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We have reached the point of total and dangerous exhaustion working in EMS.

Over 25 years as a medic, manager, and educator I have applied methodologies to

try to mitigate it, with very little or no support. EMS fatigue is something

that few really want to acknowledge or recon with, especially rural EMS.

In contrast, an RN gets saddled with an extra patient for a shift, and it's all

over the news and documenteries. The vast majority of EMS

systems have absolutely no safe harbor provisions or parameters for crews to

state they are just too exhausted to function. Overwhelmingly, if a crew goes

out of service for fatigue and exhaustion, they will be put permenently out of

service. How many EMS providers have been investigated by DSHS or taken to task

f or not having safe harbor provisions for fatigue and exhaustion, which has

resulted in MVC or medical error? Instead, the individual crew usually

castigated as weak or incompetent. Most crews fear repercussions of coming

forward with problems associated with fatigue and exhaustion. Most managers

tell crews directly or indirectly they really don't care about fatigue and

exhaustion situations.

What does your service do to mitigate fatigue and exhaustion? Is it exportable

to services of all funding and budget concerns? What is GETAC doing about this

age old problem, do they have a position paper? Do you feel it's time to go

forward to the public-at-large and tell Jonny and Susie Punchclock that a

portion medical care is being compromised while industry and government really

don't care?

aloha,

-hudso

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This is a very good point to bring up. I have not (in my years in this

business) ever heard of any such thing. I must say though, not only does this

fatigue issue involve medical errors and MVC's or any other list of incidents

that may occur at the hands of a tired medic, but I can see that it would lead

to medic burn out as well. Which would explain some services high turn over

rate. A tired, over worked and underpaid medic can be a dangerous medic. (this

said in IMHO)

A.Dempsey EMT-I/FF

kdempseyjr@...

---------------------------------

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when.

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Mike,

You bring up very good points.

I am famous, or infamous, on here for bashing management, particularly

management that uses SSM in its system, just for the factors that you mention.

I think that management that allows and requires its employees to work beyond

exhaustion faces liability for its actions in a number of ways.

1. Crew is exhausted and driver goes to sleep while driving. People are

injured or killed.

2. Patient care goes bad because the medics are not on top of their game

because of fatigue.

And other possible scenarios are available, your choice.

DSHS and GETAC NEED TO TAKE THE LEAD IN LIMITING THE NUMBER OF HOURS AND

CALLS THAT A CREW CAN MAKE in a stated time frame. Perhaps a Libby Zion Law is

needed.

And maybe it's time for every medic to join a strong, mean union.

Years ago when I was in Chicago for a period of time I would ride out with

the CFD EMS. I was amazed by the work rules they had. They were assured of

plenty of time to write patient reports, restock, clean, and relax after a

call. When they had run a certain number of calls, they would be switched to

another station with a lower call volume.

Do you really want a crew to respond to your 0500 STEMI when it's their 20th+

call of the shift?

It's a matter of safety and liability as much as a matter of working

conditions.

Gene G.

>

> We have reached the point of total and dangerous exhaustion working in EMS.

> Over 25 years as a medic, manager, and educator I have applied methodologies

> to try to mitigate it, with very little or no support. EMS fatigue is

> something that few really want to acknowledge or recon with, especially rural

EMS.

>

> In contrast, an RN gets saddled with an extra patient for a shift, and it's

> all over the news and documenteries. The vast majority of EMS

> systems have absolutely no safe harbor provisions or parameters for crews to

> state they are just too exhausted to function. Overwhelmingly, if a crew goes

> out of service for fatigue and exhaustion, they will be put permenently out

> of service. How many EMS providers have been investigated by DSHS or taken to

> task f or not having safe harbor provisions for fatigue and exhaustion, which

> has resulted in MVC or medical error? Instead, the individual crew usually

> castigated as weak or incompetent. Most crews fear repercussions of coming

> forward with problems associated with fatigue and exhaustion. Most managers

tell

> crews directly or indirectly they really don't care about fatigue and

> exhaustion situations.

>

> What does your service do to mitigate fatigue and exhaustion? Is it

> exportable to services of all funding and budget concerns? What is GETAC doing

about

> this age old problem, do they have a position paper? Do you feel it's time to

> go forward to the public-at-large and tell Jonny and Susie Punchclock that a

> portion medical care is being compromised while industry and government

> really don't care?

>

> aloha,

> -hudso

>

>

>

>

**************************************

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I just posted a message in which I referred to the " Libby Zion Law. " For

those of you who don't know, and are Google impaired (<g>) I will offer this

quick summary.

Libby Zion was a patient at a NYC hospital. She had been using cocaine and

was wild and out of control. She was also taking a MAOI drug, Nardil, which

was known to the resident who was taking care of her, and who had been up for

some 36 hours at the time of Zion's arrival at the ER.

She gave Zion meperidine to calm her. Unfortunately, meperidine (Demerol)

and Nardil are a fatal combo. It put her into malignant hypertensive crisis,

and she died.

Her daddy was a prominent lawyer and newspaper columnist. There was a

lawsuit which didn't really go anywhere because the jury found both Zion and the

doc about equally liable, but the NY Legislature enacted a law limiting the

number of hours that a resident physician can work.

That case forms the basis for an expert's opinion that injury to a patient

which can be proved to be caused by fatigue is actionable.

Gene Gandy, JD, LP

>

> This is a very good point to bring up. I have not (in my years in this

> business) ever heard of any such thing. I must say though, not only does this

> fatigue issue involve medical errors and MVC's or any other list of incidents

> that may occur at the hands of a tired medic, but I can see that it would lead

> to medic burn out as well. Which would explain some services high turn over

> rate. A tired, over worked and underpaid medic can be a dangerous medic. (this

> said in IMHO)

>

> A.Dempsey EMT-I/FF

> kdempseyjr@...

>

> ------------ -------- -------- --

> Sick sense of humor? Visit Yahoo! TV's Comedy with an Edge to see what's on,

> when.

>

>

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In a message dated 8/18/2007 3:18:07 A.M. Central Daylight Time,

wegandy1938@... writes:

Years ago when I was in Chicago for a period of time I would ride out with

the CFD EMS. I was amazed by the work rules they had. They were assured

of

plenty of time to write patient reports, restock, clean, and relax after a

call. When they had run a certain number of calls, they would be switched

to

another station with a lower call volume.

A similar system was used in Philadelphia BUT was limited to FIRE only not

EMS, that was over 5 years ago so it may have changed.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author

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I agree with the union idea Gene, but will everyone else agree? This is our

downfall now. We can never agree on anything, even if it is for our own good.

Just my $0.02.

wegandy1938@... wrote:

Mike,

You bring up very good points.

I am famous, or infamous, on here for bashing management, particularly

management that uses SSM in its system, just for the factors that you mention.

I think that management that allows and requires its employees to work beyond

exhaustion faces liability for its actions in a number of ways.

1. Crew is exhausted and driver goes to sleep while driving. People are

injured or killed.

2. Patient care goes bad because the medics are not on top of their game

because of fatigue.

And other possible scenarios are available, your choice.

DSHS and GETAC NEED TO TAKE THE LEAD IN LIMITING THE NUMBER OF HOURS AND

CALLS THAT A CREW CAN MAKE in a stated time frame. Perhaps a Libby Zion Law is

needed.

And maybe it's time for every medic to join a strong, mean union.

Years ago when I was in Chicago for a period of time I would ride out with

the CFD EMS. I was amazed by the work rules they had. They were assured of

plenty of time to write patient reports, restock, clean, and relax after a

call. When they had run a certain number of calls, they would be switched to

another station with a lower call volume.

Do you really want a crew to respond to your 0500 STEMI when it's their 20th+

call of the shift?

It's a matter of safety and liability as much as a matter of working

conditions.

Gene G.

>

> We have reached the point of total and dangerous exhaustion working in EMS.

> Over 25 years as a medic, manager, and educator I have applied methodologies

> to try to mitigate it, with very little or no support. EMS fatigue is

> something that few really want to acknowledge or recon with, especially rural

EMS.

>

> In contrast, an RN gets saddled with an extra patient for a shift, and it's

> all over the news and documenteries. The vast majority of EMS

> systems have absolutely no safe harbor provisions or parameters for crews to

> state they are just too exhausted to function. Overwhelmingly, if a crew goes

> out of service for fatigue and exhaustion, they will be put permenently out

> of service. How many EMS providers have been investigated by DSHS or taken to

> task f or not having safe harbor provisions for fatigue and exhaustion, which

> has resulted in MVC or medical error? Instead, the individual crew usually

> castigated as weak or incompetent. Most crews fear repercussions of coming

> forward with problems associated with fatigue and exhaustion. Most managers

tell

> crews directly or indirectly they really don't care about fatigue and

> exhaustion situations.

>

> What does your service do to mitigate fatigue and exhaustion? Is it

> exportable to services of all funding and budget concerns? What is GETAC doing

about

> this age old problem, do they have a position paper? Do you feel it's time to

> go forward to the public-at-large and tell Jonny and Susie Punchclock that a

> portion medical care is being compromised while industry and government

> really don't care?

>

> aloha,

> -hudso

>

>

>

>

**************************************

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Gene,

You're not bashing ! You tell it like it is!

" Certian types " of services try to compare themselves to 911 services or use

the term " the nature of EMS " while they sit on their " brain " and go home after

an eight hour day, or so.

I'm finally " learning " after 30 years in this business it's time to take a

break and let someone younger do their thing. I'd love to name names, but then

that would be truly bashing-PLUS !

So, I let the HIGHER AUTHORITY manage the situation.

Hope all is well. I'll call you sometime, when you're " bored "

Stay safe !

wegandy1938@... wrote:

Mike,

You bring up very good points.

I am famous, or infamous, on here for bashing management, particularly

management that uses SSM in its system, just for the factors that you mention.

I think that management that allows and requires its employees to work beyond

exhaustion faces liability for its actions in a number of ways.

1. Crew is exhausted and driver goes to sleep while driving. People are

injured or killed.

2. Patient care goes bad because the medics are not on top of their game

because of fatigue.

And other possible scenarios are available, your choice.

DSHS and GETAC NEED TO TAKE THE LEAD IN LIMITING THE NUMBER OF HOURS AND

CALLS THAT A CREW CAN MAKE in a stated time frame. Perhaps a Libby Zion Law is

needed.

And maybe it's time for every medic to join a strong, mean union.

Years ago when I was in Chicago for a period of time I would ride out with

the CFD EMS. I was amazed by the work rules they had. They were assured of

plenty of time to write patient reports, restock, clean, and relax after a

call. When they had run a certain number of calls, they would be switched to

another station with a lower call volume.

Do you really want a crew to respond to your 0500 STEMI when it's their 20th+

call of the shift?

It's a matter of safety and liability as much as a matter of working

conditions.

Gene G.

>

> We have reached the point of total and dangerous exhaustion working in EMS.

> Over 25 years as a medic, manager, and educator I have applied methodologies

> to try to mitigate it, with very little or no support. EMS fatigue is

> something that few really want to acknowledge or recon with, especially rural

EMS.

>

> In contrast, an RN gets saddled with an extra patient for a shift, and it's

> all over the news and documenteries. The vast majority of EMS

> systems have absolutely no safe harbor provisions or parameters for crews to

> state they are just too exhausted to function. Overwhelmingly, if a crew goes

> out of service for fatigue and exhaustion, they will be put permenently out

> of service. How many EMS providers have been investigated by DSHS or taken to

> task f or not having safe harbor provisions for fatigue and exhaustion, which

> has resulted in MVC or medical error? Instead, the individual crew usually

> castigated as weak or incompetent. Most crews fear repercussions of coming

> forward with problems associated with fatigue and exhaustion. Most managers

tell

> crews directly or indirectly they really don't care about fatigue and

> exhaustion situations.

>

> What does your service do to mitigate fatigue and exhaustion? Is it

> exportable to services of all funding and budget concerns? What is GETAC doing

about

> this age old problem, do they have a position paper? Do you feel it's time to

> go forward to the public-at-large and tell Jonny and Susie Punchclock that a

> portion medical care is being compromised while industry and government

> really don't care?

>

> aloha,

> -hudso

>

>

>

>

**************************************

Get a sneak peek of the all-new AOL at

http://discover.aol.com/memed/aolcom30tour

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I had the good fortune to work for a service that would take you at

your word when you said you were too tired. After working for a

service that MADE you stay on shift if your relief didn't show stating

you were abandoning your post, I went to work for a service that would

let you take a break if you expressed the fact you were tired. There

were quit a few times I would be without relief and I would get a call

from one of the owners asking if I would work over or take a long

transfer in the night and if I was tired I would just tell them

without fear of reprisal. There were even a few times when the owner

would show up and relieve me himself. I know that this is very

uncommon in this business, but there are a few out there. Whenever

someone ask me about work, I always refer that service because of the

way they treated me during my employment there.

>

> We have reached the point of total and dangerous exhaustion working

in EMS. Over 25 years as a medic, manager, and educator I have

applied methodologies to try to mitigate it, with very little or no

support. EMS fatigue is something that few really want to

acknowledge or recon with, especially rural EMS.

>

> In contrast, an RN gets saddled with an extra patient for a shift,

and it's all over the news and documenteries. The vast

majority of EMS systems have absolutely no safe harbor provisions or

parameters for crews to state they are just too exhausted to function.

Overwhelmingly, if a crew goes out of service for fatigue and

exhaustion, they will be put permenently out of service. How many EMS

providers have been investigated by DSHS or taken to task f or not

having safe harbor provisions for fatigue and exhaustion, which has

resulted in MVC or medical error? Instead, the individual crew

usually castigated as weak or incompetent. Most crews fear

repercussions of coming forward with problems associated with fatigue

and exhaustion. Most managers tell crews directly or indirectly they

really don't care about fatigue and exhaustion situations.

>

> What does your service do to mitigate fatigue and exhaustion? Is it

exportable to services of all funding and budget concerns? What is

GETAC doing about this age old problem, do they have a position paper?

Do you feel it's time to go forward to the public-at-large and tell

Jonny and Susie Punchclock that a portion medical care is being

compromised while industry and government really don't care?

>

> aloha,

> -hudso

>

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learningmedic wrote: Date: Sat, 18 Aug 2007 13:10:25

-0700 (PDT)

Subject: Re: EMS Fatgue

To: texasems-l

Gene,

You're not bashing ! You tell it like it is!

" Certian types " of services try to compare themselves to 911 services or use

the term " the nature of EMS " while they sit on their " brain " and go home after

an eight hour day, or so.

I'm finally " learning " after 30 years in this business it's time to take a

break and let someone younger do their thing. I'd love to name names, but then

that would be truly bashing-PLUS !

So, I let the HIGHER AUTHORITY manage the situation.

Hope all is well. I'll call you sometime, when you're " bored "

Stay safe !

wegandy1938@... wrote:

Mike,

You bring up very good points.

I am famous, or infamous, on here for bashing management, particularly

management that uses SSM in its system, just for the factors that you mention.

I think that management that allows and requires its employees to work beyond

exhaustion faces liability for its actions in a number of ways.

1. Crew is exhausted and driver goes to sleep while driving. People are

injured or killed.

2. Patient care goes bad because the medics are not on top of their game

because of fatigue.

And other possible scenarios are available, your choice.

DSHS and GETAC NEED TO TAKE THE LEAD IN LIMITING THE NUMBER OF HOURS AND

CALLS THAT A CREW CAN MAKE in a stated time frame. Perhaps a Libby Zion Law is

needed.

And maybe it's time for every medic to join a strong, mean union.

Years ago when I was in Chicago for a period of time I would ride out with

the CFD EMS. I was amazed by the work rules they had. They were assured of

plenty of time to write patient reports, restock, clean, and relax after a

call. When they had run a certain number of calls, they would be switched to

another station with a lower call volume.

Do you really want a crew to respond to your 0500 STEMI when it's their 20th+

call of the shift?

It's a matter of safety and liability as much as a matter of working

conditions.

Gene G.

>

> We have reached the point of total and dangerous exhaustion working in EMS.

> Over 25 years as a medic, manager, and educator I have applied methodologies

> to try to mitigate it, with very little or no support. EMS fatigue is

> something that few really want to acknowledge or recon with, especially rural

EMS.

>

> In contrast, an RN gets saddled with an extra patient for a shift, and it's

> all over the news and documenteries. The vast majority of EMS

> systems have absolutely no safe harbor provisions or parameters for crews to

> state they are just too exhausted to function. Overwhelmingly, if a crew goes

> out of service for fatigue and exhaustion, they will be put permenently out

> of service. How many EMS providers have been investigated by DSHS or taken to

> task f or not having safe harbor provisions for fatigue and exhaustion, which

> has resulted in MVC or medical error? Instead, the individual crew usually

> castigated as weak or incompetent. Most crews fear repercussions of coming

> forward with problems associated with fatigue and exhaustion. Most managers

tell

> crews directly or indirectly they really don't care about fatigue and

> exhaustion situations.

>

> What does your service do to mitigate fatigue and exhaustion? Is it

> exportable to services of all funding and budget concerns? What is GETAC doing

about

> this age old problem, do they have a position paper? Do you feel it's time to

> go forward to the public-at-large and tell Jonny and Susie Punchclock that a

> portion medical care is being compromised while industry and government

> really don't care?

>

> aloha,

> -hudso

>

>

>

>

**************************************

Get a sneak peek of the all-new AOL at

http://discover.aol.com/memed/aolcom30tour

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rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr

wegandy1938@... wrote: Mike,

You bring up very good points.

I am famous, or infamous, on here for bashing management, particularly

management that uses SSM in its system, just for the factors that you mention.

I think that management that allows and requires its employees to work beyond

exhaustion faces liability for its actions in a number of ways.

1. Crew is exhausted and driver goes to sleep while driving. People are

injured or killed.

2. Patient care goes bad because the medics are not on top of their game

because of fatigue.

And other possible scenarios are available, your choice.

DSHS and GETAC NEED TO TAKE THE LEAD IN LIMITING THE NUMBER OF HOURS AND

CALLS THAT A CREW CAN MAKE in a stated time frame. Perhaps a Libby Zion Law is

needed.

And maybe it's time for every medic to join a strong, mean union.

Years ago when I was in Chicago for a period of time I would ride out with

the CFD EMS. I was amazed by the work rules they had. They were assured of

plenty of time to write patient reports, restock, clean, and relax after a

call. When they had run a certain number of calls, they would be switched to

another station with a lower call volume.

Do you really want a crew to respond to your 0500 STEMI when it's their 20th+

call of the shift?

It's a matter of safety and liability as much as a matter of working

conditions.

Gene G.

>

> We have reached the point of total and dangerous exhaustion working in EMS.

> Over 25 years as a medic, manager, and educator I have applied methodologies

> to try to mitigate it, with very little or no support. EMS fatigue is

> something that few really want to acknowledge or recon with, especially rural

EMS.

>

> In contrast, an RN gets saddled with an extra patient for a shift, and it's

> all over the news and documenteries. The vast majority of EMS

> systems have absolutely no safe harbor provisions or parameters for crews to

> state they are just too exhausted to function. Overwhelmingly, if a crew goes

> out of service for fatigue and exhaustion, they will be put permenently out

> of service. How many EMS providers have been investigated by DSHS or taken to

> task f or not having safe harbor provisions for fatigue and exhaustion, which

> has resulted in MVC or medical error? Instead, the individual crew usually

> castigated as weak or incompetent. Most crews fear repercussions of coming

> forward with problems associated with fatigue and exhaustion. Most managers

tell

> crews directly or indirectly they really don't care about fatigue and

> exhaustion situations.

>

> What does your service do to mitigate fatigue and exhaustion? Is it

> exportable to services of all funding and budget concerns? What is GETAC doing

about

> this age old problem, do they have a position paper? Do you feel it's time to

> go forward to the public-at-large and tell Jonny and Susie Punchclock that a

> portion medical care is being compromised while industry and government

> really don't care?

>

> aloha,

> -hudso

>

>

>

>

**************************************

Get a sneak peek of the all-new AOL at

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In a message dated 8/18/2007 11:50:36 P.M. Central Daylight Time,

airmedic51@... writes:

And maybe it's time for every medic to join a strong, mean union.

I don't understand how you think " every Medic " can join a union?

unions are NOT just for joining and frankly in Texas Unions are at best a

JOKE. Compared to other states Texas is so pro business (not a bad thing per se)

they almost negate the power of a union even in collective bargaining as far

as I can see. Even the IAFF has little power based here compared to say

Miami where the Fire Chief send a memo to the union President for editing

before

it goes to rank and file.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

************************************** Get a sneak peek of the all-new AOL at

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In a message dated 8/19/2007 1:18:57 A.M. Central Daylight Time,

hatfield@... writes:

EMS could stand some organization, some of us have been saying that for

years, and others even longer. It really doesn't make any difference what your

personal opinions are, the organization is needed for the promotion of the

field, and the representation of the members, not for anyones personal agenda.

We have an EMS organization in Texas called EMSAT. The answer is NOT a Union

as they do have their purpose but not what we are discussing here.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

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While some of what you say may be true, don't under estimate the power of the

IAFF, even here in Texas.

EMS could stand some organization, some of us have been saying that for years,

and others even longer. It really doesn't make any difference what your personal

opinions are, the organization is needed for the promotion of the field, and the

representation of the members, not for anyones personal agenda.

As soon as we finally decide to put some trust in each other, and not assume

that everyone who promotes EMS does so for their own personal gain, then perhaps

we might find a more unified voice.When we decide that we need to represent a

'group' of people. instead of believeing that we will only respresent the

privates, or only represent those who serve strictly 911, then we might actually

be heard.

Hatfield FF/EMT-P

www.canyonlakefire-ems.org

Re: EMS Fatgue

don't understand how you think " every Medic " can join a union?

unions are NOT just for joining and frankly in Texas Unions are at best a

JOKE. Compared to other states Texas is so pro business (not a bad thing per se)

they almost negate the power of a union even in collective bargaining as far

as I can see. Even the IAFF has little power based here compared to say

Miami where the Fire Chief send a memo to the union President for editing before

it goes to rank and file.

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You are right. But sadly enough the State and Feds don't care. Managers don't

care ( some do yes I know) but the bosses have their masters to report to as

well. As an individual, we medics do care. as a whole group, most do not.As far

as a Union goes, yes I am all for it. As far as EMSAt goes, yes I am all for it.

Will either be able to change the current labor laws, no. Because congress does

not care.

learningmedic wrote:

rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr

wegandy1938@... wrote: Mike,

You bring up very good points.

I am famous, or infamous, on here for bashing management, particularly

management that uses SSM in its system, just for the factors that you mention.

I think that management that allows and requires its employees to work beyond

exhaustion faces liability for its actions in a number of ways.

1. Crew is exhausted and driver goes to sleep while driving. People are

injured or killed.

2. Patient care goes bad because the medics are not on top of their game

because of fatigue.

And other possible scenarios are available, your choice.

DSHS and GETAC NEED TO TAKE THE LEAD IN LIMITING THE NUMBER OF HOURS AND

CALLS THAT A CREW CAN MAKE in a stated time frame. Perhaps a Libby Zion Law is

needed.

And maybe it's time for every medic to join a strong, mean union.

Years ago when I was in Chicago for a period of time I would ride out with

the CFD EMS. I was amazed by the work rules they had. They were assured of

plenty of time to write patient reports, restock, clean, and relax after a

call. When they had run a certain number of calls, they would be switched to

another station with a lower call volume.

Do you really want a crew to respond to your 0500 STEMI when it's their 20th+

call of the shift?

It's a matter of safety and liability as much as a matter of working

conditions.

Gene G.

>

> We have reached the point of total and dangerous exhaustion working in EMS.

> Over 25 years as a medic, manager, and educator I have applied methodologies

> to try to mitigate it, with very little or no support. EMS fatigue is

> something that few really want to acknowledge or recon with, especially rural

EMS.

>

> In contrast, an RN gets saddled with an extra patient for a shift, and it's

> all over the news and documenteries. The vast majority of EMS

> systems have absolutely no safe harbor provisions or parameters for crews to

> state they are just too exhausted to function. Overwhelmingly, if a crew goes

> out of service for fatigue and exhaustion, they will be put permenently out

> of service. How many EMS providers have been investigated by DSHS or taken to

> task f or not having safe harbor provisions for fatigue and exhaustion, which

> has resulted in MVC or medical error? Instead, the individual crew usually

> castigated as weak or incompetent. Most crews fear repercussions of coming

> forward with problems associated with fatigue and exhaustion. Most managers

tell

> crews directly or indirectly they really don't care about fatigue and

> exhaustion situations.

>

> What does your service do to mitigate fatigue and exhaustion? Is it

> exportable to services of all funding and budget concerns? What is GETAC doing

about

> this age old problem, do they have a position paper? Do you feel it's time to

> go forward to the public-at-large and tell Jonny and Susie Punchclock that a

> portion medical care is being compromised while industry and government

> really don't care?

>

> aloha,

> -hudso

>

>

>

>

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In a message dated 8/19/2007 11:34:59 A.M. Central Daylight Time,

hatfield@... writes:

Unfortunately, EMSAT hasn’t been able to come up with an answer.

Having been on the BoD for 2 years I agree but I blame those that would

rather tear whatever it (EMSAT) does down as oppose to try to work in any

structure, that and the apparent apathy on the PROVIDER level since after all

only

250 or so out of some 50,000 Providers are members and of that only about 25

are ACTIVE in stating their opinions and beliefs and the like.

The same can be said at the national (NAEMT) level given the number of

Providers in the us versus the numbers of Members of NAEMT and their Active

Members level as well.

I too have not got answers per se but I have opinions and I do try to work

the system even though at times it appears fruitless.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

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(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

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In a message dated 8/19/2007 7:49:40 A.M. Central Daylight Time,

lverrett@... writes:

As far as a Union goes, yes I am all for it. As far as EMSAt goes, yes I am

all for it. Will either be able to change the current labor laws, no. Because

congress does not care.

Please explain to me who you " unionize " " EMS " ,

1) how do you deal with volunteers in a union?

2) what is your " local " structure?

3) how do you have collective bargaining on the level of the " whole of EMS " ?

4)answer those and there are 10 more behind them.

Also, we in Texas do not need CONGRESS to change any labor laws when if we

could must there right lobby in Austin we might be able to get the Legislature

here to impact the regulatory process so that regulations would be

promulgated to affect the fatigue issue and some other issues that have been

discussed

here.

As the Vice-President of EMSAT it's hard for me to say to some Legislator in

Austin that I think EMS Providers want XYZ and then I get to tell him I have

250 members. Really hard since he or she has not even got the time to see me

since my voice is so small.

Apathy is our first issue to overcome and we need to look in the mirror.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

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Unfortunately, EMSAT hasn’t been able to come up with an answer. The reasons

for that, are in my opinion, moot points and immaterial. What is important

is what we need to do about it. What’s the quote? Insanity is doing the same

things over and over, expecting a different result. Is EMSAT Texas’ EMS

equivalent to insanity?

Unionize? Who knows. I do know that length of shifts, hours worked etc, are

issues that unions are quite capable of dealing with, and have dealt with in

the past.

I have to admit, I am not sure what the answer is, but I know that the

answers we have had so far, haven’t worked. Why would we continue to travel

a path that takes us in circles?

Mike “The Cynic” Hatfield

Re: EMS Fatgue

In a message dated 8/19/2007 1:18:57 A.M. Central Daylight Time,

HYPERLINK " mailto:hatfield%40neopolis.net " hatfield (AT) neopolis (DOT) -net writes:

EMS could stand some organization, some of us have been saying that for

years, and others even longer. It really doesn't make any difference what

your

personal opinions are, the organization is needed for the promotion of the

field, and the representation of the members, not for anyones personal

agenda.

We have an EMS organization in Texas called EMSAT. The answer is NOT a Union

as they do have their purpose but not what we are discussing here.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/-EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/-Author/Journalis-t/Fire Protection Consultant

HYPERLINK " mailto:LNMolino%40aol.com " LNMolino (AT) aol (DOT) -com

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with

unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the

original author.

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In a message dated 8/19/2007 3:06:11 P.M. Central Daylight Time,

airmedic51@... writes:

Mike, This may might sound insane,but, if common sense took presedence over

$$$$$$$$$$

I think it may make some change for the better-maybe that's just a dream.

it's not insane as a theory but it may well be insane to think it will

happen over night. Can things change in EMS if I did not believe that with all

my

heart I'd be fishing right now.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

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Mike, This may might sound insane,but, if common sense took presedence over

$$$$$$$$$$

I think it may make some change for the better-maybe that's just a dream.

Hatfield wrote:

Unfortunately, EMSAT hasn’t been able to come up with an answer. The

reasons

for that, are in my opinion, moot points and immaterial. What is important

is what we need to do about it. What’s the quote? Insanity is doing the same

things over and over, expecting a different result. Is EMSAT Texas’ EMS

equivalent to insanity?

Unionize? Who knows. I do know that length of shifts, hours worked etc, are

issues that unions are quite capable of dealing with, and have dealt with in

the past.

I have to admit, I am not sure what the answer is, but I know that the

answers we have had so far, haven’t worked. Why would we continue to travel

a path that takes us in circles?

Mike “The Cynic” Hatfield

Re: EMS Fatgue

In a message dated 8/19/2007 1:18:57 A.M. Central Daylight Time,

HYPERLINK " mailto:hatfield%40neopolis.net " hatfield (AT) neopolis (DOT) -net writes:

EMS could stand some organization, some of us have been saying that for

years, and others even longer. It really doesn't make any difference what

your

personal opinions are, the organization is needed for the promotion of the

field, and the representation of the members, not for anyones personal

agenda.

We have an EMS organization in Texas called EMSAT. The answer is NOT a Union

as they do have their purpose but not what we are discussing here.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/-EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/-Author/Journalis-t/Fire Protection Consultant

HYPERLINK " mailto:LNMolino%40aol.com " LNMolino (AT) aol (DOT) -com

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with

unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the

original author.

************-*********-*********-******** Get a sneak peek of the all-new

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This is a very serious and real situation. We have it here in Beaumont as

equal or more than other spaces.

We have been authorized up to 7 ambulances. People look at how many calls

we make on a daily basis and do not want to come to us, even for the benefits.

If I could man 7 ambulances it would make a great deal of difference in our

call volume and fatigue.

If I raise pay to $25.00/hr, I could draw a few more people but they would

still want to work OT for those wages and if I cut OT hours, the next day I

find them on someone elses truck working part/time.

Safety is a big factor but bottom line is if I reduce hours for safety,

another private company would come in, offer 7 or 8 trucks and BS their way to a

contract. I think my medics are top of the line and the service is also, but

EVEN AFTER 27 YEARS. I am not ready to give up hope. A younger mind might

sacrifice all that has gone on before them, when the employees really cared

about the service.

Andy

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In a message dated 8/19/2007 4:34:10 P.M. Central Daylight Time,

hatfield@... writes:

The same way the IAFF deals with them.

As a way to deal with volunteers is what you're saying?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

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In a message dated 8/19/2007 4:34:10 P.M. Central Daylight Time,

hatfield@... writes:

I can assure you that I am far from apathetic, and until you are clear and

concise on my personal reasons for not joining EMSAT, I would urge you to

rethink your blanket statement that those who are not members are

‘apathetic’.

My statement regarding apathy was not meant to be aimed at you in fact I'd

say by virtue of you posts here and elsewhere you're far from apathetic on any

EMS or fire issue.

My statement regarding apathy is an indictment of the whole of EMS on a

grand scale. Too many folks could care less about theses issues unless and until

they come to haunt them. In ways it's like America in 1939 on the " European

problem " .

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

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The same way the IAFF deals with them.

It’s my answer to those and the next ten, the IAFF works for FF’s, and it’s

successful because it is powerful and represents FF’s as a whole. The same

as any EMS union/organization needs to do, it needs to fight for the rights

of the individual EMS technician. It needs to be able to ignore those who

choose to incite the crap between different types of providers. The IAFF

doesn’t care if you belong to a small FD with 6 members in your local or a

huge union with 1000 members in your local, they represent you.

If you pay your dues, you are a member, if you are a member, you are

represented by the union/organization. Period end of story.

What we have at this moment does not work, we see organizations that do, the

IAFF, Texas BNE and the likes. If what they have works, why not fashion our

structure after theirs? Because we are so different in what we do? That has

nothing to do with a representative organizations structure It’s like we

don’t want to try anything different because to do so, would be admitting

that someone else figured it out and we want to tag along .

In so much as apathy, this conversation came up once before, and I will

reiterate what I said before.

I have spent countless hours working with small rural and volunteer

organizations to make sure that they had CE opportunities for free, I have

dined with State representatives detailing the plight of Texas EMS, I have

fought Medicare tooth and nail to change the ratings of services to increase

their reimbursement rate. I still work daily to insure that EMS is never

brushed to the side, I will continue to fight for EMS, specifically Texas

EMS, and more specifically, rural Texas EMS with every breath I have.

I can assure you that I am far from apathetic, and until you are clear and

concise on my personal reasons for not joining EMSAT, I would urge you to

rethink your blanket statement that those who are not members are

‘apathetic’.

Re: EMS Fatgue

In a message dated 8/19/2007 7:49:40 A.M. Central Daylight Time,

HYPERLINK " mailto:lverrett%40swbell.net " lverrett (AT) swbell (DOT) -net writes:

As far as a Union goes, yes I am all for it. As far as EMSAt goes, yes I am

all for it. Will either be able to change the current labor laws, no.

Because

congress does not care.

Please explain to me who you " unionize " " EMS " ,

1) how do you deal with volunteers in a union?

2) what is your " local " structure?

3) how do you have collective bargaining on the level of the " whole of EMS " ?

4)answer those and there are 10 more behind them.

Also, we in Texas do not need CONGRESS to change any labor laws when if we

could must there right lobby in Austin we might be able to get the

Legislature

here to impact the regulatory process so that regulations would be

promulgated to affect the fatigue issue and some other issues that have been

discussed

here.

As the Vice-President of EMSAT it's hard for me to say to some Legislator in

Austin that I think EMS Providers want XYZ and then I get to tell him I have

250 members. Really hard since he or she has not even got the time to see me

since my voice is so small.

Apathy is our first issue to overcome and we need to look in the mirror.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/-EMSI

Owner and President of LNM Emergency Services Consulting Services (LNMECS)

Freelance Consultant/Trainer/-Author/Journalis-t/Fire Protection Consultant

HYPERLINK " mailto:LNMolino%40aol.com " LNMolino (AT) aol (DOT) -com

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

(Home Phone)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with

unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the

original author.

************-*********-*********-******** Get a sneak peek of the all-new

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HYPERLINK

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