Friend of the blog Bill Carey posted on Facebook wondering why so many in EMS think that salary is the one thing holding us back.

Curious, question for EMS folks on FB: It appears, based on comments to various news stories in the past, that the greatest solution to all that ills EMS is greater pay. Respect is restored, working conditions and staffing improve and the general idea of professionalism is better. Fire-based, hospital-based, third service, doesn’t matter, just pay us more and the service will get better.
Really?

No, not really.

The same issues I had when I got the paid gig for $4.35/hr are here at my current gig where medics average $65,000 to start (according to indeed.com).

EMS in general is paid what the market allows and what we are worth.  Keep in mind that EMS does not require a degree and Paramedics can get licensed in as little as 1 year in some places.  If some kid walked into my office and told me he went to school for something for a year my first question would be “When are you going back to finish?”

Pay is a result of our goals, not our goal.

Increasing our education standards and proving our worth to the industry is step number one.  But of course the stumbling block to education is how to pay for it.

If you think the reason you are not treated like a Professional is the size of your paycheck I think I know where your priorities are.  If your first concern is that you don’t have access to enough education I’ll ask where you live and why you’re still there.

There are high paying EMS jobs out there, folks, I’ve had one for 10 years, but you have to be willing to put the effort into it.  No one is going to wander into the station or yard one day and say “You guys are great, here’s a raise.”  Your employer has no incentive to increase your compensation unless they desire a particular set of skills that bring that kind of salary.

EMTs are entry level and their compensation reflects it.

Paramedics have more responsibility and therefore more compensation.

A flight medic has even more responsibility, so more compensation.

A Firefighter/Paramedic has a different skills set, different compensation.

You get the salary you’re getting because that’s what you’re worth to your employer.  If you started off at $10 an hour, got your degree, teach on the side, and are still making $10 you need to talk to your employer about the increased value you can bring to the organization.  Maybe you’re in line for a promotion or reassignment with your increased education and experience.

It all comes back to education.  If you learn more, not only can you increase the care you can give to your patients, but you become a more responsible care giver and show your manager that you’re not just in the seat for a thrill, but to make a difference.  Folks like that make less errors, collect less complaints and are more likely to collect extensive billing and demographic information.

That makes you a keeper and worth more to them.  You increased your value.  That is the only way you will increase your compensation.

Let’s imagine that I’m wrong and simply snapping our fingers and giving you more money is the solution.

Now you make twice what you did yesterday.  Now what?  Now will you go back to school?  Teach?  Where is the added value we’re paying for?

The patients are the same, your rig is the same, your protocols haven’t changed and you haven’t changed.  There isn’t much we as EMTs and Paramedics can directly control but our own attitude and education are the easiest to improve in a short amount of time.

Just raising your pay won’t improve your attitude or the attitude of your co-workers.  It won’t help your manager see the worker bees from the cling ons and it surely won’t help your patients.

If you think you’re worth more to your organization than you’re being compensated, tell them, and get ready to pack.  The high paying jobs are out there, but you’ll likely be in a busier system and competing against higher education and higher motivated applicants for the extra money.

Case in point: me.

When I left my last job I was a Firefighter/Paramedic serving a suburban area working on both the Engine and Ambulance.  I was making just under $10 an hour on a 24 hour schedule.

When I got my degree in EMS and began teaching I knew I could reach out an look around for something better and have a good chance of landing it.

When I got hired in San Francisco as a Firefighter/Paramedic assigned to a 24 hour Ambulance I had tripled my salary.  Tripled.  But the cost of living was double and my old shifts of sleeping most nights turned into 32 run paramedic pinball sessions that I loved, but took their toll.

I moved 800 miles to get that gig and I have the broken down UHaul story to prove it.

You can get a high paying EMS job.  They exist, but you have to work for it.

What are you willing to do to prove your worth to EMS?

Please enjoy!

In this episode, we introduce a special guest that had a major influence in MC's life…CaptainDaddy! Happy picks his brain about getting out of the job "whole". We also chat about retirement systems, budgets and whether drivers of emergency vehicles should be referred to as such.

Episode 11

Happy and Motor are at it again, finally, and this time calling out some stupid things done by stupid people while representing EMS, fire and police. From the ambulance company who lost $1 million to the 27 year old DUI while driving a fire truck and a special comment from Motorcop about a narcotics officer in Happy’s area caught stealing and selling narcotics. Quit being stupid!

EPISODE 10

Another great conference comes to a close and the blogosphere is full of great reviews, so many that I have yet to read them all.

Some highlights for me included meeting new faces, like maddog medic and Shaolin Traumashere at meetups and in the Zoll booth.

The most inspirational moment for me came on the last day as things were winding down.  It wasn’t someone inspired by our content or who writes blogs, or even someone who developed a new EMS system or program, but two sisters.

This was also the moment I realized the importance of being a person before being a blogger and how something so seemingly innocent can easily lead to disaster.

Zoll offers a CPR Challenge station so two people can do it side by side and compare their ability.  As I was sipping coffee in the booth, I looked over and saw two girls barely old enough to reach the CPR set up at the station doing their best, which was as good or better than I’ve seen sometimes in the field by “experienced rescuers.”

It was inspirational!  Here were 2 kids barely old enough to spell Emergency, having fun applying the basics of CPR!  Forget teaching this in high schools, we need to move it forward.

Then I ruined the moment, and in an awkward way.  Being the person I am, I wanted to capture this amazing moment I was witnessing.  My hand went instinctively for my phone and before I knew what was happening I was framing up a photo.

Goosebumps were forming on my arms thinking about how the description of what I was seeing could be applied in so many ways to help rescuers and lay people alike take CPR seriously.

Through the viewfinder suddenly the mother of the children was sternly, and rightly, asking me who I was and why I was trying to photograph her children.

Now this moment was stained by my wanting to be a part of it.  The mother’s interaction with me distracted the kids and the moment I had wanted to capture was gone and I felt like an idiot.  I never did snap the photo and offered my phone to her to prove it.  Apologies spilled from my mouth and I returned to the podium where my coffee was and reflected on what had just happened.

“Way to go” I thought to myself.  I could have simply watched, applauded when they were finished and had a perfect memory to use when convincing schools to add CPR classes.

I let my need to capture things digitally interfere with capturing the soul and emotion of what was happening. Something that, I now know, would have been far more powerful than a picture.

The rest of the day and our entire trip home that moment sank in and I began to second guess not getting the photo.

“Perhaps if I explained why?” The little angel on my shoulder offered.

“Oh, yeah sure, tell mom you’re taking the picture to put on the internet, that’ll go smoothly,” responded the devil on the other side.

Now when I reflect on the moment that was, then was not, I realize there was quite the crowd gathering to watch what happened and I ruined it for them as well.

Idiot.

There’s a new article in your March EMS World Magazine.  Something about starting IVs or some such nonsense.

And special props to anyone who can identify where I am in the accompanying photo.

Alright ramblers, let’s get ramblin’!

EMSToday promises to be another huge success and the folks at JEMS are working hard to make the conference their best ever.

Aside from world class presentations for every level of practitioner, manager and owner/Chief, a giant exhibit floor and the popular JEMS games on Friday night, there are a number of things I’m hoping to see in Baltimore this year.

First for me is the reaction to the brand new Brady/San Francisco Paramedic Association curriculum being debuted pre-conference.  Partnering with Chronicles of EMS producer Thaddeus Setla, the folks that brought you high quality video production for Beyond the lights & Sirens and A Seat at the Table have raised the bar in education media.  Gone are the days of a camera pointed at a lectern passing for multi-media in EMS education.  The team is signed on to complete the entire tract and you’ll likely see it in a classroom near you soon.

While on the exhibit floor, I’m going to check in with the folks at AllMed and see what’s new in uniforms and equipment.  AllMed is the supplier of the dress uniforms for Beyond the Lights & Sirens and they always have something new and exciting in the booth.  And they’re the only vendor I recall that brings a seamstress to hem those new pants right there on the show floor!

A big topic at EMSWorld was ambulance safety and I’ll be asking some tough questions of the manufacturers this year, mostly why they keep putting a little box on the back of a pickup truck and call it an ambulance.

Home this year is exactly that, our little corner of the Zoll booth #3707.  Last year we were added at the last minute and had to carve out a section in front of the closet.  Those who visited remember the crowded feeling and we ended up just standing in the isleway.  Zoll saw the crowds we were bringing in and have actually engineered a separate section of their new floor show just for us.  Come see it, meet Ted Setla and record your own “I am EMS 2.0″ video.  While there, get a free CoEMS T-shirt and find out how you can be a part of the new First Responders Network TV channel.  Oops, I’ve said too much.

The show is going to be great and the folks at JEMS will no doubt outdo themselves again.

But what to do when the classes are over and the hall closed?  That leaves the out of conference activities to us!

Here’s your cheat sheet:

Wednesday night-

Pratt Street Ale House – Directly across from the convention center, second floor, the Zoll Pre-Conference Blogger Bash, beginning at 8pm – 11pm.  A non-formal, smaller gathering to get fired up for the opening of the conference.

Thursday night-

Uno’s Chicago Grill – Farther up Pratt street in the Harbor, THIS is the meetup everyone is talking about.  Hosted by FireEMSBlogs this is the gathering that last year garnered the attention of most EMS bloggers, most fire bloggers and a handful of Chiefs who were curious what we were up to.  I know everyone last year just came to meet Mark Glencorse, but this year promises to be another amazing success.  The guys from GoForward Media know how to throw a party and have spent a year planning this event to blow all previous events out of the water.  And considering their events in Indy and Houston last year, the bar is set pretty high.  You’ll need the Zoll Pre-Conference party just to condition yourself for this one I promise you!

Did I miss anything?

A year ago we were gathered in the ballroom at the Hotel Frank in San Francisco waiting for Thaddeus Setla to press the play button.

The time finally came to show the audience what we had filmed the previous November in the engines and ambulances of an American EMS system while UK Paramedic Mark Glencorse followed along.  A hush fell over the crowd of EMTs, Paramedics, friend, industry leaders and family when Thaddeus raised his hands and said, “Our online audience is watching it right now, can we dim the lights please?”

Chronicles of EMS – The Reality Series (Season 1 Episode 1) from Thaddeus Setla on Vimeo.

25 minutes later, after a few good laughs and plenty of smiles the show finished and I found Mark in the crowd.  We were near tears seeing what Setla had done to capture the emotion we had experienced months before.  It was like reliving all we had learned in our trans-Atlantic exchange.

The evening was a great success and the following morning found us in Setla’s studio filming the first 3 episodes of A Seat at the Table.

1 year later we’ve released 23 episodes and have plenty more planned as well as in post production.

The reality series got a new name, thanks to our audience and network TV executives are curious to see what else we have in mind.

If they only knew.

In recent weeks you’ve seen A LOT of activity at the Chronicles site because we are gaining partners and growing rapidly.  No longer is “Chronicles” (#CoEMS on the twitter) simply about Justin Mark and Ted in San Francisco.  Chronicles of EMS is now only part of the content planned for he new First Responders Network TV.  We’ve partnered with fire centered production houses to create new original training and entertaining content similar to the EMS side.

And we’re not stopping there.

If Tak Response taught us anything, it’s that cross training outside your discipline is exciting, new and long over due.  For that reason law enforcement will also be included in FRN.TV, focusing on how we can all learn from each other before the incident instead of during it.

We never landed in prime time on Discovery Health traveling the world exploring EMS systems, but we have time to do better.

Keep an eye on the Chronicles of EMS site for details about our new partnership with the SFPA and Brady and how EMTs all over the country will soon be familiar with what we’re doing.

In addition, Seat at the Table has expanded into new territory, sitting down with the International Association of EMS Chiefs as well as sign language expert Louise Sattler to discuss communicating with unique patients.

We’re charging forward in every direction, working on both reality shows, training series, CE content (coming soon) and a host of scripted dramas, comedies and features that will bring EMS into the home of Americans in a way they have never seen before: Accurate and entertaining.

Thanks for all your support over the last 365 days, and I hope we can count on it in the future.

-Justin

This scenario was patched together from a few here at home and from around the community.  My service recently ran a call for nausea that included multiple persons in stacked rooms and handled it well.  But identifying the cause or possible causes of the illness can be difficult when multiple possibilities present themselves.

ICS focuses on being the first in and building from the cold zone forward.  This call would be so much easier if we were donning our Medical Group Supervisor vest and carrying the command kit into the lobby control.

Ah, if only life worked that way.  Most MCIs and Haz Mats evolve quickly and rarely come in reported as what we find.

I added the element of the unknown upstairs to make us think about what ELSE could be happening besides the seemingly straight forward CO poisoning call which, had this been contained to two adjacent rooms, is easy to include in our plan.

Medic 88 responded above us, called for a haz mat response and went off the air.  We got neither a status update on their condition or why they called for the haz mat activation so we must assume the worst: They are compromised.

On the 4th floor we have 3 or 4 patients directly needing our assistance with an unknown number possibly dead, dying or completely oblivious to the situation.  The first instinct is to evacuate the building, but scattering our unknown illness may prove more costly than not, so we need to evacuate to a place of safe refuge.

The enclosed nature of hotel rooms gives us the unique option of being able to stage our evacuation from the rooms to the hallway, establishing a warm zone.  Of course identifying those experiencing symptoms will be difficult so we need a way to identify them easily.  The MCI and triage kits are downstairs in the rig, so we’ll need to improvise.  Advise the persons you have already contacted to put on the hotel white robe (if they’re there) or drape a large white towel over their heads.  Asking them to also bring a clean washcloth to cover their coughs will help contain any airborne illness should it be present.  The 2 masks we carry are on us and we are considered contaminated until proven otherwise.

Now we have our original patients easily identifiable and a method to separate them based on signs and symptoms of illness.

This information now needs to be relayed to the other responding units.  Using clear text is key in this situation.  Identify your unit, establish command, list threats and give your status.  If Medic 88 is unreachable upstairs we must include them as victims until we hear otherwise.

For the time being we should stay on the 4th floor, triaging all the rooms who will answer the door.  Symptoms get a white towel/robe and washcloth, non symptomatic get moved the the other end of the hallway from our rooms.

This is no place to establish a command post or begin to orchestrate the response of additional units.  In most communities the first units on scene will be engine companies with basic gear and SCBA, and until we know what is going on upstairs, they should not enter the 4th or 5th floor.

Haz Mat Specialists can speak in more detail as to how they may approach this situation, but leaving what Medic 88 found unknown, I think makes us think in different ways, determining a solution for each possible situation.

Think about the following changes to the scenario:

Medic 88 reports a faulty pilot light on the water heater common to 403, 405, 503 and 505 and that symptoms clear in the hallway.

Medic 88 reports fumes of unknown origin seen coming from room 505, two patients are down inside that room.

Medic 88 calls a mayday and reports they are trapped on the 5th floor in heavy smoke, no SCBA.

Medic 88 stumbles from the stairway with blisters on their faces and arms, excessive snot from their noses and mouths, begging for help.

A hotel employee approaches you stating the hotel has received a bomb threat.

These are all exotic situations we may never see in out careers, but could actually happen when we are already set up for a different event.  Responding to any of these situations allows us to think ahead, set perimeters and stay back from the nasty stuff, but with dispatch systems keen on getting us out the door ASAP, most times without finishing the coding of the call, a simple code 2 sick call can become a dangerous unknown situation.

Think on your feet, use what is around you to your advantage and don’t forget that in this situation, YOU’RE a victim too.  At least until the heroes in the yellow suits say otherwise.

If you said “Slow down and think this through” you made the right call.

MAN DOWN! MAN DOWN!