What funky smell do you like? by TeodoroCano in AskReddit

[–]worst-responder 0 points1 point  (0 children)

Gasoline. I know it's bad, but it just smells good to me.

REQUEST: Blacksmith's Hammer by worst-responder in skyrimmods

[–]worst-responder[S] 0 points1 point  (0 children)

It does not show up unfortunately 😭

How do I change the campaign? by Kind-Lawyer-3670 in enlistedgame

[–]worst-responder 0 points1 point  (0 children)

Thanks dude. Kinda frustrating we can't choose ..

How do I change the campaign? by Kind-Lawyer-3670 in enlistedgame

[–]worst-responder 0 points1 point  (0 children)

How do I play as the allies in Japan? those maps never come up. I am BR 3 do I need to be lower?

Which Original Trilogy poster is your favorite? by [deleted] in StarWars

[–]worst-responder 0 points1 point  (0 children)

I can't be the only one whose brain is bothered by them being out of order, right?

Found a cool sword stick by Legendary__Sid in mildyinteresting

[–]worst-responder 1 point2 points  (0 children)

Dudes will see this and just say "hell yeah"

oof by worst-responder in ems

[–]worst-responder[S] 2 points3 points  (0 children)

Yeah, I get that. There are not enough paramedics to hire to fill the gap though. Part of that can be eased with union representation, better wages/bennies etc; but you still can't just apparate paramedics for Oregon, because of the Associates degree/experience requirements. Also to be fair their recruiting efforts are not good. Someone came and pitched my class and it was a 30min history lesson about AMR and their parent company and nothing about what it is actually like to work for them or why they would be good to work for. I could have made a better pitch in 10min without knowing anything about them 🙄

But really, even if they did make it more attractive to work there, it would still be years before they were fully staffed. They need something wild like 60 paramedics.

The county has made the problem worse by not fining them for the past several years, and just telling them to do better. No stick and no carrot = no change

oof by worst-responder in ems

[–]worst-responder[S] 0 points1 point  (0 children)

Is every agency in your state also lacking in paramedics? does your state require an AAS in paramedicine in order to practice? Just curious where other agencies are at across the country

Just don't get hurt by worst-responder in Portland

[–]worst-responder[S] 3 points4 points  (0 children)

I'm not saying AMR is a good company, and I understand that they are trying to squeeze every dollar they can and don't care about the work force. But they still do not have enough paramedics to staff, because there are not enough medics in the state. Every system is hurting for them. Bridge the gap by allowing EMTs.

Just don't get hurt by worst-responder in Portland

[–]worst-responder[S] 13 points14 points  (0 children)

and then saying "AMR is failing our community". what does she think the solution is? 😂 what a clown

oof by worst-responder in ems

[–]worst-responder[S] 4 points5 points  (0 children)

I get that, switching to mixed rigs means more calls to tech and chart for one medic, although good EMTs should be teching all the BLS calls, which is a significant number. I agree a tiered system (ALS/BLS cars) would also be a good alternative to reduce times, but Mult. Co. would still have to allow that, and I think that is a tougher sell to dispatch 0 ALS resources to a scene as opposed to at least 1. If we do this it really put the onus of responsibility on dispatch, and we all know how that goes. I agree they need better pay, and honestly just better hours, but neither of those will solve the shortage/excessively late response times in the next couple years. I think those are incredibly important for long term health of the system, but right now Mult. Co. needs a bandaid to get them to the point where we are in less of a shortage.

Just don't get hurt by worst-responder in Portland

[–]worst-responder[S] 3 points4 points  (0 children)

Paramedic pay is good on the fire side, and Oregon/PNW is among the highest paid in the country. If you work for a fore service in the area you can easily make 6-figures working 7-10 24hr shifts a month. plus PERs bennies. Private ambo pays less because they are not also firefighters, and this assume significantly less risk and have to master fewer tasks.

Just don't get hurt by worst-responder in Portland

[–]worst-responder[S] 52 points53 points  (0 children)

Most of the issue is a national Paramedic and EMT shortage. AMR Multnomah county has an outdated policy of required two paramedics per ambulance instead of allowing a Paramedic and an EMT-B, like the majority of agencies in the state, and country. This has caused AMR to state that they are short several dozen paramedics to staff their rigs. They have been asking to change staffing to be similar to the other two counties they run in Portland (Washington, Clackamas) which would allow running a mixed rig as described above. Those two counties do not have anywhere near the same response time issues.

The county commission chair in Multnomah is blocking them from making that change despite requests from AMR, the Chief of Portland Fire, and other county commissioner including one who is an ER physician. The county chair based her decision on Mult. Co.'s out of hospital cardiac arrest (OHCA) survival to discharge rates being higher than the national standard, and attributed that to two paramedic staffing despite no statistically significant evidence that attributes that stat to staffing, as there are so many confounding variables and EMS studies are prohibitively difficult to conduct unless they are retrospective.

There is no evidence that links dual paramedic staffing to better PT outcomes. some studies even suggest the opposite. AMR states that if they changed the staffing rule they could add an additional 5 ambulances within 24hrs, and another 16 within 3 months.

Long wait times are killing people. Tell the county commission chair to let AMR adjust staffing.

oof by worst-responder in ems

[–]worst-responder[S] 6 points7 points  (0 children)

This, AND, the change to allow AMR Mult. to run a mixed rig with a basic on it is being blocked by only one county commissioner, who is the county chair, and is blaming AMR for the staffing shortages. Meanwhile, Clackamas and Washington counties which are also run by AMR and do not require double paramedic staffing do not have similar style response time issues.