One of the biggest changes in EMS over the past several years has been the increased involvement of the fire service. Despite a somewhat famous, but date, TV series that some people adulate, most fire departments were not interested in EMS until the late 1908s or early 1990s.
The reason for that sudden change was the dramatic decrease in large building fires from the mid 1940s on. Better construction, fire alarm systems, sprinklers, and other advances meant that there were fewer fires, they spread more slowly, and were extinguished more quickly.
At the same time, the demand for EMS services was increasing for a number of reasons.
Somewhere along the line, the leaders of the fire service decided that taking over ambulance services was a good way to keep fire service jobs. Notice that I didn’t say that it was a good way to improve services, but it was a way to keep jobs.
As a result a number of large fire departments jumped into EMS. In most of the large cities where this happened, nothing improved. Arguably EMS suffered, but that’s actually a story for another time.
At the same time, and for what appear to be much different reasons, a number of smaller fire agencies got into EMS. The reason they did it was because there were no alternatives. In smaller cities and towns, budgets are tighter and departments have to do more.
When I worked in Sorta Big City, the fire department staffed each piece of apparatus with fire firefighters. Which mean that we often had four firefighters on our calls with us. Sometimes we needed them, mostly we didn’t, but it was still nice to have them (usually).
The smaller departments that I work with now or have worked with in the past don’t have that luxury. Luxury being a relative term because at a fire you really want as many people as possible.
In these towns, some quite affluent, the norm is for a fire engine to roll out the door with two firefighters on it. Then two more will respond in an ambulance. Then one will respond with a ladder truck. The shift commander will respond in his car.
If it turns out to be a fire, then staff is called in from home and other towns respond for mutual aid.
Note that the two EMS providers are also EMTs or paramedics, depending on the agency. Or maybe one of each.
A former big city fire chief used to say that modern fire departments are EMS agencies that occasionally put out fires. While that might not be true in big cities, it’s definitely true in smaller towns.
Stay with me folks, I’ll get to my point (I do have one) shortly.
What the smaller towns do almost unanimously is hire EMS providers who they then turn into firefighters. Fully qualified firefighters, to be clear. Fire departments have found that it’s easier (and less expensive) to hire a EMT or paramedic then send him through the fire academy. Around here the fire academy can be from 9-12 weeks. That’s full time and I have no idea why they keep changing the length of the program, in case you’re wonders.
Which brings me to my point. There are some number of people who become EMS providers at either level with the express goal of becoming firefighters. Which is smart because agencies are always looking for new fire fighters. People retire, get promoted, sometimes sadly die, or decide to go on to other careers. There is always some personnel churn in fire departments big and small.
If I were younger, I’d certainly look at this career path even though when I actually was younger I turned down a fire department job. I’ll spare you the story.
There some number of people who go into EMS because they want to provide medical care to people. That field has an even higher rate of attrition, again for a variety of reasons. One of those reasons is the generally low pay, lousy benefits, and poor work conditions. They love being paramedics, but hate working for low paying services doing mostly routine transfers.
The fire service generally offers better pay, good to great benefits, a pension, a union, and depending on the type of schedule they use, a lot of time off. Oh, and lots of education and training. In the departments with which i work, there isn’t a lot of sitting around. There is some, but they do a lot of training.
There is a lot to be said for working at a small town fire department. Or a bigger town fire department that provides EMS for that matter.
All which makes the following more and more baffling.
No department that I am familiar with can recruit enough paramedics. One agency had a recent opening and sent out a 100 cards to people who had passed the civil service exam. They specified that candidate must be paramedics, so that meant 100 people who had paramedic certification received cards.
They got one reply.
Which means that ninety-nine people didn’t want to go through the hiring process for a job that had better pay, better benefits, better working conditions, a pension, and stability.
What? The? F*ck?
That’s an example from one department. The others have the same issue. One just hired a guy that is still in paramedic school. Which means that he’ll come to the department with zero paramedic experience. Then, he’ll go to the fire academy and be a firefighter with zero experience. Not ideal, but he’s the guy that applied and was hired.
One paramedic/firefighter I talked with told me that a lot of people just don’t want to become firefighters. The truth is that for the most part, there is not a lot of fire fighting going on in many departments. There IS a lot of EMS going on, though.
Weird, just weird.
So, my advice here is for young people who want to become firefighters, become paramedics first. Just make sure that you become good paramedics first, because that is going to be 80% of your job.