EMS Apathy

After spending most of yesterday in recovery from a near-sleepless night at the EMS, I logged on to Twitter today and noticed an interesting tweet from Chris Kaiser (@ckemtp on Twitter – an all around good fellow and follow, by the way).  It was a link to an article about apathy in EMS.  The article, entitled “Apathy in EMS is Pathetic” asks some hard questions that all of us in EMS should be asking ourselves:  “Do EMS providers really care about EMS, or is it just a temporary job until something better comes along? Is it just a young person’s game? Do EMS providers really care about the profession as a whole and worry about its future?”  Often I wonder the same things that Dr. Bledsoe asks in his article.  Why do so many EMS people seem to apathetic when it comes to their field?

When it comes to people in my area, I can’t help but think that a lot of them don’t speak up more for positive changes because “it’s just the way it is and the way it always has been.”  Evidently they’re not alone.  A survey conducted by JEMS indicates that, despite safety concerns, the average EMS shift in the cities surveyed in their 200 City Survey remains at 24 hours and a lot of that seems to stem from tradition.  Could you imagine what EMS would be like if we kept our protocols the same just out of tradition (and, to a degree, I’d speculate that some do).  Accepting the status quo is not always in the best interests of ourselves and certainly not in the best interests of our patients.  However, many of us do and a lot of that is because of the “it’s just always been that way” mentality.

I don’t know about you but I’m all for bucking tradition (whenever and however possible).

I wrote about EMS 2.0 in my last post and it’s very much inclusive of some of the issues that possibly lead to EMS apathy.  One think CK and I discussed earlier was the need to have better pay for EMS crewmembers and treatment that actually makes a difference.  I agree 100%.  Part of the overhaul of EMS will be addressing the factors that make EMTs and medics want to jump ship.  I know of several people who are working in EMS and in school for areas of study that have little, if anything, to do with EMS.  A lot of people see EMS as a stepping stone or as a means to collect a check while they’re in school.  If that’s what they want, that’s fine.  I’m not going to fault them if it’s really what they want.  However, I think we have too many people with that mentality and we need to do all we can to reduce those who will let their licenses lapse after they graduate from school.  We need to increase the number of people who truly care about EMS, its future, about making it better and, just as important, who are in it for long-haul.  We need people whose long term career plans are to stay in EMS for as long as they possibly can, be it on the front lines or in EMS education.

The pay thing is an important factor to address as well.  The last salary survey that JEMS performed is very telling.  Did you know that even within EMS itself there are big salary discrepancies?  The average EMT makes just over $28,000 and the average medic makes about $38,000 (the medic making more is understandable since they have more education than a Basic).  However, if you continue on to support staff, an IT manager makes about $68,000.  Wow.  Now, I’m not downplaying the training and long hours that IT people put in and they are very important to what we do.  However, I don’t like the huge gap in pay between those on the front line and someone who essentially works behind the scenes.  Those who are directly responsible for patient care should be paid better than they are.  Remember, these numbers are averages and many don’t make as much as the survey claims is the median.  Especially in settings like mine, a medic may not make even over $30,000 a year.  The lower pay is a slap in the face of those who are on the front line and who work long hours and spend so much time away from their families, compared to others who make more and work 9-5 Monday-Friday.

Changes will happen but it will take time.  It took nurses decades to get the respect and pay they have.  However, they earned their respect and higher pay.  Simply put, they insisted on more education and more accountability in their profession.  They demanded that they be allowed to give better patient care overall and they proved that they deserve what they’ve achieved.  I’m not saying that us in EMS haven’t earned respect but we, as a profession, haven’t done enough in the areas of education and accountability.  EMS 2.0 is a great step in the right direction but implementing it is going to take some doing.  We have to make it attractive to the decision makers in order to truly make this successful.  We can push for it all we want but we have to get our higher-ups on board in order to make it happen.  That’s where we take pages from nursing’s playbook and act accordingly.

What do you think can be done in order to combat apathy within EMS?  What can we do to improve our working conditions, pay and our ability to care for our patients?  How can we make EMS a legitimate career and profession rather than a stepping stone to something else?  Please feel free to leave your thoughts as a comment or you can email them to me (you can leave your name off if you wish).  I may use the ideas in another post in the future.

Rural EMT-B

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2 Responses

  1. This is an interesting post, but probably not for the reasons that you want it to be.

    First on the 24 hour shift issue, I’ve “bucked” that “tradition” in my own system. In fact, no shift is scheduled for more than 12 hours. Amazingly, EMTs and Paramedics still want to work the 16 and 24 hour tours. Why? Because of scheduling convenience for them. The real question shouldn’t be how do we buck tradition but rather how do we get responders to see what is better for both them and the patients instead of just looking for convenience? Of course, one possible solution to this deals with the next issue you raised, being pay rates.

    I understand how you might see an EMT making 28,000 and a Paramedic making 38,000 a year compared to an IT Manager making 68,000 a year as an injustice, but you really have to understand the differences. For every IT Manager an agency employs, there is probably 40 EMTs and/or 20 Paramedics. In fact, the ratio is in all likelihood greater than that, but I’m being conservative. Like EMTs and Paramedics, IT Managers have certifications they must maintain. In fact, to be an actual IT Manager, there is roughly 10 basic different certifications you need, and each one cost between $250-$1000 just to test for. There are no state grants, no “challenges”, and more often than not the companies don’t reimburse them. Also, you need to remember that they are a Manager and not IT line staff.

    Which really brings me to the entire point of my comment. EMS Agencies are more than EMTs and Paramedics. Yes, without the EMTs and Paramedics the agency can’t transport patients, but without the dispatch staff the EMTs and Paramedics can’t respond to the patient, without the call takers the dispatchers won’t know where to send the EMTs and Paramedics, without the fleet maintenance department the EMTs and Paramedics won’t have ambulances capable of responding, without logistics the EMTs and Paramedics won’t have the necessary equipment to treat a patient, without the billing personnel the agency can’t collect money for doing the transport, and without the IT department to tie call receiving, dispatch, and billing together electronically the system becomes very inefficient and will require more people than it already does. “Support” personnel are just as important as line staff. Too often line staff dismiss their contributions and there needs to be an understanding that without these people, we would not be able to accomplish the mission.

    I think what we really need to do is look at the pay rates for similar services in our area of public safety, such as Law Enforcement, Fire Suppression, and Sanitation. Why don’t the starting pay rates for EMTs match those for Firefighters and Peace Officers? Why aren’t Paramedics on the same scale as a Fire Lieutenant or Police Sergeant? I think that is really what we need to compare ourselves to in order to remain grounded with reality, and focus on getting us to their levels instead of non-related support personnel not on the same level.

    • Dave, thanks for the comment and for even viewing my little corner of the blog world. You made some good points, some of which I hadn’t thought about. One thing I will say is that I wasn’t trying to downplay the role of support team members. They are just as essential as any EMT or medic. However, the gap in pay is staggering. While I know that (at least for the most part) they deserve the money they get, those on the truck should get a little more than they do now. I’m not saying that a medic should get paid $60K like the IT manager but I would think an average closer to to 45ish would be better.

      24 hour shifts have their advantages but they also have a lot of disadvantages. A lot of people have the concerns about safety and I do too. I never felt at any time that I was endangering my partner or patients the other night when I didn’t get much sleep but I know that others haven’t been so fortunate. It’s something to ponder.

      I also think that the pay thing plays a lot into educating people and our elected officials about what it is we really do. Sure, a lot of calls are total BS and we do spend a good bit of time between calls doing what seems like nothing but when we have to go to work, we go to work and we work hard. Most people don’t understand that, at least in my experience. A lot of people don’t understand that we work 24, 48 or even 72 hour shifts and how tough it can be. It all boils down to education.

      Dave, thanks again brother. I look forward to more feedback from you!

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