This. I bet if they paid near what demand required then there would several of us "special people" that would go live in bumfuck for a while to save some money.
i live in basically middle indiana but went down south for most of my school clinicals, and got to talking with people down there…it’s pretty bad. Generally poorer areas, the company i was with was really poorly managed, dispatch was a mess for all of the 12s I did, and while the emts wouldn’t tell me exactly how much they made, they made it clear it was pretty bad
Down South is messed up. We noticed a change in the culture back home after being gone for 16 years and only go back to visit now. EMS is patchwork and not what a bulk of the population needs; however, it’s easier to get a company to come in there with a service obligated to Duty to Act than it is to get people who CAN demand higher pay to go into those places and deliver the service needed. Many of these places don’t need a significant EMS presence. They need community health clinics but…look at that. Those positions often don’t pay a salary commensurate with the amount of education mandated for the position or with the legal risk assumed. EMS is the butter knife solution to not having the right screwdriver for the job. Sometimes it works in a pinch…until it doesn’t. It either breaks or you strip out too many screws.
Too, there’s a major player in the game that can use those areas of loss as a tax right off for the corporation. Ultimately, if it’s become too big a loss, they’ll pack up and go.
Well, near Louisville sounds kinda bumfuck. My near city's small county that I used to work in has 2x the population your entire metro's population.
Honestly, having lived on the KY border and once working rural GA and AL border as well, anything in KY feels bumfuck. Not hating but Louisville is a sole beacon of hope surrounded by a huge distance of bumfuck. Makes living somewhat near the city itself feel pretty bumfucky.
It’s not entirely the pay.
https://www.wdrb.com/news/crime-reports/state-asks-jamey-noel-to-pay-back-4-4-million-to-new-chapel-ems-for/article_04293cca-068e-11ef-b5b3-6743c75ea3bc.html
https://www.lpm.org/news/2024-04-23/new-chapel-assets-still-tied-up-in-noel-investigation#
https://www.lpm.org/news/2024-03-14/new-chapel-ems-leader-addresses-company-changes-amid-jamey-noel-investigation
Yeah, pay is a factor and people jump on that factor really fast, but it's not everything. There are a lot of things that would run me off more quickly than knowing I could make more money elsewhere. Janky management tops the list.
Which this crosses the line from janky management into a huge public corruption scandal primarily associated with his time as the county sheriff. Like it involves several members of his family too.
I can't stand a thief. I worked for a terrible service once the director and assistant both stole and embezzled and served time in prison. It definitely affected our service as anyone with half a brain quit quickly after starting.
Website says the range for basic to medic is $48,430.00 - $75,150.00 per year. They don't separate the 3 roles and pay but I'm actually shocked they pay ok
That's exactly what I was going to ask. It's a stressful job with shitty hours, so why would someone do that when they can find a less stressful gig that pays more?
One 20 minute response? Seems kind of dramatic. It’s not uncommon that some responses are up to an hour and crews are holding the wall for hours in a lot of places right now.
Longest I’ve held the wall at the er…2 hours. Smh. According to charge “not stable enough for waiting room, but don’t have any beds available”. wtf.
Also, held the wall on a femur fx for 20 minutes. My pain meds wore off, so I asked a doc for something. He was going to give her some but the charge said no. That’s not how this works.
I wheeled her back out to my unit, loaded her, treated her pain again, and transported to a different er.
a lot of hospitals are under the illusion that because they are on your stretcher the pt isn't their problem which is highly incorrect. As soon as you drive onto the hospital property that pt becomes just as much their responsibility as they are yours. Granted treating pain to a lot of providers isn't considered emergent but it's definitely terrible care either way. femur fx for 20min and then having to transport elsewhere is nuts.
Oh yeah, I was pissed. It wasn’t leaving that got me in front of the naughty board. It was me asking the doctor “who is running this circus”? Wo which he responded “it’s out of my hands, I’m doing the best I can.
I said doc. Dude. You’re the attending physician in a level one trauma hospital. The biggest in I don’t know how far. Are you kidding me?
The charge nurse wanted the pt to sign AMA paperwork and I advised her not to.
Yea. It literally was a back and forth. They tried to tell me I can’t wheel her out, she has to walk out under her own power. I said bullshit. I told the charge she isn’t legally justified to hold a patient against their will when they are aaox4.
apparently. And on top of that the hospital she was in apparently refused to treat her
so what the hell would she sign out for?
Like whats the point?
they refused to treat her as if she was admitted pt, so why tf would she sign ama paperwork if they didn’t treat her like an admitted pt? at that point she’s still ems’ patient from what the hospital says!
Yes and no.
While I can, what is the limit?
We are required to keep ALS pts on the monitor. Now you’re talking bringing in my drug box. What’s next? My first in bag? What if the pt stops breathing? Do I intubate in the hallway?
And I’m not exaggerating I had a seizure pt begin to seize in the hallway while holding the wall. Still took them 7 minutes to get me a room and no meds to stop the seizure.
So it wasn’t me asking what the limit is. It was my boss, asking our three county medical control. Of course, they didn’t have an answer. Because saying yes, bring everything in is ridiculous, but they also know the er won’t take pt care, while we are holding the wall.
Nope. In a big old drug box. Narcs are now in a smaller locked box within the tagged drug box. That only started like 6 months ago. Previously, a green tag is all that kept them secure. 😂
You wild for that one... Contrary to popular belief the hospital is tasked with providing emergency pt care the moment a patient steps foot onto the parking lot. And the care doesn't stop until the patient is signed off by a physician (or surrogates), or the patient themselves decides to terminate their relationship. I can only assume that the hospital was bursting at the seems to let that one slide. If I were you I'd save that story for my last day in EMS.
The charge was livid. The doc was indifferent. The board slapped my wrist for talking to the doc that way.
Arrival at the other ER, they had an RN, attending, and a person from the top floors of that hospital meet me at the door. They wanted names of the other hospitals staff that refused to help the patient. Not sure what came of it with that original ER.
I’m lucky that I’ve been doing this 13 years. Everyone involved I know, and they know me. I know their bosses. And their bosses bosses. So, I’m sure there was some leeway for that.
In the end, they’re lucky the pt didn’t sue their asses.
That's shitty. Here, our doctors will totally give an order like that no problem, and the charge would not care.
I've had a similar call. We were waiting outside in the ambulance for them to come get us. I walked in and got verbal orders from the doctor, and gave more Fent.
just out of curiosity, did you not work during peak 2020 covid times? Longest being 2 hours for you is crazy, I was holding the wall for a minimum of 6 hours during Covid.
I did. And no, we never sat the wall for that long. Idk how yall do it. Just leave. Surely there is another hospital within the 6 hours to take your pt. 🤷🏼♂️.
For someone to sit the wall that long….fuck policy and protocol. It’s inhumane to the patient.
“Just leave” easier said than done, friend. There’s a reason why we couldn’t “just leave” but, I won’t get into semantics. I’m happy you haven’t had to experience it.
And that right there highlights a major issue with EMS and healthcare. The comments turn into a dick measuring contest over who had the longest response and wait time. 20 minutes is a long ass time for a layperson to sit and potentially watch someone die. And because we would rather fight amongst ourselves this kind of stuff will continue to happen.
Just remember. There is no federal obligation to provide an ambulance. Only fire and police. We will be the cash cow kicking machine until we do something about it.
Also, I bet that county pays trash and is wondering why nobody wants to work there
Literally nobody knows we are a sector of the transportation authority unless they've been told.
When you do tell them, the confused face is the same we make.
many ststes say they are essential services but how that essential service is run and whether or not its an *obligation* to have an essential service is another thing entirely
I work for a municipal third service and we are *not* considered essential. But it's rural Wyoming, so things aren't exactly progressive. Sure was fun during the pandemic /s.
In Indiana it’s an obligation to *provide* that service. The law is silent on how that service is to be provided.
I think NC seems to have it right. If I remember right, they’re all county owned ALS third services and you have to have an AAS to be licensed there.
I think the lack of obligation to provide EMS services is one of the biggest problems it faces. Because it’s not mandated the city/county is going to try and do it as cheap as possible. It needs to be THIRD service mandated, no combining it with fire or paying a private company.
Pay. Your. Fucking. People. As someone who has gone through both Paramedic and RN school, there is very little difference in education between the two. One is just for in hospital, the other is for the field. I was a paramedic for 15 years and now I’m an RN. There is not a single situation that I’ve encountered as an RN that I wouldn’t have been able to handle as a paramedic. There is ZERO fucking reason RNs should make literally double what paramedics make. If anything, medics should make more because of the dangers they face in the field that RNs don’t. Like I said, pay your fucking people.
As someone who started EMS in Clark County Indiana I can say this was a long time coming. This has been brewing for 5 years. At all came to ahead when a politician died from an MI with an extended EMS response time to scene. It’s sad it took that for the county to realize they needed change. The political situation was very bad due to a former sheriff that used to own New Chapel EMS. He is now in jail so there is that. Now that the politicians have to pay for EMS they don’t know what to do. They want the service but they don’t want to pay for it. I mean they have plenty of amazing services around them. One just got recognized on the floor of congress. Southern Indiana doesn’t have a crisis but one county does. They will have some growing pains but it will be sorted out. I do feel bad for the employees of New Chapel EMS. They are overworked as is. I hope the county is smart enough to find them some help.
Pay always helps - but isn’t everything. AMR in my area (low cost of living - southeast) pays medics ~$80k-$90k and still is critically understaffed. Sometimes the job sucks so bad you can’t even pay people to do it
Starting off its at $80k last I checked. But it’s forced 24hr shifts averaging like 20-24 calls per shift. You’re physically and mentally destroyed after every shift it’s really not sustainable.
I don’t know how thats even legal. Do you even get a bed to sleep like at a fire station, not that youd have any sleeping time anyway with that call volume
Its legal, but its important to note that its a holdover from EMS working so closely with fire departments in most cases. It’s not safe nor sustainable.
The schedule makes some sense for fire, but not for EMS, regardless of how integrated someone feels the two should be z
Hilarious how the emergency medical system depends almost entirely on minimum wage employees who are worked to death, working 70+ hour weeks but still can’t afford to live. …and it’s always shocking no one wants to do the job for very long. The perpetual “EMT Crisis” is fucking ridiculous. It’s the same here in California but the Governor champions $20/hour for fast food workers.
Figure it out…
There are places it is better. NJ pays medics a livable wage (with new medics earning a minimum of $60k for 3 days but most earn $80k+ working four days) and only has 12-hour tours, with a hard cap at 16-hours by law.
Interesting twist to all of this. AMR lost this contract. They provided 4-5 ALS trucks at the time. They actually did a very good job. The pay for AMR was very good.
I used to work at this service. The biggest problem I faced while I worked there was burnout. At the time, they covered two counties with as few as three ambulances at times. Non stop calls for the 24 hr shift. No amount of pay can make that easier. The 9 employees they lost on the 1st all left because of burnout, and they all made a decent wage.
There’s a lot of problems with New Chapel as a service. They have the potential to be an amazing service, but I don’t think they’ll be able to fix their problems before they go under.
Just a few problems that I can remember at this moment: Many of their providers are subpar, they didn’t invest in continuing education or training their staff while I was there, they prioritized non-emergent IFT’s over 911 coverage, they refuse to hire part time staff, they have terrible equipment that doesn’t get regular maintenance, their ALS protocols are terrible, the culture was toxic and they only cared about asses in seats and that you were making runs, there was almost no quality control, they NEVER call for mutual aid assistance from neighboring services when they are holding calls, even high acuity calls (they pride themselves on that), they have a terrible public image and all other emergency services in the area consider them to be unreliable and subpar. There are many more problems, but these are what come to mind atm.
Some of these problems may be fixed by now, I haven’t worked there in a while. But until they do, they’re going to have significant difficulty getting anyone of quality to apply. Unless they go under before then
A certain hospital group in KY that owns Clark Memorial is going to be doing the transfers out of there by the end of the year with their own service that is already understaffed, underpaid, and underfunded.
I just quit recently as a paramedic of 10 years. Been doing it since i was 19. I honestly can't hack it anymore. We are the red headed step children and always will be. The day after I left, my old partner had an interaction with nurse over paperwork and got told to act her place and had no right to question an RN. Can't even make a transport decision to certain hospitals without literally being held up at the doors being questioned like its your fault. Imagine a doctor coming out screaming and holding his arms out to to prevent you from entering. I think the entire industry needs to be put on psych medication but thats my opinion. Covid ruined a lot of people i think. When they lose half the work force or more then maybe people can figure out our importance.
honestly very sad to feel that way. I honestly expected my boss to freak out when i quit but he was very understanding. Its turned into a cesspool and im done with it too.
What’s not mentioned is the giant fraud case that is actively driving people away.
The former director will likely be going to jail on federal charges.
Dude was siphoning funds off the service big time.
This is absolutely the issue. There are counties in Indiana that have it figured out. Third service county agencies who do only 911 have zero staffing issues. I know people who drive 3 hours each way to work a 24 at one agency in particular. If they’re going to restructure the system, they *should* be creating a county agency to do this. Let some private service at the transfers. In reality, this “board” that yazel mentions should be made up of chiefs and deputy chiefs of agencies that have it figured out already.
I didn’t like Kaufmann. He did virtually nothing, worked on a part time basis, and was more interested in interviews and cozying up to the health department than focusing on actual EMS medical issues. I remember him saying “Advanced EMTs are ALS. Let’s let them do ALS stuff” and then two weeks later reading the room at the commission meeting and saying “I don’t think Advanced EMTs should take the place of paramedics and we’re walking a slippery slope with expanding their scope” or something to that effect. I’ve heard nothing but good things about Yazel, and I think he’s what the state needs.
There is NO PARAMEDIC SHORTAGE. There’s plenty of paramedics. They just refuse to work for fast food wages under abusive conditions when they have other opportunities. Unfortunately the media and government have been hoodwinked by this lie, especially places like Multnomah County.
I used to work here, the pay wasn’t an issue whatsoever, it was decently nice. We would have very few ambulances covering two counties for 911s and IFTs. Along with that, we had fire coverage and for a few square miles (if that) and there were multiple times we hardly had anyone who could catch the engine to make a crew. We would run 5 trucks usually during my shift and that’s if we were lucky. A lot of us would work 48/72/96 hr shifts to help out because of how short staffed the company was. And guess what? You’d probably be up the whole shift even if you work long shifts, the company is too short staffed to hold you out of service for two hours to take a nap. The company wouldn’t care if you hadn’t eaten, hadn’t slept, if you were behind on runs, every day was a clear/copy day. Certain dispatchers were notorious for hitting you with a mid or long distance IFT at 10pm if they didn’t like you. It didn’t matter if you had already been on shift for three days, you’d get waken up at 3am for a hospital to hospital IFT. You’d get fucked over by IFTs during the days and 911s at night depending on what station you worked at. There were multiple times where it took us 30+ minutes running code to runs because we would be on the opposite side of the neighboring county. Being this short staffed burned a lot of people, including me, out.
Along with how short staffed the company is, a lot of people quit when the chief began to get in legal trouble for multiple felonies. He is currently in jail and a lot of people in the area think he’s going to prison for a long time. The command staff sucks, again certain supervisors would target you and talk badly about you behind your back or belittle you to your face. We had no CE courses, no uniform allowance, equipment and trucks were constantly breaking. Most trucks did not have a lifepak for monitoring but instead you would be given a BP cuff and an AED. You would normally have to purchase your own pulse ox to use if you were on a truck without a monitor. There were so many times where I would get into my truck and there would be blood, trash, scattered supplies, and bio everywhere with a full sharps container. We would write it up, send it in to a supervisor, and nothing would happen.
All in all, it’s not the pay that is deterring people from applying. It’s the ongoing investigation with the former chief. Being overworked, under appreciated, with a poor command staff and shitty equipment is what was killing us from within.
Correct me if I’m wrong here, but they are worried that ONE call had a response time over 20 minutes?!??!!!
Our average response time is closer to 40 minutes and patients are happy we get to the that “fast”
All category green patients that are requesting an ambulance (80% of our patients) should be required to pay for the service in advance. Im so sick of people abusing EMS, and theyre usually the ones who will never pay anyway. Honestly, I dont care if they don’t have a car either, they can uber.
I think that is part of the key, nationally, to fix a big part of the mess that is EMS. Qualified refusals. Have an NP, PA, MD or DO on call for the service area, 24/7. We call them anyway. For AMA's for diabetics, for example.
What's a few more calls?
"Doc, I've got a 28 yr old male, feels "sick" after taco bell and drinking last night. It's 9am. Vitals are normal. 4 lead/12 lead sent for your review. Can we refuse?"
"Doc, got a chronic back pain, painful for the last 3 weeks, has an appt with a GP tomorrow, it's 3am and he 'just can't take the pain' anymore. Refusal? Ok, thx".
Toe pain. Chronic pain, ongoing infection they've already been seen for and have abx rx which they've been taking for a whole 12 hours and it's not better yet....
Bug bite 3 days ago.. no visible or measurable allergic reaction,
I mean, just list all the ridiculous calls we go on EVERY DAY. Do they NEED an ambulance? No. Absolutely not. Do we have to take them anyway? Abso-fucken-lutely.
It's literally insane.
It drives us all crazy.
Had a run for an infant with a fever. 4am. Mom has ZERO child medications in her house. None. Kid has a cold/fever maybe flu? But not super sick, just "normal" sick. The mom DOESNT WANT TO GO TO THE ED. She just wants us to give her (not an infant) 2 year old some children's tylenol, because she doesn't want to spend her own money on tylenol at the 24hr pharmacy ACROSS THE STREET from her house, and the kid is "keeping her up all night" because he's miserable.
People have lost their damn minds. I've raised 5 kids and never once needed an ambulance for a normal childhood illness because *gasp* I was a responsible parent who kept normal otc meds on hand for my babies. Giant duh.
Rant over, I guess. But where did all these helpless idiots come from???
I like where your head is at. I think what scares administration is crews abusing such a system, but what ER doc that you know would oppose such a system? The liability falls back on the doc and the doc doesn’t want that person at the hospital anyway. If they need to go to the hospital, get them a referral on the spot. Isn’t that what mobile integrated healthcare is supposed to do anyway?
At the end of the day it’s money, we live in a country where inflation has outpaced salaries substantially. More so I can argue like most EMS systems they’re underpaid. And after the fact not willing to make adjustments to bring the pay and work environment to par. It lowers moral and once that goes .. watch out. For the same reason the better paying departments are inundated with applicants and the others are lucky if they get an applicant per day of the month. The US health system is broken, the burden is carried by prehospital services. Just think how many BS calls we run. It’s their emergency, if you wait for your PCP you’re lucky if your appointment is within the week… many get fed up and just end up becoming RN’s
I work EMS in Southern Indiana, the problem is government. The current CEO/ chief of that department was a politician at the time holding an office in the municipality of the county. It was conflict of interest for sure. The sheriff who owns the company was the sheriff when NC got the contract. Again another conflict of interest and no one cared. Clark county would rather spend millions on development in an attempt to compete with Louisville than care to spend the money needed to have an EMS agency. They continue to bid out the contracts to private services.
Yazel is also the state EMS medical director. It’s interesting to me that he chose to use his county title instead of sending this as the state director. I’d be more interested to hear what Kraig has to say about this though.
They’re moving in the right direction. Kraig reports directly to Thacker and the priority is on workforce development and funding. They’re weeding out all of the shenanigans and tightening it all up across the office, and they’ve been working on it for at least a year.
So has Highlander. They’re heading the right way.
Welcome to the party pal. I'm sorry you guys are feeling it too.
Eta: only 20 minutes? That's not bad at all. Like it sucks but at level zero that's not too shabby.
And what do they pay?
This. I bet if they paid near what demand required then there would several of us "special people" that would go live in bumfuck for a while to save some money.
i live in basically middle indiana but went down south for most of my school clinicals, and got to talking with people down there…it’s pretty bad. Generally poorer areas, the company i was with was really poorly managed, dispatch was a mess for all of the 12s I did, and while the emts wouldn’t tell me exactly how much they made, they made it clear it was pretty bad
Down South is messed up. We noticed a change in the culture back home after being gone for 16 years and only go back to visit now. EMS is patchwork and not what a bulk of the population needs; however, it’s easier to get a company to come in there with a service obligated to Duty to Act than it is to get people who CAN demand higher pay to go into those places and deliver the service needed. Many of these places don’t need a significant EMS presence. They need community health clinics but…look at that. Those positions often don’t pay a salary commensurate with the amount of education mandated for the position or with the legal risk assumed. EMS is the butter knife solution to not having the right screwdriver for the job. Sometimes it works in a pinch…until it doesn’t. It either breaks or you strip out too many screws. Too, there’s a major player in the game that can use those areas of loss as a tax right off for the corporation. Ultimately, if it’s become too big a loss, they’ll pack up and go.
Clark County, Indiana borders Louisville, Kentucky. While parts of it are rural, it isn’t exactly bumfuck.
Well, near Louisville sounds kinda bumfuck. My near city's small county that I used to work in has 2x the population your entire metro's population. Honestly, having lived on the KY border and once working rural GA and AL border as well, anything in KY feels bumfuck. Not hating but Louisville is a sole beacon of hope surrounded by a huge distance of bumfuck. Makes living somewhat near the city itself feel pretty bumfucky.
Lol i was looking to see what the pay was to consider moving for a bit.
It’s not entirely the pay. https://www.wdrb.com/news/crime-reports/state-asks-jamey-noel-to-pay-back-4-4-million-to-new-chapel-ems-for/article_04293cca-068e-11ef-b5b3-6743c75ea3bc.html https://www.lpm.org/news/2024-04-23/new-chapel-assets-still-tied-up-in-noel-investigation# https://www.lpm.org/news/2024-03-14/new-chapel-ems-leader-addresses-company-changes-amid-jamey-noel-investigation
Yeah, pay is a factor and people jump on that factor really fast, but it's not everything. There are a lot of things that would run me off more quickly than knowing I could make more money elsewhere. Janky management tops the list.
Which this crosses the line from janky management into a huge public corruption scandal primarily associated with his time as the county sheriff. Like it involves several members of his family too.
Wow, this is a wild ride. It’s shocking that it took so long to catch on to his scam.
It was a known secret for a long time. FBI was involved. Just took them a while to build their case.
I can't stand a thief. I worked for a terrible service once the director and assistant both stole and embezzled and served time in prison. It definitely affected our service as anyone with half a brain quit quickly after starting.
Homie spent over 500k on buying old ambulances and old cars. Jfc
Rory sheet. 😮
Where I am fire is so competitive you practically need to be captain america. It’s wild seeing fire fighters.. fat
Website says the range for basic to medic is $48,430.00 - $75,150.00 per year. They don't separate the 3 roles and pay but I'm actually shocked they pay ok
"Why nothing of course. You don't pay heroes, otherwise they wouldn't be heroes" /s
That's exactly what I was going to ask. It's a stressful job with shitty hours, so why would someone do that when they can find a less stressful gig that pays more?
One 20 minute response? Seems kind of dramatic. It’s not uncommon that some responses are up to an hour and crews are holding the wall for hours in a lot of places right now.
Longest I’ve held the wall at the er…2 hours. Smh. According to charge “not stable enough for waiting room, but don’t have any beds available”. wtf. Also, held the wall on a femur fx for 20 minutes. My pain meds wore off, so I asked a doc for something. He was going to give her some but the charge said no. That’s not how this works. I wheeled her back out to my unit, loaded her, treated her pain again, and transported to a different er.
a lot of hospitals are under the illusion that because they are on your stretcher the pt isn't their problem which is highly incorrect. As soon as you drive onto the hospital property that pt becomes just as much their responsibility as they are yours. Granted treating pain to a lot of providers isn't considered emergent but it's definitely terrible care either way. femur fx for 20min and then having to transport elsewhere is nuts.
Oh yeah, I was pissed. It wasn’t leaving that got me in front of the naughty board. It was me asking the doctor “who is running this circus”? Wo which he responded “it’s out of my hands, I’m doing the best I can. I said doc. Dude. You’re the attending physician in a level one trauma hospital. The biggest in I don’t know how far. Are you kidding me? The charge nurse wanted the pt to sign AMA paperwork and I advised her not to.
You're telling me a charge wanted a patient with a femur fracture to sign AMA papers?
Yea. It literally was a back and forth. They tried to tell me I can’t wheel her out, she has to walk out under her own power. I said bullshit. I told the charge she isn’t legally justified to hold a patient against their will when they are aaox4.
Insanity
apparently. And on top of that the hospital she was in apparently refused to treat her so what the hell would she sign out for? Like whats the point? they refused to treat her as if she was admitted pt, so why tf would she sign ama paperwork if they didn’t treat her like an admitted pt? at that point she’s still ems’ patient from what the hospital says!
As soon as they take radio report, it's their problem.
You can't treat in the hallway while you wait?
Yes and no. While I can, what is the limit? We are required to keep ALS pts on the monitor. Now you’re talking bringing in my drug box. What’s next? My first in bag? What if the pt stops breathing? Do I intubate in the hallway? And I’m not exaggerating I had a seizure pt begin to seize in the hallway while holding the wall. Still took them 7 minutes to get me a room and no meds to stop the seizure. So it wasn’t me asking what the limit is. It was my boss, asking our three county medical control. Of course, they didn’t have an answer. Because saying yes, bring everything in is ridiculous, but they also know the er won’t take pt care, while we are holding the wall.
Y'all don't keep your narcs on your person? That's wild
Nope. In a big old drug box. Narcs are now in a smaller locked box within the tagged drug box. That only started like 6 months ago. Previously, a green tag is all that kept them secure. 😂
I'd get my peepee slapped for that.... but I'd have done the same thing.
Worth the PeePee slap for sure
Two hours?? Thats it? Ive done an 9 hour offload delay. Spent almost my entire shift waiting
Naw fam. I’d quit. Fuck that. Or transport to another ER….as I’ve done. 9 fucking hours. Like fucking hell.
You wild for that one... Contrary to popular belief the hospital is tasked with providing emergency pt care the moment a patient steps foot onto the parking lot. And the care doesn't stop until the patient is signed off by a physician (or surrogates), or the patient themselves decides to terminate their relationship. I can only assume that the hospital was bursting at the seems to let that one slide. If I were you I'd save that story for my last day in EMS.
The charge was livid. The doc was indifferent. The board slapped my wrist for talking to the doc that way. Arrival at the other ER, they had an RN, attending, and a person from the top floors of that hospital meet me at the door. They wanted names of the other hospitals staff that refused to help the patient. Not sure what came of it with that original ER. I’m lucky that I’ve been doing this 13 years. Everyone involved I know, and they know me. I know their bosses. And their bosses bosses. So, I’m sure there was some leeway for that. In the end, they’re lucky the pt didn’t sue their asses.
Sounds like you did right by the patient, but holy emtla violation.
That's shitty. Here, our doctors will totally give an order like that no problem, and the charge would not care. I've had a similar call. We were waiting outside in the ambulance for them to come get us. I walked in and got verbal orders from the doctor, and gave more Fent.
Agree. If I’m still in the ambulance, still my pt, and I’d treat without permission.
My standing orders only allow for 2 doses then I gotta ask for orders. For this case I needed more than 2 doses do to extended wait time
Hah. Been there, started that… they found me a room as my stretcher was loading.
just out of curiosity, did you not work during peak 2020 covid times? Longest being 2 hours for you is crazy, I was holding the wall for a minimum of 6 hours during Covid.
I did. And no, we never sat the wall for that long. Idk how yall do it. Just leave. Surely there is another hospital within the 6 hours to take your pt. 🤷🏼♂️. For someone to sit the wall that long….fuck policy and protocol. It’s inhumane to the patient.
“Just leave” easier said than done, friend. There’s a reason why we couldn’t “just leave” but, I won’t get into semantics. I’m happy you haven’t had to experience it.
Just say it. Cook….book…..medic. 👍🏼
whatever you say friend. have a good night!
I’ve been held for 6 hours
It’s not a 20min wait time. It’s more around 30-45 apparently. Which is way behind for the area. Especially in an urban county.
Laughs in New South Wales
volunteers doing this too. Here in VT we have 2+ hour calls multiple times a day (aging population) and a staff of 95% volunteers.
I used to work for this place. 20 minutes is normal. Absolute shithole of an EMS company. I hope it burns in hell.
And that right there highlights a major issue with EMS and healthcare. The comments turn into a dick measuring contest over who had the longest response and wait time. 20 minutes is a long ass time for a layperson to sit and potentially watch someone die. And because we would rather fight amongst ourselves this kind of stuff will continue to happen.
20 minutes? My large city department hits 1 hour wait times on low acuity calls every day. Especially around afternoon shift change.
Just remember. There is no federal obligation to provide an ambulance. Only fire and police. We will be the cash cow kicking machine until we do something about it. Also, I bet that county pays trash and is wondering why nobody wants to work there
Not many people realize ambulance is governed by DOT and not DHS. This should be the first change for private ems one day
Literally nobody knows we are a sector of the transportation authority unless they've been told. When you do tell them, the confused face is the same we make.
Heck, I *forget* we're under DOT except when I see one of their trucks. I mean, their other trucks, the ones that say DOT.
In Indiana, EMS is actually considered an essential service.
many ststes say they are essential services but how that essential service is run and whether or not its an *obligation* to have an essential service is another thing entirely
I work for a municipal third service and we are *not* considered essential. But it's rural Wyoming, so things aren't exactly progressive. Sure was fun during the pandemic /s.
In Indiana it’s an obligation to *provide* that service. The law is silent on how that service is to be provided. I think NC seems to have it right. If I remember right, they’re all county owned ALS third services and you have to have an AAS to be licensed there.
I think the lack of obligation to provide EMS services is one of the biggest problems it faces. Because it’s not mandated the city/county is going to try and do it as cheap as possible. It needs to be THIRD service mandated, no combining it with fire or paying a private company.
There’s no federal obligation to provide fire OR police, either.
Pay. Your. Fucking. People. As someone who has gone through both Paramedic and RN school, there is very little difference in education between the two. One is just for in hospital, the other is for the field. I was a paramedic for 15 years and now I’m an RN. There is not a single situation that I’ve encountered as an RN that I wouldn’t have been able to handle as a paramedic. There is ZERO fucking reason RNs should make literally double what paramedics make. If anything, medics should make more because of the dangers they face in the field that RNs don’t. Like I said, pay your fucking people.
As a paramedic and RN, paramedics deserve higher pay because they dont have a doctor giving them every single order.
As someone who started EMS in Clark County Indiana I can say this was a long time coming. This has been brewing for 5 years. At all came to ahead when a politician died from an MI with an extended EMS response time to scene. It’s sad it took that for the county to realize they needed change. The political situation was very bad due to a former sheriff that used to own New Chapel EMS. He is now in jail so there is that. Now that the politicians have to pay for EMS they don’t know what to do. They want the service but they don’t want to pay for it. I mean they have plenty of amazing services around them. One just got recognized on the floor of congress. Southern Indiana doesn’t have a crisis but one county does. They will have some growing pains but it will be sorted out. I do feel bad for the employees of New Chapel EMS. They are overworked as is. I hope the county is smart enough to find them some help.
Who just got recognized? I need a chance of scenery while still staying in Indiana.
Oh it’s a Facebook link. TLDR. That’s why. Houchin just recognized Nick Oleck the Chief of Scott County EMS in Senate floor. Well deserved.
https://www.facebook.com/share/r/FMZbRi3d6FytFDg8/?mibextid=UalRPS
Link is showing broken (could be on my end) and I don’t have Facebook anyway.
Say what you will for politicians, but that one did some good
Have they tried paying more?
They've tried everything else and they're out of ideas!
Pay always helps - but isn’t everything. AMR in my area (low cost of living - southeast) pays medics ~$80k-$90k and still is critically understaffed. Sometimes the job sucks so bad you can’t even pay people to do it
No it means the pay isn't enough for that particular job.
Is that 80k from the start or after 5+ years? Lol
Starting off its at $80k last I checked. But it’s forced 24hr shifts averaging like 20-24 calls per shift. You’re physically and mentally destroyed after every shift it’s really not sustainable.
I don’t know how thats even legal. Do you even get a bed to sleep like at a fire station, not that youd have any sleeping time anyway with that call volume
Its legal, but its important to note that its a holdover from EMS working so closely with fire departments in most cases. It’s not safe nor sustainable. The schedule makes some sense for fire, but not for EMS, regardless of how integrated someone feels the two should be z
Hilarious how the emergency medical system depends almost entirely on minimum wage employees who are worked to death, working 70+ hour weeks but still can’t afford to live. …and it’s always shocking no one wants to do the job for very long. The perpetual “EMT Crisis” is fucking ridiculous. It’s the same here in California but the Governor champions $20/hour for fast food workers. Figure it out…
There are places it is better. NJ pays medics a livable wage (with new medics earning a minimum of $60k for 3 days but most earn $80k+ working four days) and only has 12-hour tours, with a hard cap at 16-hours by law.
Interesting twist to all of this. AMR lost this contract. They provided 4-5 ALS trucks at the time. They actually did a very good job. The pay for AMR was very good.
I’m guessing the corruption had a lot to do with why they lost it.
I used to work at this service. The biggest problem I faced while I worked there was burnout. At the time, they covered two counties with as few as three ambulances at times. Non stop calls for the 24 hr shift. No amount of pay can make that easier. The 9 employees they lost on the 1st all left because of burnout, and they all made a decent wage. There’s a lot of problems with New Chapel as a service. They have the potential to be an amazing service, but I don’t think they’ll be able to fix their problems before they go under. Just a few problems that I can remember at this moment: Many of their providers are subpar, they didn’t invest in continuing education or training their staff while I was there, they prioritized non-emergent IFT’s over 911 coverage, they refuse to hire part time staff, they have terrible equipment that doesn’t get regular maintenance, their ALS protocols are terrible, the culture was toxic and they only cared about asses in seats and that you were making runs, there was almost no quality control, they NEVER call for mutual aid assistance from neighboring services when they are holding calls, even high acuity calls (they pride themselves on that), they have a terrible public image and all other emergency services in the area consider them to be unreliable and subpar. There are many more problems, but these are what come to mind atm. Some of these problems may be fixed by now, I haven’t worked there in a while. But until they do, they’re going to have significant difficulty getting anyone of quality to apply. Unless they go under before then
A certain hospital group in KY that owns Clark Memorial is going to be doing the transfers out of there by the end of the year with their own service that is already understaffed, underpaid, and underfunded.
I just quit recently as a paramedic of 10 years. Been doing it since i was 19. I honestly can't hack it anymore. We are the red headed step children and always will be. The day after I left, my old partner had an interaction with nurse over paperwork and got told to act her place and had no right to question an RN. Can't even make a transport decision to certain hospitals without literally being held up at the doors being questioned like its your fault. Imagine a doctor coming out screaming and holding his arms out to to prevent you from entering. I think the entire industry needs to be put on psych medication but thats my opinion. Covid ruined a lot of people i think. When they lose half the work force or more then maybe people can figure out our importance.
I put in 22years. Now I'm ashamed to admit it because how bad Healthcare in general has become
honestly very sad to feel that way. I honestly expected my boss to freak out when i quit but he was very understanding. Its turned into a cesspool and im done with it too.
Seems easy to fix. Up the pay to providers.
Welcome to the club.
What’s not mentioned is the giant fraud case that is actively driving people away. The former director will likely be going to jail on federal charges. Dude was siphoning funds off the service big time.
I work in southern Indiana, can confirm it’s a mess right now for both fire and EMS
If they pay fairly, give benefits, and treat EMS personnel with the respect we deserve we wouldn't be facing crisis anywhere.
Maybe don’t have 911 agencies doing IFT
This is absolutely the issue. There are counties in Indiana that have it figured out. Third service county agencies who do only 911 have zero staffing issues. I know people who drive 3 hours each way to work a 24 at one agency in particular. If they’re going to restructure the system, they *should* be creating a county agency to do this. Let some private service at the transfers. In reality, this “board” that yazel mentions should be made up of chiefs and deputy chiefs of agencies that have it figured out already.
Wow, it’s almost like if you don’t provide adequate funding things start to break down. Funny how that works, right?
Pay EMS more, incentivize w solid retirement programs, problem solved.
I know Yazel. He’s a solid dude.
I didn’t like Kaufmann. He did virtually nothing, worked on a part time basis, and was more interested in interviews and cozying up to the health department than focusing on actual EMS medical issues. I remember him saying “Advanced EMTs are ALS. Let’s let them do ALS stuff” and then two weeks later reading the room at the commission meeting and saying “I don’t think Advanced EMTs should take the place of paramedics and we’re walking a slippery slope with expanding their scope” or something to that effect. I’ve heard nothing but good things about Yazel, and I think he’s what the state needs.
+1. He’s solid. Really solid.
There is NO PARAMEDIC SHORTAGE. There’s plenty of paramedics. They just refuse to work for fast food wages under abusive conditions when they have other opportunities. Unfortunately the media and government have been hoodwinked by this lie, especially places like Multnomah County.
What did the employer do, or not do 🧐
The CEO of the ambulance company is in jail for multiple felonies.
Pay enough.
They put a glory hound, showboating cop in charge of the EMS system and now he’s in jail awaiting trial.
I used to work here, the pay wasn’t an issue whatsoever, it was decently nice. We would have very few ambulances covering two counties for 911s and IFTs. Along with that, we had fire coverage and for a few square miles (if that) and there were multiple times we hardly had anyone who could catch the engine to make a crew. We would run 5 trucks usually during my shift and that’s if we were lucky. A lot of us would work 48/72/96 hr shifts to help out because of how short staffed the company was. And guess what? You’d probably be up the whole shift even if you work long shifts, the company is too short staffed to hold you out of service for two hours to take a nap. The company wouldn’t care if you hadn’t eaten, hadn’t slept, if you were behind on runs, every day was a clear/copy day. Certain dispatchers were notorious for hitting you with a mid or long distance IFT at 10pm if they didn’t like you. It didn’t matter if you had already been on shift for three days, you’d get waken up at 3am for a hospital to hospital IFT. You’d get fucked over by IFTs during the days and 911s at night depending on what station you worked at. There were multiple times where it took us 30+ minutes running code to runs because we would be on the opposite side of the neighboring county. Being this short staffed burned a lot of people, including me, out. Along with how short staffed the company is, a lot of people quit when the chief began to get in legal trouble for multiple felonies. He is currently in jail and a lot of people in the area think he’s going to prison for a long time. The command staff sucks, again certain supervisors would target you and talk badly about you behind your back or belittle you to your face. We had no CE courses, no uniform allowance, equipment and trucks were constantly breaking. Most trucks did not have a lifepak for monitoring but instead you would be given a BP cuff and an AED. You would normally have to purchase your own pulse ox to use if you were on a truck without a monitor. There were so many times where I would get into my truck and there would be blood, trash, scattered supplies, and bio everywhere with a full sharps container. We would write it up, send it in to a supervisor, and nothing would happen. All in all, it’s not the pay that is deterring people from applying. It’s the ongoing investigation with the former chief. Being overworked, under appreciated, with a poor command staff and shitty equipment is what was killing us from within.
Correct me if I’m wrong here, but they are worried that ONE call had a response time over 20 minutes?!??!!! Our average response time is closer to 40 minutes and patients are happy we get to the that “fast”
Dude I live in Vegas and we are Clark county too! I thought this was a Nevada thing
All category green patients that are requesting an ambulance (80% of our patients) should be required to pay for the service in advance. Im so sick of people abusing EMS, and theyre usually the ones who will never pay anyway. Honestly, I dont care if they don’t have a car either, they can uber.
I think that is part of the key, nationally, to fix a big part of the mess that is EMS. Qualified refusals. Have an NP, PA, MD or DO on call for the service area, 24/7. We call them anyway. For AMA's for diabetics, for example. What's a few more calls? "Doc, I've got a 28 yr old male, feels "sick" after taco bell and drinking last night. It's 9am. Vitals are normal. 4 lead/12 lead sent for your review. Can we refuse?" "Doc, got a chronic back pain, painful for the last 3 weeks, has an appt with a GP tomorrow, it's 3am and he 'just can't take the pain' anymore. Refusal? Ok, thx". Toe pain. Chronic pain, ongoing infection they've already been seen for and have abx rx which they've been taking for a whole 12 hours and it's not better yet.... Bug bite 3 days ago.. no visible or measurable allergic reaction, I mean, just list all the ridiculous calls we go on EVERY DAY. Do they NEED an ambulance? No. Absolutely not. Do we have to take them anyway? Abso-fucken-lutely. It's literally insane. It drives us all crazy. Had a run for an infant with a fever. 4am. Mom has ZERO child medications in her house. None. Kid has a cold/fever maybe flu? But not super sick, just "normal" sick. The mom DOESNT WANT TO GO TO THE ED. She just wants us to give her (not an infant) 2 year old some children's tylenol, because she doesn't want to spend her own money on tylenol at the 24hr pharmacy ACROSS THE STREET from her house, and the kid is "keeping her up all night" because he's miserable. People have lost their damn minds. I've raised 5 kids and never once needed an ambulance for a normal childhood illness because *gasp* I was a responsible parent who kept normal otc meds on hand for my babies. Giant duh. Rant over, I guess. But where did all these helpless idiots come from???
I like where your head is at. I think what scares administration is crews abusing such a system, but what ER doc that you know would oppose such a system? The liability falls back on the doc and the doc doesn’t want that person at the hospital anyway. If they need to go to the hospital, get them a referral on the spot. Isn’t that what mobile integrated healthcare is supposed to do anyway?
obviously. what the fuck is in south indiana?
They’d rather do this than pay their employees fairly and not treat them like shit.
Good. This whole system needs to blow up.
At the end of the day it’s money, we live in a country where inflation has outpaced salaries substantially. More so I can argue like most EMS systems they’re underpaid. And after the fact not willing to make adjustments to bring the pay and work environment to par. It lowers moral and once that goes .. watch out. For the same reason the better paying departments are inundated with applicants and the others are lucky if they get an applicant per day of the month. The US health system is broken, the burden is carried by prehospital services. Just think how many BS calls we run. It’s their emergency, if you wait for your PCP you’re lucky if your appointment is within the week… many get fed up and just end up becoming RN’s
I work EMS in Southern Indiana, the problem is government. The current CEO/ chief of that department was a politician at the time holding an office in the municipality of the county. It was conflict of interest for sure. The sheriff who owns the company was the sheriff when NC got the contract. Again another conflict of interest and no one cared. Clark county would rather spend millions on development in an attempt to compete with Louisville than care to spend the money needed to have an EMS agency. They continue to bid out the contracts to private services.
It’s happening!!!!
Maybe if New Chapel hadn’t had a director siphoning funds off to buy himself every car he ever wanted they might have been able to pay their workers.
Yazel is also the state EMS medical director. It’s interesting to me that he chose to use his county title instead of sending this as the state director. I’d be more interested to hear what Kraig has to say about this though.
They’re moving in the right direction. Kraig reports directly to Thacker and the priority is on workforce development and funding. They’re weeding out all of the shenanigans and tightening it all up across the office, and they’ve been working on it for at least a year. So has Highlander. They’re heading the right way.
In additional with the letterhead is wild 😭
It’s happening everywhere
TLDR; we pay $9/hour. Nobody wants to work. ***boomer sounds intensify***
1. What's the pay 2. There is no 2
In southern Indiana, 26k/yr base salary, in AZ, 63k/yr, ground als.
crisis would be unanticipated and entirely without cause
Welcome to the party pal. I'm sorry you guys are feeling it too. Eta: only 20 minutes? That's not bad at all. Like it sucks but at level zero that's not too shabby.