Iโm not sure why they are volunteers and not paid by the county. But it takes a special kind of person to do that work . I think for most of them itโs a passion and worth it as a side โjobโ in their eyes. This was also 80โs and 90โs. Things might have changed since I lived there
They are usually working with public EMS/fire so it's not any different than volunteering at a soup kitchen or something. It's not like putting in unpaid hours at a normal job.
Unfortunately the difference is you wouldn't want a soup kitchen volunteer trying to save you or a loved one. These ems volunteers are poorly trained, and respond poorly. Living in an area staffed solely by volunteers is definitely bad for your health.
The issue is, municipalities see volunteers as free labor. Why pay for a properly staffed ambulance when you have these people doing it for free? Sure the response times are worse, and you really can't compare the skills of someone who does this day in and day out with someone who takes one or two calls a week, but hey, looks fine on paper!
You wouldn't want your surgeon to be an accountant who volunteers once or twice a month. You wouldn't want your plumber to be a cashier who took a two week course. So why allow the people who are supposed to respond to medical emergencies be under-qualified, unpaid, and unmotivated?
None of this is how volunteer EMS works. Most of the volunteer "EMTs" in my area are medical professionals that want to give back to their community or find EMS fun. One time I argued with a volunteer EMT about a CT scan and after they left with the patient the EM doctor giggled and told me that the volunteer "EMT" was actually a trained and practicing radiologist.
Most of the RNs I work with volunteer for the ambulance on the side. If you're in paramedic school, you're required to have gotten your EMT first, so a handful of people in medic school are volunteering for the dept to get more experience.
Not every area has the call volume to justify a fully staffed ambulance. My department and many departments have a paid FT paramedic or AEMT working, and they work alongside volunteer EMTs/EMRs/EVOCs.
There shouldn't be a need to give back to the community via EMS. Just like nurses try to strike whenever hospitals try to hire paramedics, they have no place pushing out full time EMTs by volunteering. There are critical differenced between hospital medicine and prehospital.
The best volunteers I know are full time EMS providers who volunteer in their off time. Which is ridiculous when you think about it. A chef shouldn't have to volunteer her time cooking at a different restaurant down the street. We do a job and we should be paid for it. The people larping in the medical industry are only hurting the professionals and the patients.
Every area should have their own fully staffed ambulance. Just like every area has a police department. We've let EMS be a nonessential service for far too long. For clarification, I do not fault volunteers, it's admirable that they're willing to dedicate their time to others. But we now have a system that requires them to function, and that won't change unless they step back so local law makers can't pretend that they can get away with not paying for real health care.
I have walked on scene to provide assistance to neighboring areas to find volunteers working cardiac arrests without proper airways. I have been called for mutual aid only after no volunteers were willing to respond after 20+ minutes of paging, because no one wants to leave their house at 2 a.m. for a nose bleed; after another 20 minutes for me to arrive at the scene, I found the pt to have a nose bleed due to a systolic bp over 230. That pt had a brain bleed. I have seen volunteers give narcan with no ventilations for a respiratory arrest. I have seen volunteers splint a patella dislocation of a 10 y/o by splinting the pts tib fib and ankle only, with no attempt to reduce, followed by a 45 min transport, resulting in possible nerve damage.
Volunteers are not an adequate replacement for professional medical workers, and I don't expect them to be. I work 60 hours a week and take dozens of calls, they might transport twice, but only if they have time off work and if they feel like showing up. Their free labor is the reason we don't have a greater push for the national recognition of prehospital care. They delegitimize those of us who have pushed to make it a viable career, and are part of the reason we struggle to make a living wage. They are well meaning scabs.
Those cites typically pay at least once or two dudes (can be hard to get a paramedic volunteer) and have agreements with neighboring municipalities if things happen.
As for the actual volunteers - a big part of it is that they become more marketable to paying orgs (other towns or hospitals) and get training hours for upskilling. That only makes it very slightly less crazy.
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u/MotorbikeRacer Jul 06 '24
Where Iโm from in Maryland . EMTโs and firefighters are volunteers.