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Why do you think the EMS industry is having troubles recruiting and retaining employees?

Reports from around the nation describe mass shortages of paramedics and EMTs. Managers have cited a number of issues to account for this downward trend, including non-competitive wages, mandatory training, and a changing mentality among the younger work force. However, departments in Calif. and Tenn. are gearing up for major surges in EMS employees in the near future.

Why do you think the EMS industry is having problems with recruiting and retaining employees? What changes do you think need to occur to turn this around? And for current paramedics/EMTs, have you considering a possible switch to another profession?

Tags: employees, management, pay, recruitment, salary, wages

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I really think one of the biggst issues is pay. Of the three public safety fields EMS is the lowest paid unless you are a fire based service. If you are a private, a third service or a PUM you make no where near what a fire based EMS worker makes.

And in fire based services quite often time " on the box " is viewed more as a have to then a want to. I know of quite a few departments who use getting off the box as a promotion.

As far as recruitment, EMS is the forgotten step child of public safety, even though EMS workers have more contact with the general public in time of need then the fire side. EMS is quite often viewed as a ride to the Emergency room. Nothing more. When people think Public Safety they think police and fire only.

We really need to do more about how EMS is viewed by the general public. That would go a long way in fixing quite a few of the issues.
I'd be careful with the generalities. There are places where municipal and county paramedics (I don't like the term "third service") make as much or more than their police and fire colleagues.

And where what you say about public opinion is true, how much time and effort has EMS invested in building a public image? Almost every PD and FD of any size has a full or part-time public information officer. How many EMS agencies do? Does yours? If not, why would you expect that the public would know anything about you?

Skip
Yes there are places where municipal medics make as much, but its not very often that its true. Whee it is true they dont seem to have the retention issues as much. Yes you still get the EMS workers who get burned out, but those communities quite often look at their people as investments not just employees.

EMS in general has invested NO time in building a public image.

Lets face it, we really are a young service. EMS in its current form is less the 40 years old. Our scope of practice has changed so much in that short time that people in general really have no clue. Its not their fault. Its ours as a whole.

Those of us working the streets are the best public information officer a service could ask for. WE have the chance to educate people every time we interact with them. But how many of us really take the time? How many are encouraged by our employer to take the time?

While yes PD and FD departments quite often do have PIOs, they also have a longer history. Quite often they also have better funding and are able to fund those positions. From the top down ( all the way to FEMA ) EMS for so long has been pushed to the back burner. We need to change this.

Another issue with the general publics perception is the fact that 90% of what EMS does is very private while LEOs and FF work in the spot light. This there is nothing we can do about, and we shouldnt. We cant tell the public how we saved John Doe from sudden cardiac death, yet the fire department runs a house fire and it makes the paper.

Where I am at its funny. A MVA makes the paper. Fire and myself spend 1.5 hours on an extrication. I spent most that time right in the vehicle with the patient. I wont even go into everything I had done for this patient while fire was getting him out and police were directing traffic. The papers made one mention of EMS and it was printed that we ASSISTED fire and PD at the scene. It was a team effort between fire and EMS that saved that child. The extrication was team work with the fire caption and myself directing it. Yet I only ASSISTED?? While Im not looking for a pat on the back, this just shows how EMS is viewed
Along with what John said about pay, I agree. As far as retaining, I'd say people get burnt out at an alarming rate. There is nothing really covered in whether it be EMT or Paramedic school about all the BS calls and the alarming rate of abuse on the system. We get into this job for the almighty "I want to help people", not to be called just because they want a ride for a papercut. We want to be productive and useful, not taxi drivers and paper-pushers.

Just like a lot of people get into marriages with unrealistic expectations, a lot of newbies get into this profession thinking its gonna be a 24/7 adreneline rush with non-stop bandaging, drug-pushing, baby-delivering, live-saving intervention-ing job. Once you get into the field, its rather deflating to see that all those exciting calls we saw on episodes of Emergency! only happen every now and again. And for some folks it may only happen once in a career. I've come to acknowledge and accept the fact that at least for the population I serve, 80% of my job is public education and thats how I can help them. Its educating them on the true necessity of taking their meds, how to pay attention to their bodies and educating them on their diagnosis'.

I am in a fire-based EMS arena, and at least for us, being a medic and God-forbid actually like being a medic is to wear a big 'ol scarlet letter on your chest. There is such a stigma to being a medic where I work, but that stems from past foul-ups on admin's part with the merger, split, merger again, split and then merger again. Riding the box is considered punishment in most cases if you're the FF/EMT. And a lot of FireMedics say they want to ride the engine, but not because they want some fire time, its cause they just want off the box for a while. The abuse of the EMS system in this area is off the charts. I think a PSA should be done to educate the public on what we're really here for.
I'd have to go with pay also. I work part-time/on call/perdiem for the local service right now in my spare time. I just got my EMT-Basic and I'd love to work EMS full time, eventually make my way up to paramedic, but the money and benefits just aren't there. Even as a medic, I wouldn't make anywhere near what I make in my full time job.
For over thirty years, I have watched changes take place in EMS, and for the most part they have been good changes to better our Pre-hospital education and skills practices, while we turn over to our institutions more viable and stable patients. For those of us who have been around EMS for a long time, we continue to hold our positions as Professional and Career oriented; however, there are many who believe that what they do is just a job. And with that attitude, we talk about our partners, gossip about the mistakes they make and pass along information that could only excite those who would qualify for the Jerry Springer Show. We hold little respect for our Profession, our Partners and ourselves and until that changes, we will continue to make little money, our patients and their families will continue to believe that we are trained on the job and we will continue to find ways to downgrade what we do.

I believe that EMS needs to have reinforced information in our classrooms that remind us of the old adage of "What We Hear Here, Stays Here." We need to always say positive things about our partners and learn from their mistakes, as well as, our own. We need to teach others how to better perform the skills we excel at, and allow them to teach us in return, while remembering to teach them only at the level their license permits them to practice. When Paramedic students fail to pass their Boards, we need to hold them to the level they maintain with their license, as an EMT is still an EMT until their license reads at a higher level. And finally, we need to change the titles of our superiors to match those of the Fire and Police Departments, as the words Sergeant, Lieutenant and Captain carry an immediate respect for those who are being addressed.

Thanks for Reading,
Terry Ventocilla, EMT-P/Paramedic Instr. Coord.
Member of MAEMT Board of Directors
Michigan Assoc. of EMTs
I agree with your post. I think for me, what I here you saying is that we need to be more professional in all areas of practice. One area that gets my attention is attire. Looking professional is a big deal. It "says" to others about the competence of the emt or emt-p. My favorite--- a few years ago I way an emt-p with a baseball cap on.. ok,,, I can live with that. BUT,, he had a tourniquet tied around the cap with a 16 and 14 angiocath wedged in it. I guess he was prepared. And we wonder why we don't get respect.
Management, Management, Management
It doesn't matter how long you have put in on the job, all that matters is who's butt you kiss to get to the top. I have a boss with less time in the field by 18 years, with no collage credits, and NO experince in any management office ever, but he is the boss. Now my company is in finacial disray and the board blames the workers, not the fact, they have made bad choices and just bought a truck with out the money for it. I also think that the pay is poor, work conditions suck and the hours are long and seem never ending. lets also add in to the mix, we are only Ambulance drivers and that is how our public veiws us. They will yell and call you names, complain about you in a second and expect you to be as happy as pie when you answer their call at 0200 hours for a diaper change.
Sounds like you are pretty unhappy, Steven.

Two questions:

1. Why do you still work there?

2. What are you doing for yourself and for your organization to make things better?

PS If you don't want to go on a call at 0200 for someone who needs help, you're probably in the wrong business! Nobody, but nobody, calls us because they are having a good day. Even if their problem doesn't seem worthy of your talents, that's somebody's mom, dad, aunt, uncle, or child who has asked for your assistance. They deserve your compassion and respectful treatment.

Skip
Did I say i didn't do my job for "those people", and is this not a forum to vent. you have to be a manager that gets to sleep in his own bed, does not answer calls any more, and have all the hollidays with his family. Don't question me about what I wrote, can't help if it hit home.
Steven-

I am not in a management position but I have to agree with Skip. Why do you still work there? It sounds like a toxic environment for you. Is it by chance an AMR service or other private company? I worked for AMR for 9 years before I decided I had enough of their crap and I left. This required me moving to another area but I am much happier. While I have been in EMS for 16 years and generally enjoy what I do, I realized several years ago that I had to have something else to fall back on or to change direction. Consider going back to school and getting your degree or a different degree. Find an industry that you love working in and go for it. EMS is not for everyone nor is it a long term career for most. I hope you find something that makes you want to get up everyday and go to work!
PS Skip,

My mother has MS and can change her own diaper at 0200 hours with out calling for HELP.

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