Fire Based EMS

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Permalink Reply by Scott Richardson on April 20, 2008 at 10:23pm

Mr. Dixon,

It sounds like your problems are similar in nature to many of the other brothers on this thread. I think we are all speaking the same thought in different sentences. We are all blessed to have this hobby. I cannot call it a job, in fact I have told my wife that when I go I want my tombstone to say: "Do you believe we got paid for this?" She doesn't see the humor in it...

I happen to be an LT on an engine and miss practicing medicine enough to switch with a paramedic if they are an acting officer. I have been a paramedic for 10 years and wouldn't have gotten off the bus for anything. That being said, we had extremely ineffective leaders at the time. I now make it my job to ensure my medics, along with my EMT-Bs are taken care of. I wish you luck in helping your department understand the importance of balance for everyone!

Be Safe! Scott

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Permalink Reply by Michael D. Smith on April 21, 2008 at 10:24am

At my department we all are fire/medics, we all rotate positions on the medic and the engine. In our area we are a small suburban department which is referred to as an either/or station, either the medic or engine. Our problem is there are guys who have demonstrated a fear of fire and unwillingness to do the right thing on the medic. It just seems that these guys are just plain lazy, making comments like, "I did it that way because it is easier." I counter, "But it is not the right thing for the patient." their retort, "So, it makes me feel better!" They just don’t get that this is not about them....IT'S ABOUT THE PATIENT!
Mike

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Permalink Reply by Tom Isbell on April 26, 2008 at 9:02pm

A fire based paramedic should learn to do it all. Most paramedics here would love to get on a ladder truck or something just to do something different.

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Permalink Reply by Tom Isbell on April 26, 2008 at 9:04pm

The fire and ems service is a genuine God given calling.
When you are given the opportunity you just need to step up and rise to the occasion.
Good point Brent.

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Permalink Reply by Chris Fleming on May 15, 2008 at 9:05am

Hey Chris,
I know exactly what your talking about. Here's the abreviated story. Our city had a third service EMS department. They were civillian employees that were under the Fire Dept, but had their own director. In 1997 The city manager wanted them to merge completely into the fire dept and become civil service employees. I think his logic had something to do with overtime and FLSA. Anyhow, both unions were not very excited about the idea of merging into the firefighter's union and there was a lot of resistance, rumours, back stabbing and disrespect on both sides of the fence. The civillian employees were given the firefighter's civil service exam and just had to pass it. There is some question as to whether they were required to do the physical fitness portion of the test. This was before we adopted the CPAT. Once they passed it they were put through drill school with new recruits that were hired. Essentially, they became cross trained firefighter/paramedics but were given no firefighting duties. This was ok with these employees that didn't want to be firefighters. As time went on we began to see new firefighter paramedics desire to do both jobs. By default we had paramedics on engines and ladders all over our city! More medics were riding fire apparatus than ambulances! However, the Deputy Chief of EMS (one of the old civillian employees) refused to give those medics the tools they needed to operate as paramedics from the fire company. His logic was that they couldn't keep their skills up while riding fire apparatus. Nevermind that fire companies responded on all ALS, and Trauma calls and usually were on scene first. This came to a head one day when someone coded in a restaurant in front of a cardiologist. Since all of our ambulances were tied up, the fire company was on scene alone for some time. That day the engine had 3 paramedics on it! The cardiologist was beside himself that these paramedics had no IV supplies or drugs. The patient died. The D/C of EMS broke down and gave the fire companies IV supplies. The old third service medics continued to believe that you can't be a medic and ride a fire truck and that's the policy we still go by even though the majority of firefighter paramedics wanted to do both disciplines. Needless to say, there are some bad feelings still festering. People are being transfered to ambulances because the administration won't buy into the idea of a paramedic fire company as a part of our EMS delivery system. The fire companies go, but can't operate at more than an intermediate level. When the ambulances respond to fires, if it's the old third service employees they don't even gear up! The newer folks gear up report to command and get an assignment. We run into problems when the crew is "mixed". Basically, the long and short of it is that our fire department administration is running our whole EMS delivery system based on non-firefighting Firefighter medics. Sad, but true. The odd thing is, that we have one employee who refused to cross train and is still employed. If those folks didn't want to be firefighters they could have kept their jobs and just stayed civillian paramedics. If your dept. does go with a full on EMS delivery service check in with the IAFF for ways to truely be successful as fire based EMS.

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Permalink Reply by Barry Aptt on May 15, 2008 at 12:52pm

My Department operates the ambulance and has for 50 + years. We have goen to an ALS level program since 1999, but many of these paramedics only want to be firefighters. Our ambulance crew aoperates as part of a trcuk crew. When responding to a fire scene, the up front ambulance operates as the interior crew while the remaining 3 on the truck operate as outside vent/roof vent utilities security. if there are no victims, then the up front ambulancecrew is at the whim of the IC and can be assigned to do almost anything.

I would say our biggest problem is that they want to be paramedics to get the job, but once they get the job, they don't want to do the job. Our treatment of patients does not suffer because of this but leads to some bad blood in the firehouse.

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Permalink Reply by Chris Fleming on May 15, 2008 at 2:10pm

I hear you there, Barry. I guess my take on the whole thing is that if you are a firefighter and EMS provider, no matter what the level, you are obligated to do what the public asks of you to the best of your ability. Whether that means fighting fires, caring for the sick and injured, or any other task we have the training and tools to handle. Remember, as a professional (career or volunteer) it's not about us!!! If you are not "On the Job" to help people, but rather to get an adrenaline buzz and stroke your ego you are here for the wrong reasons. The other issue is "burn out". Folks become paramedics to do the juicy calls, not to give taxi rides. That's the beauty of ALS fire companies, it saves your ALS resources from burnout. (Assuming your engines and ladders don't respond on EVERY EMS call.) You may want to try an objective rotation to lighten the load a little on the folks in the ambulances. I know the crews on the fire apparatus may not like it at first, but you'd be suprised after a while; something new occassionally isn't bad. Some departments (Montgomery County, MD. comes to mind) have had success with the crew rotation and the troops like it. You can check with their EMS division or with the IAFF. Best of luck and stay safe!

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Permalink Reply by J.D. Tehle on May 15, 2008 at 6:17pm

In my department you don't have a choice. you run EMS and Fire. if it's an ems run we take the ambo/medic unit if it's a fire we take the rigs. can't imagine only wanting to run ems but i suppose there are people like that out there!hahaha

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