Long hours, low pay: So what do we do?
As field providers, we have to grow up and escape the chains of the past
Editor's note: Ambulance crews in N.M. have been assigned 72-hour shifts. Art Hsieh argues that such working conditions, along with pay, training and other issues, can't improve until EMS can show its effectiveness as an industry.
"Wanted: EMS providers to work for an ambulance service. Must be able to stay awake for long periods of time yet still function at peak efficiency. Must be able to work for low wages. No experience necessary. Rapid seniority is possible."
I'm sure this is not how the service advertises for new staff. But unfortunately, reality usually overshadows good intentions. I suspect the issues that plague this service are chronic and not unusual. The inability to recruit and retain EMS staff has been an issue for as long as I've been in the industry, and it's merely symptomatic of the big issues that we haven't been able to solve.
Why is the pay so low? I'm sure you have some ideas; here are mine:
- Low reimbursement rates by government and private health insurance (since we can't demonstrate our effectiveness as a whole)
- Large regions of the country where people do it for free (I'm not slamming volunteers, but it's hard to justify reality-based wages when people pay for the privilege of providing EMS)
- Lack of recognition of the training and preparation EMS providers need to perform the job
- Self-enforcing perception of the stepping-stone nature of the industry
- Inconsistent spheres of influence at state and national levels
What is happening in N.M. and elsewhere across this great country won't change until these issues are resolved. As field providers, we have to grow up and escape the chains of the past.
We're not simply emergency care providers, and we never have been. Our jobs are multi-faceted, and to do all of the tasks well requires significant training and experience, neither of which we typically have.
Experience won't come until working conditions allows for job stability, family and health.
Working conditions won't improve until reimbursement does.
Reimbursement won't rise until we can demonstrate our effectiveness as an industry beyond cab rides.
And so on.
Challenging? Yes. Insurmountable? No.
As I've said before, this is an all-hands situation. Everyone needs to be on board for this. Other countries have worked to make this happen, and we can too.
It will eventually trickle back to the service in N.M., which will be able to retain quality staff and serve its community well.