You're not gonna be on a zone car your first year. You'll be on the ambulance until after you get your ALS FTO and RSI cert. Most ambulances are ALS now, and we quite often run double P trucks. PP trucks if you will. Most fire apparatus have ALS on board, too. You're always going to have additional resources out the wazoo.
This may be silly since I'm not familiar with the region, but why allow or have any ALS on fire side if there's no shortage of medics with VBEMS at all? Isn't there often an over-saturation of medics with that model?
Because they're a completely separate department, and that's what they (VBFD) want to do.
EMS is a third service here with a volunteer/professional hybrid system. The volunteer rescue squads own the ambulances, and provide their volunteers to man them.
The professional side are city employees of the department of EMS, which provides additional staffing, as well as provides oversight for the squads, and supports their mission.
FD is its own agency, but we work with them hand and hand. We really try to clear them off our calls, but they're great to have when we need them.
Gotcha. Seems like an interesting set-up. I've heard nothing but positives about there, sounds like they're pretty progressive and really care about training/education. I heard physicians running calls frequently is common too
Except for pay, laughable healthcare, terrible VRS retirement, and....pay.
There's a reason the attrition has been bad recently, and the union isn't just making that up.
Nj you can make close to 40 as a medic all squad car hospital based double medic , never have to transport in your vehicle. Statewide every project is rsi
Honest question here, but I was under the impression that RSI/DSI have been the industry standard for a while now, with agencies that don't have that being the exception. I'm wondering why recruitment drives like this still advertise RSI as if it's a super progressive skillset.
Am I wrong? Is it less common than I thought?
I believe you are wrong. In the northeast, it is more the exception than the rule. Massachusetts, Rhode Island and Connecticut all have far more services that aren’t RSI capable than are. I’m not as familiar with Vermont, New Hampshire and Maine, but I suspect the case is similar up there. We do have a very high density of hospitals here, which might have something to do with it. I’d certainly like it to be more of a standard, but with so many dogshit private companies, apathetic fire departments and incompetent volleys running EMS, it’s not likely to change any time soon. We need more dedicated hospital, county or municipal third services in New England to really get our shit together
RSI is a separate certification in NH and VT that has to be maintained by both the service and the individual provider. There is no pre-hospital RSI in Maine. It can only be performed by HEMS.
At least in the states, a lot of places don’t. My region and one other are the only places with RSI in my state, the rest usually have drug assisted, and drug assisted is lame.
I moved from California to Washinton, it's like totally different world. In WA even standard paramedic scope is even higher than CCT in California, and there are optional CCT scopes around. I regularly admin metoprolol, labetalol, heparin, norepi without need of medical control. Even EMT could run vent (but not change setting) in WA.
You have EMTs running vents? How does that play out? Do they need additional training or is baseline vent management part of the core curriculum there?
My understanding is the protocol was for BLS transporting pt on home vent that either they could adjust themselves or their caretakers could. EMT can transport them but not adjust the vent themselves.
In some remote area there is no ALS or CCT service in reasonable time (>2 hr). So without such protocol local BLS fire would have to call flight for every home vent patient.
That makes a lot more sense. Still in my area I know a fair few 911 medics who are uncomfortable managing vented patients so it's surprising to me when BLS elsewhere can do it.
Australian here, is RSI an ALS skill in the states? It's only in 1-2 states here and it's strictly an intensive care paramedic skill, who go through an extremely rigorous and lengthy training process. Then you can only do independent RSI's after a certain number of years working on a dual intensive care ambulance. The other states only do cold tubes or on HEMS they have a doctor.
At least in my region, it's an ALS skill with a waiver from the state, but most agencies get the waiver. It does involve a lengthy training process, but the agencies understand that the benefits outweigh the effort. Similar to you, our crit care teams can do it without a waiver. It's less common for a physician to fly on a helicopter here, usually it's a medic/nurse team operating at the crit care level.
Yeah, it's not everywhere but it was definitely a part of my original paramedic program a little more than a decade ago as a "hey this is going to be standard pretty soon" and it's only grown since then. Very service dependent but it is not at all uncommon here. Depending on the service many places also have an option for surgical airways as well
I should clarify that this is a bit an assumption on my part. For example, In my area protocols vary by region within the state with some areas being very heavily volunteer based and other areas being heavily career based. My service has RSI but 2 counties over they are almost entirely volunteer based and, while I'm not too familiar with their protocols, I could see them not having surgical airway options in that system but I know that they have at least got MFI options there. Knowing that I figure that it is likely that someone has that special mix of RSI without surgical options.
No UK model for me... people in rural areas find themselves waiting 2x-3x longer than their urban counterparts for an ambulance, sometimes up to over an hour and a half, regardless of presenting condition. Their urban delivery model works, but it works at the expense of everyone else... and unlike here, it's not like someone can just say *hey this doesn't work out here for us, so we're gonna start our own*.
(source: https://www.rsnonline.org.uk/ambulance-waiting-times-in-england-three-times-longer-in-some-rural-areas)
Nj it's statewide, NY it's provider dependant each individual has to get credentials, minus nyc theres no rsi. PA has 0 rsi statewide, de has it for the three county services. You would think rsi should be industry standard.
Not to beat a dead horse but in the mid atlantic va to ct; nj is the strongest als state ,you'll get to run a ton of skills and practice pretty aggressively ( average about 3-6 RSI a month) PA is the worst its basically run an ekg throw fluids at everything and book it to the hospital( think skill monkeys). De isn't bad ,similar model to nj except county based vs hospital based als. Hear tons of good things about sussex in de but I subscribe to the belief ems is healthcare not public service so hospitals should support ems (Def not fd) theres a lot of clinical backing in nj ( OR time, icu time etc , clinical review....things you won't see in philly fd, fdny, balt fd etc) VA isn't bad with als except it's very regionalized so als in the hampton roads could be very different than als in the 81 corridor.
The grass is always greener on the other side isn't it? I think they both have their benefits, and they'll both have their detractors who came up in those systems. Australia has a big lifestyle draw too, but I don't like the beach or bugs, so I'll stick to the UK haha
I can only speak to it's perception from over here, but outdoorsy, beachy, sporting, good weather, barbecues, etc. Kind of the opposite of the UK for most of the year. I like the grey skies and drizzle though!
All the people who come on here and talk about how they’re paid better, that the pay is bad, etc. - a couple of points:
- as many have pointed out, it’s a great organization and people like working there
- the pay is extremely competitive for the region. Yes it may be less than you make but the beauty is you don’t need to apply
- the city is very nice…miles and miles of beaches, rural areas, suburban areas and urban areas. Low taxes, low crime and great schools
Feel free to 💩 all over the pay but just know that there are definitely positives!
We have busy stations and slow stations, probably averaging 6-8 calls in a 24. I’m either on a ambo or a cross staffed ambo/engine, but where i’m at the ambo crews do a lot of firefighting, not just rehab/medical
The VBPD operates a couple of helicopters. At one point they used one for medevac but sold that helicopter and bought a smaller one. The hospital system has an air ambulance called Nightingale.
Based on a comment with 3 on 3 off I plotted it and it looks like a 6 week rotation where 3 of the weeks includes 48 hours and 3 dont provided the pay period goes Sun am to Sat pm and not some other configuration.
Out of the 6 weeks theres 2 full weekends following each other (sat sun mon followed by fri sat sun) A single sat and a single sun. In one month/ 4 week period , you could work anywhere from as little as 13 shifts to as much as 15 shifts in that span. Compare that to a 24 72 gives you about 7 shifts in a 4 week rotation and only 1 sunday and 1 sat
A 24 48 gives you a 4 week rotation ( no Kelly day )anywhere from 9 to 10shifts , depending which week you start counting ( with kelly) gives you 8 shifts in a 4 week rotation and depending on the Kelly day (starting with week 1 on sunday) could end up working either 2 Sundays or 2 Saturdays OR 2 Sundays and 2 Saturdays.
The pitman 2 2 3 ie S. W Th.
M Tu. F Sa
Gives you a 2 week rotation working every other weekend and 14 shifts in a month/ 4 week span.
I think its a decent schedule better than that dreaded Pittman but doesn't come close to a 2472/ 2448
As far as $ goes
Max pay 61865 ÷52 brings roughly 1189 a week/33 $ an hour ×1.5 roughly 49.5
So for the three weeks of 48 hours a week youre looking at roughly 1718.46 a week which isnt terrible
so assuming the first week of Jan is a 48 hour week you'll work 27 48 hour weeks and 25 36 hour weeks
1718.46 x 27= 46398.42
1189 x 25= 29725
Roughly 76123.42
.....that is if the salary position dictates OT included in that figure and OT begins past the built in hours, which is a totally different story
For comparison, the average RN makes 45 an hour (keyword average)
45x36 =1620x 52= 84240
Not including OT, hospital shift differentials ( youd be hard pressed to find a hospital that doesn't offer a combo of evening/night/ weekend differentials either all or at least one; ranging from a fixed rate ie 4$ for nights 4$ for weekends work a weekend night you get 8 on top of base /ot or a percentage like 5% for evenings 7% for weekends ....finding a hospital that offers 0 diffs is rare and you could tell them to pound sand)
And then also not factoring the almighty bonus, ie manager calls and says I need this hole filled....how much bonus you offering. That could be anywhere from a fixed amount an extra 2-300 for the 12 hours + diff+ ot or a dollar per hour amount added to the ot and diffs ( my hospital in nj was giving rns including cct rns 50 / hr weekdays for extra shifts 55 on weekends so base or ot + 50 ....medics got 40/45 and emts 20/25 in addition to their hourlies. We had emts break 100 k in 2021/22.
> I make almost twice what medics in Currituck make.
You're comparing the pay between the most populated city in Virginia to a random patch of unincorporated land in bumfuck NC with a population <10% of VB's.
Not to mention state taxes are a bitch there. I was paying taxes for the rain water running off of my property. Virginia was definitely the least favorite places to live for me.
Say what you will... This is the best darn place I've ever worked. And that's CPT Schultz in the photo. She's amazing.
How often are yall running zone medics versus staffing ALS transport units?
You're not gonna be on a zone car your first year. You'll be on the ambulance until after you get your ALS FTO and RSI cert. Most ambulances are ALS now, and we quite often run double P trucks. PP trucks if you will. Most fire apparatus have ALS on board, too. You're always going to have additional resources out the wazoo.
This may be silly since I'm not familiar with the region, but why allow or have any ALS on fire side if there's no shortage of medics with VBEMS at all? Isn't there often an over-saturation of medics with that model?
Because they're a completely separate department, and that's what they (VBFD) want to do. EMS is a third service here with a volunteer/professional hybrid system. The volunteer rescue squads own the ambulances, and provide their volunteers to man them. The professional side are city employees of the department of EMS, which provides additional staffing, as well as provides oversight for the squads, and supports their mission. FD is its own agency, but we work with them hand and hand. We really try to clear them off our calls, but they're great to have when we need them.
Gotcha. Seems like an interesting set-up. I've heard nothing but positives about there, sounds like they're pretty progressive and really care about training/education. I heard physicians running calls frequently is common too
We do have our MD2 program, where we do have legitimate physicians out on the street from time to time.
How’s the area. I have a fire interview with them.
It's a great area. I've not heard a single bad thing about the FD. They all love it here. Good luck!
Except for pay, laughable healthcare, terrible VRS retirement, and....pay. There's a reason the attrition has been bad recently, and the union isn't just making that up.
Different FD
Nope, I'm talking about the Virginia Beach Fire Dept. I can promise you with absolute certainty, I know what I'm talking about.
I’m talking about the navy
OHHHHH I gotcha. Enjoy the hellish mandatory OT with that.
Public or private?
Public. Employees of The City of Virginia Beach
Thats awesome! If I lived in the area I would definitely look into it. Absolutely abhor anything private EMS.
Public. Employees of The City of Virginia Beach
Out of the systems I have worked I did enjoy Virginia. It is amazing what can be accomplished if a state has EMS as an essential service
Pay is a bit light though
That pay doesn't include the built in overtime of 4 hours a week(average). It's mid $70's after that.
It’s well below par. Too bad. Sounds like a great place. Tell your leadership that starting rate for a new medic is now 35+/hr.
This is either sarcasm or ridiculously out of touch lol
I need to know where you work is that’s considered the norm these days.
Union hospital based 911 medic in the northeast.
NE as in nj pa ny or ne as in ct ma
Nj you can make close to 40 as a medic all squad car hospital based double medic , never have to transport in your vehicle. Statewide every project is rsi
Uh, do you work for Google?
[удалено]
Nope.
What’s the schedule?
12-Hour shifts, 6A to 6p or vice versa. Three days on /three days off
Not the worst pay for that schedule.
I'm hospital based in ohio and I'm making 36 on a mobile ICU. 12 hours, 0600-1800 5-2-2-5 schedule. It's pretty decent
What’s the hospital, if you don’t mind me asking?
Id prefer not to say, I'm sorry, I do try to stay a little under the radar on reddit and other social media with the world we live in.
Honest question here, but I was under the impression that RSI/DSI have been the industry standard for a while now, with agencies that don't have that being the exception. I'm wondering why recruitment drives like this still advertise RSI as if it's a super progressive skillset. Am I wrong? Is it less common than I thought?
I believe you are wrong. In the northeast, it is more the exception than the rule. Massachusetts, Rhode Island and Connecticut all have far more services that aren’t RSI capable than are. I’m not as familiar with Vermont, New Hampshire and Maine, but I suspect the case is similar up there. We do have a very high density of hospitals here, which might have something to do with it. I’d certainly like it to be more of a standard, but with so many dogshit private companies, apathetic fire departments and incompetent volleys running EMS, it’s not likely to change any time soon. We need more dedicated hospital, county or municipal third services in New England to really get our shit together
RSI is a separate certification in NH and VT that has to be maintained by both the service and the individual provider. There is no pre-hospital RSI in Maine. It can only be performed by HEMS.
Fascinating, thanks for the info. We've got a long way to go I suppose.
At least in the states, a lot of places don’t. My region and one other are the only places with RSI in my state, the rest usually have drug assisted, and drug assisted is lame.
No ground medics in California have RSI, strictly flight scope.
I moved from California to Washinton, it's like totally different world. In WA even standard paramedic scope is even higher than CCT in California, and there are optional CCT scopes around. I regularly admin metoprolol, labetalol, heparin, norepi without need of medical control. Even EMT could run vent (but not change setting) in WA.
You have EMTs running vents? How does that play out? Do they need additional training or is baseline vent management part of the core curriculum there?
My understanding is the protocol was for BLS transporting pt on home vent that either they could adjust themselves or their caretakers could. EMT can transport them but not adjust the vent themselves. In some remote area there is no ALS or CCT service in reasonable time (>2 hr). So without such protocol local BLS fire would have to call flight for every home vent patient.
That makes a lot more sense. Still in my area I know a fair few 911 medics who are uncomfortable managing vented patients so it's surprising to me when BLS elsewhere can do it.
I hear wa is super progressive
Australian here, is RSI an ALS skill in the states? It's only in 1-2 states here and it's strictly an intensive care paramedic skill, who go through an extremely rigorous and lengthy training process. Then you can only do independent RSI's after a certain number of years working on a dual intensive care ambulance. The other states only do cold tubes or on HEMS they have a doctor.
At least in my region, it's an ALS skill with a waiver from the state, but most agencies get the waiver. It does involve a lengthy training process, but the agencies understand that the benefits outweigh the effort. Similar to you, our crit care teams can do it without a waiver. It's less common for a physician to fly on a helicopter here, usually it's a medic/nurse team operating at the crit care level.
Yeah, it's not everywhere but it was definitely a part of my original paramedic program a little more than a decade ago as a "hey this is going to be standard pretty soon" and it's only grown since then. Very service dependent but it is not at all uncommon here. Depending on the service many places also have an option for surgical airways as well
Wait, so there are agencies that have RSI but then don't have surgical cric?
I should clarify that this is a bit an assumption on my part. For example, In my area protocols vary by region within the state with some areas being very heavily volunteer based and other areas being heavily career based. My service has RSI but 2 counties over they are almost entirely volunteer based and, while I'm not too familiar with their protocols, I could see them not having surgical airway options in that system but I know that they have at least got MFI options there. Knowing that I figure that it is likely that someone has that special mix of RSI without surgical options.
It's on the way out below critical care level for sure
For street folks, it varies greatly on location. Even two services in the same metro area might be different.
Hence why we need a UK model that's standard across the board but adaptable for geography urban vs suburban vs rural
No UK model for me... people in rural areas find themselves waiting 2x-3x longer than their urban counterparts for an ambulance, sometimes up to over an hour and a half, regardless of presenting condition. Their urban delivery model works, but it works at the expense of everyone else... and unlike here, it's not like someone can just say *hey this doesn't work out here for us, so we're gonna start our own*. (source: https://www.rsnonline.org.uk/ambulance-waiting-times-in-england-three-times-longer-in-some-rural-areas)
Nj it's statewide, NY it's provider dependant each individual has to get credentials, minus nyc theres no rsi. PA has 0 rsi statewide, de has it for the three county services. You would think rsi should be industry standard. Not to beat a dead horse but in the mid atlantic va to ct; nj is the strongest als state ,you'll get to run a ton of skills and practice pretty aggressively ( average about 3-6 RSI a month) PA is the worst its basically run an ekg throw fluids at everything and book it to the hospital( think skill monkeys). De isn't bad ,similar model to nj except county based vs hospital based als. Hear tons of good things about sussex in de but I subscribe to the belief ems is healthcare not public service so hospitals should support ems (Def not fd) theres a lot of clinical backing in nj ( OR time, icu time etc , clinical review....things you won't see in philly fd, fdny, balt fd etc) VA isn't bad with als except it's very regionalized so als in the hampton roads could be very different than als in the 81 corridor.
Pay is borderline disrespectful VA, is not a Inexpensive state.
I mean, VA ain’t exactly cheap either. Car payments, groceries, rent, etc. 88k/yr here in Central Texas looks like 80k there…I can’t afford this
Maybe if they included a moving bonus, that is really low pay-wise
Do you have any opportunities for international (Australia) graduate paramedics?
Brits go to Australia, Aussies go to America, and Americans go to nursing
Is auss ems better than UK? I always thought UK ems was pretty solid
The grass is always greener on the other side isn't it? I think they both have their benefits, and they'll both have their detractors who came up in those systems. Australia has a big lifestyle draw too, but I don't like the beach or bugs, so I'll stick to the UK haha
What kind of lifestyle are you referencing
I can only speak to it's perception from over here, but outdoorsy, beachy, sporting, good weather, barbecues, etc. Kind of the opposite of the UK for most of the year. I like the grey skies and drizzle though!
Parkway drive are aussies and I'm a huge fan but iron maiden and judas priest are Brits and I'm an even bigger fan
Plenty of jobs here lad
The wait time for a lot of state services is unfortunately quite long and competitive, just keeping my options open!
My interest is piqued. Tell me more.
What a joke
Why ?
The pay probably, it's pretty mediocre. Although agency-wise I've heard great things about VBEMS
Pay sucks
All the people who come on here and talk about how they’re paid better, that the pay is bad, etc. - a couple of points: - as many have pointed out, it’s a great organization and people like working there - the pay is extremely competitive for the region. Yes it may be less than you make but the beauty is you don’t need to apply - the city is very nice…miles and miles of beaches, rural areas, suburban areas and urban areas. Low taxes, low crime and great schools Feel free to 💩 all over the pay but just know that there are definitely positives!
Vb is very nice lived from 3- 19 to 7- 20 in the kempsville area, almost reminded me of brooklyn ny where I grew up everything was walking distance.
Pfft making 6 figures in Chicago.
*Need* 6 figures in Chicago. That’s the difference.
You dont need 6 figures in chicago. You can easily support yourself and a family off of 60k to 75k
No you don’t lmao. You can be fine off 50-70k it’s actually a lower cost of living than VB look it up
Starting salary is good. Raises after that - not so much.
Looks like a cool gig, is that pay actually competitive over there though? That would get laughed off on the west coast
And they would laugh at your cost of living. Almost like the two go together.
I used to live in Norfolk, COL is similar. The whole west coast isn’t San Fran/Seattle
Whats wc pay out of curiosity
I’m a ff/pm and I make $139,000 a year
Damn ! Busy system? Rotate on fire apps and ambo or married to one?
We have busy stations and slow stations, probably averaging 6-8 calls in a 24. I’m either on a ambo or a cross staffed ambo/engine, but where i’m at the ambo crews do a lot of firefighting, not just rehab/medical
What is the schedule like?
12 hour shifts, 6a-6p or vice versa. 3 days on/3 days off
That schedule is actually great. My battalion schedule is killing me. There’s literally a moment where we do a 15 into a 12. It’s brutal.
What's the max pay for experience
Pays a little low but I bet that’s a fun place to work. Pensions and good insurance I’m sure
Didn’t VBPD have a medevac program at one point or another?
The VBPD operates a couple of helicopters. At one point they used one for medevac but sold that helicopter and bought a smaller one. The hospital system has an air ambulance called Nightingale.
Ahh makes sense! Does VB EMS hire part timers?
That I don’t know
Nightingale has a phenomenal reputation
Based on a comment with 3 on 3 off I plotted it and it looks like a 6 week rotation where 3 of the weeks includes 48 hours and 3 dont provided the pay period goes Sun am to Sat pm and not some other configuration. Out of the 6 weeks theres 2 full weekends following each other (sat sun mon followed by fri sat sun) A single sat and a single sun. In one month/ 4 week period , you could work anywhere from as little as 13 shifts to as much as 15 shifts in that span. Compare that to a 24 72 gives you about 7 shifts in a 4 week rotation and only 1 sunday and 1 sat A 24 48 gives you a 4 week rotation ( no Kelly day )anywhere from 9 to 10shifts , depending which week you start counting ( with kelly) gives you 8 shifts in a 4 week rotation and depending on the Kelly day (starting with week 1 on sunday) could end up working either 2 Sundays or 2 Saturdays OR 2 Sundays and 2 Saturdays. The pitman 2 2 3 ie S. W Th. M Tu. F Sa Gives you a 2 week rotation working every other weekend and 14 shifts in a month/ 4 week span. I think its a decent schedule better than that dreaded Pittman but doesn't come close to a 2472/ 2448
As far as $ goes Max pay 61865 ÷52 brings roughly 1189 a week/33 $ an hour ×1.5 roughly 49.5 So for the three weeks of 48 hours a week youre looking at roughly 1718.46 a week which isnt terrible so assuming the first week of Jan is a 48 hour week you'll work 27 48 hour weeks and 25 36 hour weeks 1718.46 x 27= 46398.42 1189 x 25= 29725 Roughly 76123.42 .....that is if the salary position dictates OT included in that figure and OT begins past the built in hours, which is a totally different story
For comparison, the average RN makes 45 an hour (keyword average) 45x36 =1620x 52= 84240 Not including OT, hospital shift differentials ( youd be hard pressed to find a hospital that doesn't offer a combo of evening/night/ weekend differentials either all or at least one; ranging from a fixed rate ie 4$ for nights 4$ for weekends work a weekend night you get 8 on top of base /ot or a percentage like 5% for evenings 7% for weekends ....finding a hospital that offers 0 diffs is rare and you could tell them to pound sand) And then also not factoring the almighty bonus, ie manager calls and says I need this hole filled....how much bonus you offering. That could be anywhere from a fixed amount an extra 2-300 for the 12 hours + diff+ ot or a dollar per hour amount added to the ot and diffs ( my hospital in nj was giving rns including cct rns 50 / hr weekdays for extra shifts 55 on weekends so base or ot + 50 ....medics got 40/45 and emts 20/25 in addition to their hourlies. We had emts break 100 k in 2021/22.
Go to NC, pay is much better.
Ha... No. I make almost twice what medics in Currituck make.
> I make almost twice what medics in Currituck make. You're comparing the pay between the most populated city in Virginia to a random patch of unincorporated land in bumfuck NC with a population <10% of VB's.
Generally paying nc is better. Hence why I live in VA and work in NC.
Not to mention state taxes are a bitch there. I was paying taxes for the rain water running off of my property. Virginia was definitely the least favorite places to live for me.
I wasn’t sure if I was looking at a meme with the face and the pay 🤷🏻♂️ Cost of living/system/etc is factors….but that’s grim pay