Fire Based EMS

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Permalink Reply by Chris Piepenburg on April 1, 2008 at 11:18pm

Thank you both for your replies....I would like to hear from as many folks as I can. I work for a department who does transport and don't get me wrong we have some great Firefighter/Paramedics and strive to be good at both jobs and then we have those who want to be paramedics with the fire department pay. I tend to get worked up more than I should with this issue, but it is something i truly believe in. I, like you Brent, tend to think that the medic guys get the nozzle more times than not if you really want it. But like I said before we have those that hang back until a lesser job is given. When it comes down to it I want a partner on the medic unit who will be there when i need him most on the fireground.

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Permalink Reply by Jay Michael on April 2, 2008 at 9:53am

I have worked in a fire service that provides ALS care for the last 22 years. The paramedics have been treated like the proverbial "red headed step child". When I was on the ambulance I loved the job, I was a paramedic before I was hired here, 20 years as a medic total. Now our department has several ex-paramedics in administrative positions and the "red headed child" syndrome is almost gone. Many of our fire company officers are paramedcs and we run 2 paramedic Engine companies.
The fire service is here to assist the citizens in their communities. The fire service, in my opinion, benefits greatly by having EMS.
In response to your question, I have never delt with a firefighter/paramedic who didn't want to work on the fire apparatus. The medics seem to be knowlegable and aggressive in their fire duties. We all train together and work together well. It is not all a bed of roses between the personnel but we have the same type of problems between engine and truck people.
I will say the busier we are, the less personnel problems we have.

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Permalink Reply by Scott Richardson on April 2, 2008 at 7:46pm

Hey Chris,

Great discussion Chris!

I am fortunate to work with Chris at a department that is truly blessed with great equipment and people. We have been a fire based EMS transporting department for about 14 years now. Within the last five years we have seen more and more paramedics on engines and ladders. I still function as a paramedic but I am a LT on an engine so I don't get to practice as much as I would like to.

The problem with firefighters that are paramedics not wanting to perform firefighter functions is multi-faceted. Leadership, hiring expectations, behavior expectations and accountability are among the big issues in my opinion.

If someone is making say $65,000 as a firefighter-paramedic and is unwilling to give 110% to their job they are always welcome to go back to the private ambulance gig for $30,000.

I hope I didn't offend anyone here.

BE SAFE...Scott

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Permalink Reply by Scott Richardson on April 2, 2008 at 8:44pm

I wholeheartedly agree; you can make a tremendous amount of money in the privates. I simply mean to say that many firefighter paramedics do not appreciate how well we have it with the insurance, etc.

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Permalink Reply by Mike Lassiter on April 5, 2008 at 8:31am

I happen to work with several people like this, I also work with paramedics who would rather be on the engine than the bus. My department usually responds as first responders on all medical calls. Jasper County Fire/Rescue provides the ambulances. I also work part time for the county when my schedule allows. Jasper County pays pretty good money, and there are those who want their main focus to be EMS. They are firefighters because it's a job requirement, and I can't blame them. We are blessed with having some excellent EMT-Ps, EMT-Is, and EMT-Bs on our ambulances. They are very good at what they do, and while the equipment may not be the latest and greatest, it's still pretty decent. Those who desire to work the ambulance are allowed to do so. Not to mention the fact that if you want to fight fire, the ambulance is a pretty good place to be as they do that a good bit.

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Permalink Reply by Jeffrey D. Dixon on April 11, 2008 at 8:48am

We are a fee for service County dept. that runs 16000 calls a year. We staff 10 medic units and 5 more ALS engines. We have ALS providers that "opt out" and no longer assist the dept in providing ALS coverage increasing the workload on the ones left. Add in the lack of either initiative or work ethic of the younger people coming in and we hire fewer ALS or ALS qualified to run the calls. And yes, EMS in fire service is still a bastard child that provides millions of dollars in funding that allows the firefighters to get new gear, start new training programs, buy new equipment for specialty services.
1.So while we're out there running our collective rear ends off so you can have more toys to keep from being bored... complain that we don't feel like playing your reindeer games when we're not sleeping, eating lunch 3 hours late, and buried in paperwork that has to be done perfectly so that the bills get paid....
2.Yes, we get paid more, we run more calls, have much more responsibility (lives are in our hands), are required to keep up much more training as our certifications lapse every 2-4 years (ACLS/PALS/ITLS/AMLS/ etc.). Add firefighter to our names and we're responsible for your job too which involves making up the training you had the opportunity to complete because you weren't running a med call. My 110% can't be measured the same way as your 110%.
You are obviously young in the service and haven't sat in the other seat yet. Eat your lunch on time and count your blessings.

This is what I get for reading these forums before I've had my morning coffee!!

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Permalink Reply by Chris Piepenburg on April 11, 2008 at 10:50am

Mr Dixon,

I have been in the fire service for 13 years and have been a medic on an engine and ambulance, where I currently sit. The biggest problem I have is that there seem to be a number of medics who want nothing more than to ride on an ambulance. Their title is Firefighter/Paramedic, but for many it is a title alone. Many seem to come into the fire service for the pay and to not have to sit on a street corner waiting for a call, they could give a hoot less about doing the actual firefighter part of the job and this shows when it is time to fight a fire. You have the duty to be good at both parts of the job, the firefighter and the paramedic. And to me if you just want to be a paramedic who does not want to do fire please stay with the privates!

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Permalink Reply by Michael Ward on April 13, 2008 at 7:04pm

How about the firefighter/paramedic that got medic certification in order to get on the job and now refuses to make any effort at patient care ... to the point of being a member of an engine company first responder standing next to a person drenched in sweat complaining of trouble breathing. Care provided was a nasal cannula and assurances that ",,, the paramedics on the ambulance are on their way." There was ALS equipment on the rig that could have significantly improved the patient's condition, but this person did not think it would make a difference.

We have a cultural challenge. While the IAFC and IAFF promote the concept of fire-based ems, the message breaks down before it gets into the fire stations and on the streets.

To answer your question. The DEPARTMENT sets the standards that the COMPANY OFFICER is expected to enforce.

Now, there is a chance that the paramedic/firefighter may prefer to stay off the engine to avoid a daily dose of harassment, belittling or other activities that may make the paramedic/firefighter not feel safe as a member of the fire company. This goes beyond the normal ball-busting that is part of daily life.

Transport units spend most of their days outside of the fire station. That is one way to stay out of the fray.

Mike
22 years as a firefighter/paramedic in an urban county, including eight years as a company officer and four years as an ems administrator. County fire and rescue provides both first responder and transport.

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Permalink Reply by Scott Richardson on April 19, 2008 at 10:18pm

Mr Dixon:

I am sorry to hear there is so much animosity in your department between paramedics and firefighters. I have a few questions if you don't mind. Those that opt out of ALS; are they promoted to officer or "off" the ambulance? Does your department support your continuing education? That is, do they pay you to attend or provide you with continuing education?

What are you referring to when you say "reindeer games"? I am kinda new at this so forgive me if I am missing something here. As for being busy, it appears your department is similar to most moderate departments (16000/10 ambulances divided by 365=~5 calls a day average), is this correct? Is that 16000 EMS runs or does that include fire runs as well?

Finally 110% is not comparable based on firefighter/paramedics vs. firefighters vs. paramedics OR fire based versus Private or hospital based ambulances. 110% is relative to ones knowledge, skills, abilities and many other intangibles.

I think Chris's point here is that many paramedics that work for private or hospital based EMS "take the test" to be firefighters because the pay is MUCH better. Often times these paramedics go through the academy and feel like they are done with the fire suppression gig. Unfortunately these same medics feel they are entitled because they generate revenue for the department. Sometimes they fail to realize that they are getting more money to do both jobs. If they don't feel they are getting paid commensurate to their job they have a few options; quit, go work somewhere else or promote and change things rather than complaining about them.

Again, I am sorry to hear there is so much animosity between your paramedics and firefighters. It would appear this issue is much broader based than just firefighters and paramedics though. It sounds like there are some significant leadership issues as well.

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Permalink Reply by Robert Owens on April 20, 2008 at 10:58am

We have 2 problems with the firefighter paramedics.

1. Typically they get hired as a previously certified paramedic and have no fire experience they get certified and then kinda let it lapse wich is good for 70% of the calls. The problem exists when we do get a fire and these guys can't cut it.
2. The guys get hired as firefighter medics and will do everything they can do to get out of riding an ambulance calling in sick claiming burn out etc.

I wish we had guys that only wanted to ride the medic unit it would make life alot easier.

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Permalink Reply by Chris Piepenburg on April 20, 2008 at 8:33pm

Wow...seems like everyone has a different problem. I my mind I wish everyone would give 110% to both jobs of being a good firefighter and paramedic. I know that it is hard, but i think that is the reason fire/medics tend to get paid a little more.

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Permalink Reply by Jeffrey D. Dixon on April 20, 2008 at 9:04pm

Mr. Richardson

You get extra points in the officer process for being ALS. ALS officers are supposed to ride the rig 2-4 times a month, which is rare. Some keep their ALS long enough to become officers, then opt out, keeping their certification, just opting to not use it for the county. It does cost them $3000/yr. to opt out.

The dept. does support some of my CEU's. It does not support the nonparticipating ALS providers, but we do provide a great deal of in house CEU training also. I am one of the instructors and have been approached several times to provide an officer or officer candidate with the needed CEU's to maintain certification, even though they are nonproviders. My outside CEU participation depends on a recent print out of CEU's, my recertification date, and the current training budget. A majority of my outside CEU training is out of my pocket or on my free time. This is turn I bring back to the benefit of my brothers in arms.

When I refer to reindeer games, I'm addressing the repetitve "training" to fill time to make the Bat. Chief happy by looking like they are doing something productive. "Let's pull and repack hose" for the 4th or 5th time this month, practice using the struts on the picnic table again, or throw the ladder against the side of the empty strip mall, again. It's not rocket science. If I find an overturned picnic table with people under it... I'm more than ready.

And if the law of averages worked for all depts, nobody would be all that busy. Reality is 3 stations are on the I-95 corridor and of those, 2 average 7 calls a day (shift is 5a-6p). The outlying country stations sometimes will do that in a month. EMS goes on all fire calls except alarm drops. EMS units are equipped with SCBA's and tools and are included in the manpower dispatched to handle any fire. There are times the EMS crew is on the knob, securing utilities or doing search and vent.

I love my job. I'm usually on the medic 2 days a week and the engine one day a week. When I precept a new medic, I'm on the unit for 2-3 months straight. I get more flack from the firefighters because they had to do 6 or 7 hours of RIT training when I only participated for 2 or 3 hours between running calls.... You wanna complain...get your medic so I can ride the engine more often.

I guess I could also complain the same way when all of our firefighters are required to be BLS to get the job. Do they tech BLS calls?? Are you crazy? Most have no idea how to take a manual blood pressure or bandage or splint something. I could complain when they don't keep their skills up to meet that part of their job expectations...

I just get tired of hearing people complain. They should be happy to have a job like ours. When the shift starts and the Lt. says, I need you to be on the medic today... tell him it all pays the same and I'll go wherever you need me. Do your shift, earn your pay, and quit grumbling.

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