Monday, July 7, 2008

In lieu of original content

I posted this as a comment on Ambulance Drivers blog. I ended up getting a bit wordy I guess.

I posted it here as well so that any of the lazy firefighters other hose monkeys who I might offend can take me to task here, without cluttering up AD's place.

I also invite your comments on it all.

AD you're right. And I still think you're a little wrong too.

I also know you don't hate hose monkeys. (Hey who could hate a cute little monkey?)

And the more I think about this the more it really does seem like a Men vs. Women thing.

(Would that make me a cross-dresser?)

Anyway, back to the argument/dialog.

Regardless of what size or type of department you talk about, the understanding/acceptance/respect will have to start with individuals.

Let me tell you a couple of secrets about the fire service;

A lot of people believe that it's easy to get a fire department job. They think that firemen need no college or technical education to get hired. And they think that we sit around all day playing dominoes and washing the trucks.

Well, that's not completely true, but it is based on some fact. The truth of that tends to attract employees to the fire service that are, shall we say sometimes less the energetic. They want to sit around all day and play dominoes. If they are forced to do any more than that they are unhappy and do it poorly.

On the other hand, we hire a great number of people who know what the job is, and want to do it well. They truly want to help people, whether it be working car wrecks, house fires, or pure EMS calls. This group does well as firefighter/paramedics.

On the other hand, that first group doesn't even make good firemen, much less anything else.

As someone else pointed out on Rouge Medics blog I think, being a basic firefighter is not that technical. Once you learn the basics, you really don’t forget them. It’s only when you start to add the driver/engineer training, or the Haz-Mat, Rope Rescue, Swift Water, Confined Space, Officer 1 and 2, that you really start getting into things you need to continuously study/practice to do well.

And you know what else? Being a Haz-Mat tech has about as much to do with being a basic fireman as being a Paramedic does. Same goes for almost all the other “extra” training I cited above. So why is it that we just accept that a fireman can be a good Rope Rescue guy, but it’s hard to accept that a fireman can be a good paramedic? Notice that I didn’t say a good firefighter and Rope Rescue and paramedic.

So, back to your question “What will it take for medics to achieve equality in the firehouse?”

If we are talking about an integrated department then I offer the following:

First and foremost the hiring standards need to be the same. You can’t expect equality if you hire a person with a high school diploma to be a fireman, and require a medic to have a 2-year degree to get hired.

Second, pay and benefits need to be the same- on a base level. Stand by, I’ll come back to this in a moment.

Third, train everyone to both basic EMT, and basic firefighter levels. That way when the medic asks the fireman for a 4X4, he doesn’t come back with a piece of wood. Also, the medics won’t stand there looking like a lost kid when a fireman asks for something off the truck.

Fourth, allow the employees to pick a preferred specialty in addition to the basics that everyone has. Let the folks who want to do EMS do EMS. Let the folks who want to be on the rope rescue teams do that.

Fifth, pay folks for what they do. Some call it certification pay. Figure out some way to compensate for the additional workload and training required for the specialty they have. Paramedics would likely get the most in a fair system.

Sixth, promotions need to be based on competitive testing. The basic FF/paramedic and the FF/Haz-Mat tech should be allowed to compete for the same promotion to the next level, everyone understanding what exactly that job is. Only after passing the test and promoting should they be required to gain the certifications needed in that job.

Seventh, allow lateral transfers. If one of the Medics has grown tired of EMS, allow them to change specialties when an opening is available.

That’s my take on a combination department.

For separate services to get along, I think it’s a matter of education. We must educate the public, and by doing that we educate the various services. Both the police and fire departments have done well with “public safety education” in schools. We need to add EMS education to that. EMS must do a better job of tooting its own horn. We need better visibility to the public, to the other services, and maybe most of all to governmental policy makers at all levels.


Rogue Medic said...

Mr. Fixit,

First you're a cute monkey, then you are cross dressing, then you're calling me rouge, not rogue. Please send a picture, I hear these internet relationships work out very well. :-)

Or is the rouge part of an attempt to get me back on a big red truck?

There are plenty of other dysfunctional relationships in the emergency world. Look at NYPD/NYFD. Somebody needs to go in and bust some brass-wearing heads to get them to start behaving professionally toward each other.

This kind of childish rivalry is not good for anyone.

You make some good points, but playing with my hose in public is still not what I want in my job description. :-)

Cross-training won't help me to provide good care to my patients, but will distract me from providing good care.

Hey, if this cross-posting/cross-dressing/cross-training thing catches on, think of the blog traffic!

Ambulance Driver said...

Good suggestions, Mr. Fixit. Now leave some of those comments on, so the people who sign the checks know how popular my columns are. *grin*

And some of those suggestions will be duly noted in Part III.

Mr. Fixit said...

AD, done!

Rogue Medic, I am so sorry. Many apologies for the typo.

And I'm not advocating a combination department as the end-all be-all solution. But, for good or bad, that seems to be the direction a lot of cities are going.

My point was that if you are in a combination department, the cross-training at the basic level of each is a way (not necessarily the way)to break down some of the "us and them".

And just so you know, there is nothing wrong with playing with your hose in public. I do it all the time.



Rogue Medic said...

Mr. Fixit,

I get more amusement out of the rouge medic than anything else. It allows me a more feminine side, don't you think.

As far as playing with my hose in public, my mother reads what I write and my CPR card has expired. :-0

Playing with it all of the time might be a little too much, but probably is good for the blood pressure.

I oppose the dual role, not because I think that I am going to make a difference in what a big city does, or even a small city, but because I think it is the wrong approach.

I vote. I don't vote for the rouge or the cyanotic party, even though one seems to be trying to flatter me by calling themselves rouge. I vote for the candidate/party that I feel is closest to what I believe, no matter how unlikely that the candidate will be mentioned much in the election coverage.

TOTWTYTR said...

Mr. Fixit you have some great points in your post. The problem is getting someone to actually implement them. In an ideal world there would be the kind of mutual respect and ease of moving between one side of the house and the other. Unfortunately, that doesn't seem to happen in any large systems. Which are the systems we generally talk about when we talk about the fire-EMS rift.

Perhaps the biggest thing that needs to happen is that upper management needs to change the culture in such a way that it filters down to the firehouses.

You know how easy that is to do.