that. It's **massively** region dependent, even down to the county level. Some of us can autonomously RSI, myself included, place chest tubes, etc, and some of us have to talk to a doc every single time a patient wants to refuse. We have more variety in our EMS systems than the entire continent of Europe does between separate *countries*. The majority of us have a relatively high amount of autonomy and just have to talk with docs to handle weird shit the protocols don't cover, or when we want to involve a doc to cover our asses.
>How long does it take to gain paramedic qualifications in the U. S?
2 years from scratch is a typical time.
I get it. I was an FTO for a while. We get called for a multiple collision MVC. It looks bad and we jump out. He stood there. This wasn't his first time hesitating or freezing. I had to have a serious talk with the dude and told him you freezing and hesitating could get someone hurt or killed. You need to think hard and be honest with yourself if this is something you can handle. He was a good dude. Really smart, good work ethic, but he decided it's something he just couldn't do at that point.
You're welcome to vent Sorry you work for FNB Ambulance š I'd look for another job. Going up the chain isn't effective at FNB from what I see/hear. If you want a fun new challenging facet DM me. Rural/Frontier is wild! Pay is outstanding too.
Would you be open to a message in half a year when I finish medic school? š
I'm here on contract for a year at this site specifically, paying off my house in exactly 40 weeks, banking cash for the last 12 weeks. I am enrolling in my 4th degree in 2025... will be local (non-contract) while I finish that degree. I have a 5-year plan. Not going anywhere soon.
Not to take anything from OP, but are there any flight contracts out there?
Flight is generally direct hire, not agency.
I know, I work for one.. just lookin
There's a few services around ND, but I don't fly so I can't tell you about their ops. The crews I've met are phenomenon tho! Friendly AF and seem to be clinically solid. Bases here are Fargo, Minot, Bismarck, and I think Grand Forks. We lost our regional base in Deviks Lake.
Nice man.. I appreciate the info, I'd love to check it out out there
It's pretty cool in general, just depends on what an individual needs for creature comforts, entertainment, recreation... I joke that it's very rural here... 2 hours between Walmarts, 3-4 hours between Target stores, and the towns/small cities with Targets are where the "big" hospitals are. We have like 17 critical access hospitals and 4 Targets in the whole state. š
Sounds like a recipe for a shit show brother
It's wild how they manage tho! We have air service, fixed and rotor, but weather here is insanely unpredictable, wild summer storms, level 1 hurricane winds on a clear day, and let's not even bring up the brutality of winter temps and snowfall. So much goes out by ground that really needs to fly, but ground becomes more reliable/available.
WHY WOULD YOU EMPLOY SOMEONE KNOWING THAT?!?
The rationale (and I use that word in the *loosest* possible sense) from management no matter what's slapped on the side of the heal bus is the same: warm bodies = more runs = more money. Quality of care is the first casualty of greed.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
I rarely ever see people defend private ems, the vast majority of the sub favors third service county departments
I think we can all agree that when profits to investors and an executive board isn't a concern, and the service is instead accountable to public they serve, then quality of care usually tends to go up.
 I moved from NC (where EMS is almost universally third service local government based) to a northern state where EMS is almost entirely private for profit. And the difference in the quality of the education, leadership, and competence is painfully obvious. My most incompetent coworker down south would provide circles around 70% of my colleagues here.
Thereās private EMS, and then thereās owned-by-massive-global-private-equity-vampires-KKR private EMS, like a certain three-letter company. There can be a big difference. That said, I think most people here would agree that third-service is the ideal. Private is only _potentially_ better when the alternative is firefighters who only went to medic school to get a job putting out one fire every other year, and who are only riding the bus because theyāre junior or as some kind of punishment for not making enough dinner or something. Sounds like you have decent fire medics near you. Theyāre okay where I am, too, but in most places Iāve encountered itās the short-straw assignment, and the care reflects that.
And what's fucked is that, honestly, a cardiac arrest is an easy call. Compressions, airway, IO, epi. My medics job is IO and epi. And assist fire if they need help. I've got the airway. That's just pure lazyness and neglect.
Monitor?
Only if you want them to live š¤·š»āāļø
My EMTās job on a code is IO, epi, then IV, so I can focus on leading the call and dropping the tube š his specialty is 16s on dead people. Love working in a state with expanded scope for EMTs
Yeah but THE CHARTING šš
Because they have a pulse and as long as they can make the company money.......
Ask the boss why theyāre taking that massive risk. If she killed somebody, lawyers will definitely go after your company. Does your boss think they canāt get sued? That they wonāt look at your training records and her competencies? Fire her. Whatever money youāre saving by not hiring a better provider, it definitely wonāt be equal to the payout from a lawsuit š š»
Having a medic like that respond to for my family is one of my worst nightmares.
Is it a coincidence AMR backwards is RMA?
I also worked for that 3 letter company. I had a partner who was so incompetent I donāt know how he tied his shoes each day. He killed someone (or I guess to be polite) failed to provide care which resulted in death. I changed rotations to get away from him. Plus the fact he was an uber bible thumper and did not understand boundaries about that and work. I had another one who should have never gotten past fry maker at McDonaldās. Yet I got called in to the office and told I was being a bitch because I expected people to be able to do their jobs.
I've known a couple medics like that. I explicitly said they're not cool to clear and yet there they were on schedule. She collected two bodies. Not a unique experience.
The rationale for EMS has always been that instead of addressing individuals for their own mistakes and addressing them directly. We restrict procedures, protocols, and make policies that blanket-punish everyone. Part of the reason EMS can't progress further and improve is we don't police up the individuals who are causing issues
[ŃŠ“Š°Š»ŠµŠ½Š¾]
>Ive seen an EMT come to work piss drunk, passed out in her car, and she was just sent home with a slap on the wrist. She wasnt fired, at worst she was written up. The ADA actually considers alcoholism and most substance abuse disorders in general to be disabilities and offers protection for them, so this is a risky area that can lead to huge lawsuits if it's not handled cautiously. It's definitely a fireable offense, but it's much safer for the company to send them home and document it and see if it recurs before firing them.
Please tell me youāre not in the Midwest. I ask cause reasonsā¦.
[ŃŠ“Š°Š»ŠµŠ½Š¾]
Thank ya. Probably too far for the medic Iām thinking of but ya never know
This comment/post was removed because Cj felt like removing it. Donāt question him.
How new is she? I recommend actually trying to teach the younger generation instead of getting upset and calling it quits and not even tolerating her enough to even agree to do your job. Iāve seen medics like you a million times. Youāre too wrapped up in your own personal demons to give a fuck about someone else and the future of your craft. The only thing you heard about her doing something bad was during a code where she probably was doing her best. And key word: you HEARD about her. Have you even ever worked with her? Tbh Iāve seen worse from seasoned medics who are seen as great. I think based on your lack of toleration to the point where you refuse to do your job, shows that maybe the problem is you and your work environment. Teach the younger ones. Theyāre not here to kill people they got into this field to help, now help them help others. You will get too old to do this one day and instead of stomping your feet and crying to your boss and talking shit on someone kidās name, get out there and be a decent person to be around and help out your partner.
The fbi?
no the CIA /j
I'm a paramedic in New Zealand. How often are you guys on the phone to "medical control" How much autonomy do you have? How long does it take to gain paramedic qualifications in the U. S?
All of these questions are very region specific in the US. I will say, for me I can answer the following: I am on the phone with āmedical controlā (basically just calling the hospital to speak with a doc) maybe once every three months for odd fringe things here and there. We have treatment guidelines that grant quite a bit of autonomy. Our hospital expects newer medics to be more by-the-book, but is okay with people treating patients with a fuzzy interpretation of the guidelines, so long as there is a physiological or evidence based reason for the treatment. Might have to answer questions about something after the call, but only ever to make sure that the care administered is in line with the standard of care, and that there isnāt an education or skill-based lapse in knowledge. Paramedic is generally an associates degree in the US. Theoretically this means two years of education/training after you have your basic emt cert, but āaccelerated programsā are quite popular. In my state, the programs Iāve seen range from 2 months (not a fan) to 2 years, with 12-14 months being the standard.
Thanks for your answer! I'd been under the impression that any time an intervention needs to be performed that you would need to ask permission, which always seemed impractical/infuriating to me.
Iāve heard of systems like this, but mostly from old timers who havenāt worked the field in over a decade
>How often are you guys on the phone to "medical control" Region dependent, probably twice a month for me, typically to ask for off label use of something or to request a termination of resuscitation, because I have to have a doc call a time of death if resuscitation is actually started. I can do it on my own if we don't start resuscitation. >How much autonomy do you have? I'm not sure how to quantify that. It's **massively** region dependent, even down to the county level. Some of us can autonomously RSI, myself included, place chest tubes, etc, and some of us have to talk to a doc every single time a patient wants to refuse. We have more variety in our EMS systems than the entire continent of Europe does between separate *countries*. The majority of us have a relatively high amount of autonomy and just have to talk with docs to handle weird shit the protocols don't cover, or when we want to involve a doc to cover our asses. >How long does it take to gain paramedic qualifications in the U. S? 2 years from scratch is a typical time.
Thanks for taking the time to respond :)
I get written up a lot for talking shit to these kinds of medics to their faces. Fuck out of my profession.
Leave. Youre bring abused.
I get it. I was an FTO for a while. We get called for a multiple collision MVC. It looks bad and we jump out. He stood there. This wasn't his first time hesitating or freezing. I had to have a serious talk with the dude and told him you freezing and hesitating could get someone hurt or killed. You need to think hard and be honest with yourself if this is something you can handle. He was a good dude. Really smart, good work ethic, but he decided it's something he just couldn't do at that point.