|WELCOME TO THE WONDERFUL WORLD OF EMS
|This is the exciting world of the Emergency Medical Service. EMS agencies across the globe have an amazing array of
specialized services that can be called upon to assist in any number of specialized rescue situations. From tactical
medical support for law enforcement to dive teams, bike medics, K-9 search and rescue, fully equipped Haz-Mat
operations teams, high angle rescue teams, medical helicopter transport, mounted EMS units, search and rescue
teams, and heavy rescue squads.
Yes this the exciting world of EMS everywhere except New York City. While FDNY EMS EMT's and Paramedics provide
the best pre-hospital care with the recourses available, the truth is, because of FDNY and the City of New York we are
far behind the rest of the world in providing the wide range of EMS services that are offered by even some of the most
rural EMS agencies in the United States.
Unfortunately most of the problems that I write about are not unique to FDNY EMS but are spread throughout the world
of EMS. I feel most of the problems are caused by FDNY's total lack of managerial competence and that has in part led
to the total failure of the FDNY EMS "merger". Let me explain it this way. Did you ever see 2001 a Space Odyssey?
Remember in the beginning of the movie there were the apes? All was well for millions of years until the day the monolith
appeared and the apes all screamed wildly and were afraid? That is what the takeover was like. We appeared overnight
and were far more advanced than FDNY technologically. The Fire Chiefs panicked and were totally overwhelmed by our
presence. They had no idea what to do with EMS.
It was like giving a loaded gun to a monkey. Only bad things could happen. Keep in mind EMS is a high tech field that is
constantly changing. Advances in health care require that EMS continually change to keep up with all the advances in
modern medicine. Firefighting however has stayed the same throughout time. Sure the advancement of the fire engine
changed how Firefighters get to the fire but otherwise the wet stuff goes on the red stuff and the fire goes out. You can
take a Firefighter from the 1400's and ask him "How do you put out a Fire?" He will say "With water." Until scientists
invent something new Firefighters will continue to put water on fires until they go out. I doubt Firefighting will ever
change. It's that simple. This is one of the reasons Firefighters shouldn't be involved in EMS.
I want you to think about this for a moment. The FDNY Emergency Medical Service is run by The Fire Commissioner. Sal
Cassano is a Firefighter and he has no background in EMS. Edward S. Kilduff is FDNY’s Chief of Department he is a
Firefighter and he has no background in EMS. The top Fire Department Commissioners also have no background in
EMS. One more step down we have the Chief of EMS. He is Abdo Nahmod. However he is way down in the FDNY food
The Chief of FDNY EMS should be a civil service position so that the person in charge is in power because of merit. But
it is not that way. All positions above EMS lieutenant are now a position where it's "who you know". The EMS Chief
should have the power to run EMS as he/she sees fit. It is not that way at FDNY. As it stands now we could be run by the
Sanitation Department. The head of Sanitation doesn't know anything about running an EMS system. What's the
To begin let me tell you that EMS workers are total outsiders in the Fire Department. We are second class citizens in a
department that was supposed to "welcome us". FDNY welcomed EMS workers by taking away our career path that we
had under HHC that lead us from EMT's and Paramedics to the careers of Nursing, and Physician Assistant. To make up
for this FDNY created a "promotional" exam for EMS workers that lead to Firefighter. This has made a bad situation
worse. Now EMS is overrun with applicants who are looking for the golden ticket to Firefighting. They go to EMS to serve
out their 2 years so they can take a back door exam to Firefighter. These are people who probably could not pass the
regular test for Firefighter and don't care about EMS. All they are looking for is their Fire Academy start date. This has
totally decimated the EMS ranks.
FDNY took away our shields, and our identity. They changed our uniform and put these huge FDNY EMT AND FDNY
PARAMEDIC cloth patches on the front and back. It makes you feel like a prisoner of war.
The Firefighters continue to overshadow EMS and everything EMS workers do. We are no longer called EMS at events
and ceremonies that are held by the City. We are lumped in as rescue workers as in "I would like to thank all of the
Firefighters the Police Officers and all of the rescue workers who responded on 9-11" It's so bad that the Fire
Commissioner has called us "Ambulance drivers". The Fire Department took away EMS Medal Day from us in 2008.
While we still get awards we are totally overshadowed by the Firefighters.
The media doesn't know we exist anymore. If there is a good story involving EMS it's "The Firefighters blah, blah,
blah".....If there is a bad story they say EMS. The Firefighters call us "slugs" and "animals" but that isn't as bad as what
they call the public. They call them "Fat animals" on their website and say that the people who need EMS are "human
The EMT's and Paramedics of FDNY EMS earn 30-40 thousand dollars less than Firefighters, Police Officers, Sanitation
Workers, and Court Officers. We are the lowest paid uniformed service. While there are many issues affecting the
members of FDNY*EMS the low pay is a huge factor in the high turnover and low morale of FDNY EMS EMTs and
Paramedics. The FDNY EMS paycheck is very small. Every two weeks you earned about $1400.00. I get 26 of these
wonderful paychecks a year, one paycheck every 2 weeks. This may sound like a lot of money if you live outside of
NYC. Sadly in New York the money doesn't go far. The cost of living in NYC is very high. For example a starter home in
NYC is 450,000 dollars. So for approximately $700.00 a week I get to respond to calls where people are suffering or
dying. These daily calls include rape, child abuse, shootings, stabbings, car wrecks, suicides, fires, people with AIDS,
people suffering from cancer, TB, amputations, emergency childbirth, seizures, strokes, cardiac arrest, severe burns,
and many other horrifying situations.
FDNY EMS has a pension that is very small and virtually unreachable for most EMS workers. Even with the new 25 and
out pension the salary is so low that when a new EMT retires in 25 years they will have a pension of about 25,000
dollars a year. If you are OK with the fact that you and your family will live in a cardboard box in an alley because it's all
you can afford when you retire then this is the pension for you. The chances are greater that the Earth will be destroyed
by a rogue asteroid than EMS workers getting a livable pension. I feel that the public should see the truth about what the
members of FDNY*EMS earn. It is time to give the members of FDNY*EMS a fair living wage so we can feed our family's
and pay our bills. Even though we are the lowest paid emergency service we still handle over 1,300,000 emergency
calls for help every year and serve the people of NYC with pride.
There are no official meal or bathroom breaks at FDNY EMS. Unlike almost every other EMS service in the country
FDNY EMS members get the honor of having to sit in the ambulance on a street corner for 8-16 hours a day. It's like
being in a prison without the benefits of a library, and a weight room. It's nice to see FDNY cares about the EMS
workers' health and welfare. Studies show that sitting in a running ambulance for long periods of time is directly linked to
back problems, and GI disorders. Can you imagine the firefighters sitting in the fire truck all day long on a street corner
waiting for a call? Of course not. We have ambulances and command cars that are mobile death traps. They are
supposed to replace the ambulances every 5 years but the truth is most of the fleet is older than that. People in NYC
say they are concerned with some of the diesel MTA buses driving down their street leaving a trail of soot and smoke.
What they should take a look at are the 300 diesel EMS trucks that are parked on street corners all over the city with the
engines running. Because we don't have a station to go to we have to sit on busy street corners across the city spewing
diesel fumes into the air 24 hours a day seven days a week. If EMS trucks were stationed at the fire houses the savings
on fuel costs alone would be tens of thousands of dollars a day. Just imagine millions of dollars saved every year. Oh
there is one more thing I want to mention. Medical studies link diesel fumes with high rates of cancer and respiratory
ailments. Is FDNY looking into any of this? No.
In order to increase morale FDNY has mandations (Otherwise known as forced overtime). This is a huge problem in the
communications division as well as in the field. Because of under staffing and high turnover there are always empty
shifts to be filled. Nothing beats a 16-hour workday 5 days a week. Don't make plans to do anything. Do you need to
pick up your kids from school? FDNY doesn't care. If we leave we could lose our job. FDNY continues to forcibly staff
vacant EMS ambulance slots with people who are on overtime. They need to hire more people and not force people who
are exhausted to stay for overtime. FDNY must have gotten their ideas on staffing from the Egyptian pharaohs who used
three people to move 40-ton slabs of rock while constructing the pyramids. People who are having a medical emergency
do not want someone who is exhausted making split second life or death decisions. That is not quality medical care.
Staffing by constant mandation is simply poor management (*Note: all management under FDNY is poor) and an abuse
of authority, it's designed to destroy morale. In any other organization these issues would be a huge red flag. At FDNY
this doesn't bother management at all.
FDNY is still returning EMS workers who were injured in the line of duty to full duty status. Oh, you blew out your back?
Broke your neck? Need surgery? Too bad get back in your ambulance and have a good tour. To give you an example
of how things work at FDNY I have a friend who was carrying a heavy patient down the stairs to the ambulance. As they
were going down the stairs he had back pain. After getting checked at the hospital they found three herniated disks in
the lower back. He needed surgery. FDNY's Bureau of Health Services (Located at FDNY headquarters in Downtown
Brooklyn) wanted him to come in every 4 days to be seen. He tells them he has pain when he walks and he can't sit up
straight. He walks with a cane. BHS tells him they don't care and if he doesn't show up right away they will put him back
to work full duty. What nice Doctors.
Here is an interesting little fact. Right after NYC EMS was taken over by FDNY the Fire Department moved quickly to
close our Emergency Response Squad. ERS was responsible for all of the technical support to EMS. From generators,
to Haz-Mat equipment ERS has it all. This was one of the best spots at NYC EMS and their level of EMS expertise was
unmatched. However FDNY feared anyone with a brain so they closed it down. We could have used ERS at the World
Trade Center on 9/11 but FDNY would never admit it. FDNY also shut down three out of five Major Emergency
Response Vehicles (MERV's) We could have used those on 9/11 as well. It only took FDNY 10 years to replace them
with vehicles that are at best substandard. Oh, even though we now have new MERV's (After a 10 year wait) The people
who are supposed to drive the MERV's are driving around the city in a supply truck gathering up medical equipment left
at hospitals until the next big one comes in. The MERV is no good unless there is someone manning it 24/7.
Here are some frightening facts about EMS across America. A study commissioned by The Newspaper USA Today
reports that researchers have conservatively estimated that 1,000 cardiac-arrest victims die in the United States each
year, in part because of slow EMS response.
In the United States salaries for EMS personnel are low. In Montana, an emergency medical technician (EMT) makes as
little as $14,000 a year. Most full-fledged paramedics in Oklahoma make less than $33,000. This is another reason that
we have a problem attracting people to careers in EMS.
A recent study in Pre-hospital and Disaster Medicine Magazine shows that less than 12 percent of the EMS responders
in the United States are equipped to help victims of chemical weapons. New York City is not prepared in my opinion.
In a report from the George Washington University Homeland Security Policy Institute, in 2005 EMS received only 4
percent of the first-responder funding allocated by DHS [The Department of Homeland Security]." Police agencies and
Fire Departments got the other 96 percent of the funds.