Reality is very different than the musings of a young man bent on saving the world. Reality is harsh and blunt and often a splash of cold water in the face of those who intended to make a difference.
Reality is Private EMS.
Out of ever 100 people who go to EMT school only 75% will complete it and pass. Out of those 75 people only about 5 will end up on municipal departments, 40 will end up working in a volunteer setting only and the 30 remaining people will find themselves braving the wilds of Private EMS. The above statistics are mine and mine alone. I don't really care if you don't agree or have a differing opinion. This is what I've observed in the last 18 years and as such I consider it fact. Your facts my vary, so be it.
Bigger isn't always better. You have the big ones like Rural Metro, AMR and Acadian then you have several THOUSAND smaller outfits. Some are mom and pop squads and some are bigger players on the local or even State level. They all deserve your attention and your scrutiny.
There are a few things you need to consider before jumping feet first into the acid pool that we know as private EMS. I wouldn't be doing my readers any favors if I didn't try to educate you in even the smallest fashion before you made this huge decision. Lets explore a few of these things:
- Is the service for profit or non-profit? Seems pretty straight forward but there are huge advantages and disadvantages to both. Your personal politics may play a big role in deciding who to work for. Remember if you have picked EMS as a career you have already put yourself behind the 8-ball by not finding a municipal job but you can still become very successful working in private EMS. You just need to make your decision based on your personal preference. I wont tell you which I work for, it would only skew your decision making process and you really have to do this one yourself.
- Is there room for growth in both the company and yourself? Another no-brainer for those of us who have been here for decades but a tough one for that 21 year old EMT that has trouble making ends meet. Don't just jump at the first job that comes your way, remember at this time in the history of private EMS it's an employee market. Meaning more and more managers are competing for fewer and fewer "Good" EMTs.
- Is the company financially sound? Do a little digging through the interwebs here. Remember, if they can't pay their bills how will they pay you? All BIG companies go through restructuring at some point or the other so be wary of "Old" information. How is the company doing now?
- What is the public perception of the service? Nothing will grind you into the dust faster than going to work for a company that has a piss-poor reputation. You won't save it, you won't make it better, you wont rise above it. Unless the philosophy changes from the inside out it will only drag you down, kick the shit out of you and leave you feeling used. The bright side of this is that when you walk into my office broken and beaten by crappy XYZ ambulance service you would have seen the worst and you'll appreciate what I have to offer you.
- Pay and benefits? This one catches new EMTs all the time. XYZ ambulance service is paying 2 dollars more per hour than ABC ambulance service and they have offered me a job!! Hell ya, I'm going to be making bank! WRONG young EMTling, master tells you to examine the facts. The is a finite amount of money being received from all ambulance runs. Every service charges pretty much the same to remain competitive and the Fed and State sure as hell don't pay a lot on the Medicare / Medicaid calls. XYZ is robbing from Paul to pay Peter most of the time. You can be Peter or Paul but I assure you, you'll be one of them. You want to find a nice median rate with an insurance premium you can live with. Uniforms should be provided (not payroll deducted) and you shouldn't have to pay for any pre-employemnt "testing".
Enough of that for now. When you have considered those 5 things it will be time for you to start filling out applications. This is where the fun begins!
If your handwriting sucks your application goes immediately into my circular file, better known as the trash can. After all if you can't neatly fill out an application how in the hell will you neatly fill our a PCR in the back of a moving ambulance? You'd be surprised how many people are denied jobs at good services because they lack common sense.
If you are asked to take a personality or Turing test understand that it is important. Give all the questions some thought and realize that some of the top minds in the nation KNOW you will try to tell the employer what they want to hear. They expect it, here is where it gets tricky; if you answer all of those questions COMPLETELY honestly you'll probably get a low score. Seeing as everyone from the beginning of time has lied on those or "fluffed" their answers the curve is horribly off. "Have you ever stolen company property?" You answer NO, even though you glance at your pocket and notice 3 pens and a stapler you swiped from your last job. If you answer YES to this you're pretty much out of the running. It's bullshit, I know it, but this is how it has to be. Trust me on this one young EMTling, I've taken and failed more of those tests than I can count simply by answering honestly.
Piss test. Yep, it will happen. Nope we're not dum-dums. You can't fake it, you can't skew the results. I'll just make you re-take it. There is no "cure all" on the market that will take it out of your system, no matter what Tommy Chong says. I've seen it all, heard it all and ya, done it all. You can't fool me. Get clean, then come take your test. Although I don't think what you do on your off-time is any of my business, someone does and unless you have a medical pot card don't even bother wasting your time taking the test. Probably better you don't even fill out an application until you are clean because it's going to look awful strange when you postpone your interview and whizz quizz for 30 days after you're called in.
Training. Suck it up butter-cup. Do as much training as the company will offer you. This is free money and in private EMS it don't come around often. During this time someone will either be showing you how to do the work or they will observe you do the work. That safety net is awful nice for your first few weeks. No matter how well you did in school, no matter how much of a god-damn genius you are when it comes to patient care you still got to remember that I haven't met a patient yet who has read the book and dies as prescribed. Go into your training like a fresh chalk board (I'm dating myself) ready to gather and store as much information as you can. Show respect to those who have walked before you and for the love of god keep your mouth closed unless you have something relevant to say.
Be on time, every time. I've seen many a competent EMT lose their job because they were chronologically challenged. No one cares about you except your mother. No one cares you don't have child care. No one cares your vehicle broke down. No one cares your alarm didn't go off. No one cares about anything except you showing up on time, every time.
Dress the part. You're expected to be a medical professional, dress like it. Learn to use an iron, never forget an undershirt. Polish your boots, comb your hair. Easiest way to make sure you look the part is do a little research on military dress, learn it, do it. You should have a stethoscope, penlight, trauma sheers and a notepad with pen and a multi-tool never hurts either. Without these things you just look under-prepared. The opposite also hold true though. If you walk in looking like inspector gadget with every bit of crap under the sun attached to your belt you will likely be scoffed at and asked to lighten your load a little. We joke saying that the newness of an EMTling is directly proportionate to the amount of shit that hangs from them.
Well my lunch break is over; 9 interviews, 3 reports and a termination to go before my day is over. I wish you the best of luck and I hope to see you become a successful EMT. EMS is a very small community, we will meet at some point. I'll be expecting you to be prepared.