I'm sitting in a peds ER right now. My base pay is $25.50, apparently adjusted for my experience (I got my medic card at the end of 2015 and have worked for a few combo fire deparments since).
That said, I work nights, so shift differential puts me at $29.33 during the week and $31.88 on weekends.
Responsibility lands somewhere in the middle. I can (and do) do tech stuff; bring patients back from the waiting room, vitals, plaster splints, 12 lead application.
But I also do almost-nurse things, like triage/history of preent illness questions techs can't do. For whatever reason, I *can't* perform initial assessments or assign chief complaints. Reassessments are fine.
Can do IVs, meds (generally same as field protocol but by order)
Only paramedics can do IOs, with a few exceptions (team leads with no confidence in doing them).
Edit to clarify: I've only been here a few months, and the pay is based solely on my outside experience. Apparently I'm almost but not quite at the top the scale.
Was an ED medic and charge nurse, we looked into the triage thing heavily. It comes down to Medicare requirements for all patients to be under the care of an RN in the hospital setting. This is how your hospital is likely getting around that. By essentially claiming the RN doing the triage is somehow responsible for that patient. Some places have an RN cosign certain parts of the chart.
If places could get away with having medics do the entire RN role they would for money reasons. As shitty as that is. As a medic we had some who worked as techs and some who worked as nurses. I took a full patient load as a medic, just had to have someone triage for me. But we had full scope, could and did crich, intubate, and we could give any medication. Needed an RN cosign for blood initiation. We could cosign for the RN when they started their own blood.
CMS guidelines look at the primary assessment, which is just XABCD essentially, literally 3 clicks for us. It's similar with LPNs but the RN has to do the entire first assessment for them. Which is a scope of practice and Medicare thing.
I've heard of critical access hospitals having medics do EVERYTHING, including running triage, but almost certainly they're skirting rules someway or another. My level II trauma ED has medics staffed in triage but you wouldn't ever be able to staff an entire ED with medics, there's always a nurse they're dumping responsibility on in the background.
When I was charge I would just sign off on whatever and have the medic triage and assess, assuming I knew they weren't an idiot.
I'm sure at least some of that various by state, too. They claim our scope of practice is about as liberal as is possible to get versus the state revised code (in-hospital, that is).
Theoretically, I'd be in scope to intubate, but they tell me I'm far enough down the line that it's unlikely it would ever get to me. It would be more likely one of the attendings or RT or what have you.
Also, allow some margin of error due to my newness in this role.
Well CMS is the regulating body for any hospital that wants to bill. Which is why it's essentially the same rule you have to get around for every hospital in the country. States can further restrict that but unless the hospital wants to get shut down they're stuck.
That's kind of funny because most of my intubations have come from working ED. We intubated in Cath lab and ICU occasionally too. Our RTs would never be allowed to intubate, and we had a few ED attendings who were family med trained. So I was friends with a couple who never intubated and would pass tubes off, and a few EM docs who were medical directors that loved helping us keep our skills up.
I was just laid off of a stand alone ER. I was hired as a medic and was allowed to do my full scope of practice. The Er was owned by 12 ER doctors. It was a concierge hospital and therefore really catered to the patients. The doctors chose to not take any federally funded insurances (Medicare/medicaid, triage) if you had those it was self pay. Because of that we didn’t take ambulances so there were very few emergencies. All that to say I didn’t get to do my scope of practice. I gave meds, IV’s, the docs were even teaching me how to do sutures. I couldn’t assess the pt, do the acuity, or discharge the patient. I did everything else for 2/3 the pay. I made $26 an hour. It was aggravating and very frustrating to be doing almost the same job as them but get paid less. I even went to them asking for a raise to $35. Nurses were getting $39. It wasn’t the same as them but close. No go. I was laid off because I was the only medic there and they didn’t have a use for me.
Side note- I understand why I couldn’t do those three things. The nurses have it locked down. I was very aggravated with EMS representation. I want them to push more for us outside of the ambulance. Give us more opportunities besides the truck. A person shouldn’t have to work 30+ years on the ambulance then retire. In my area there are very few promotion opportunities. The community paramedic thing is a bust here. We can do almost the same jobs as nurses, the need to be lobbying for more rights for us. I understand why. If the do that and succeed there will be a massive migration of medics to better paying jobs. I guess it’s a catch 22 but medics shouldn’t really have to change careers to make money.
Our jobs are very different than the nurses. We don’t really serve a roll in the hospital. Well, we do, but can’t be utilized to our full potential because of the nursing lobby. Oh, and they pay — they won’t pay us for an increased scope.
Emt or paramedic (they don’t care they just want experience with 911) in the ER with your phlebotomy goes for $39/hour. Starting medic wage on a box is $31.41
Yeah don’t do that. There are some places that hire basics and medics to do the same job. It’s great for basics who can expand their score a bit. It’s terrible for medics. Both wind up emptying bedpans.
I did that for a few months and it was basically the same experience. We struggled to find a place. I didn't see the benefit to either me or the ER having a few paramedics floating around. I couldn't give meds without orders, RT and residents handled airway stuff, so really all I did was start IVs, do 12-leads, and get blankets.
In my area, ER medics make anywhere from $19-28/h base. Those numbers are split between the 3 major hospital systems in my area and the experience you have.
The one I'm at, Medics are literally just cheaper RNs since we do almost everything the RN does in the ED. We can intubate second after the ER MD, we can do breathing treatments but its usually RT's job. We are part of the trauma team if available along with doing tech-duties like bringing patients back, labs, campus transportation, etc. We also occasionally take care of a number of patients but on paper, their care is under an RN.
Sounds about right. On the road you have a far wider scope. Which is why most medics I know take education bonuses and become Respiratory therapists and such.
Current full time ER Paramedic at a busy Level 2. I make $21.24 per hour plus $1.00 per hour shift differential for afternoons. Our top out wage is $29.80.
We are assigned in triage or floating for the day. I have all the same medication access as the RNs, can transport anything they can, and unlike the RNs I am allowed to do needle decompressions, and EJs. We do have intubation privileges as well, can push RSI meds, and can even push TnK. You’ll also need expected to assist with central line placement, and understand how to run the rapid transfuser. We are allowed to admin blood products as well. Ultrasound IVs are also within scope.
Basically everything the RNs can do skills/meds wise plus some more invasive extras. However, I can never take a patient assignment and I’m not supposed to discharge people.
It’s a great job where you’ll get massive amounts of exposure to tons of serious patients more than I’d ever get elsewhere around me, just the pay is terrible.
I’m either going to get my RN, or try to fly as a medic at some point, or just leave EMS altogether at some point. I still have yet to make up my mind what the heck I truly want to do.
I'm sitting in a peds ER right now. My base pay is $25.50, apparently adjusted for my experience (I got my medic card at the end of 2015 and have worked for a few combo fire deparments since). That said, I work nights, so shift differential puts me at $29.33 during the week and $31.88 on weekends. Responsibility lands somewhere in the middle. I can (and do) do tech stuff; bring patients back from the waiting room, vitals, plaster splints, 12 lead application. But I also do almost-nurse things, like triage/history of preent illness questions techs can't do. For whatever reason, I *can't* perform initial assessments or assign chief complaints. Reassessments are fine. Can do IVs, meds (generally same as field protocol but by order) Only paramedics can do IOs, with a few exceptions (team leads with no confidence in doing them). Edit to clarify: I've only been here a few months, and the pay is based solely on my outside experience. Apparently I'm almost but not quite at the top the scale.
Was an ED medic and charge nurse, we looked into the triage thing heavily. It comes down to Medicare requirements for all patients to be under the care of an RN in the hospital setting. This is how your hospital is likely getting around that. By essentially claiming the RN doing the triage is somehow responsible for that patient. Some places have an RN cosign certain parts of the chart. If places could get away with having medics do the entire RN role they would for money reasons. As shitty as that is. As a medic we had some who worked as techs and some who worked as nurses. I took a full patient load as a medic, just had to have someone triage for me. But we had full scope, could and did crich, intubate, and we could give any medication. Needed an RN cosign for blood initiation. We could cosign for the RN when they started their own blood. CMS guidelines look at the primary assessment, which is just XABCD essentially, literally 3 clicks for us. It's similar with LPNs but the RN has to do the entire first assessment for them. Which is a scope of practice and Medicare thing. I've heard of critical access hospitals having medics do EVERYTHING, including running triage, but almost certainly they're skirting rules someway or another. My level II trauma ED has medics staffed in triage but you wouldn't ever be able to staff an entire ED with medics, there's always a nurse they're dumping responsibility on in the background. When I was charge I would just sign off on whatever and have the medic triage and assess, assuming I knew they weren't an idiot.
I'm sure at least some of that various by state, too. They claim our scope of practice is about as liberal as is possible to get versus the state revised code (in-hospital, that is). Theoretically, I'd be in scope to intubate, but they tell me I'm far enough down the line that it's unlikely it would ever get to me. It would be more likely one of the attendings or RT or what have you. Also, allow some margin of error due to my newness in this role.
Well CMS is the regulating body for any hospital that wants to bill. Which is why it's essentially the same rule you have to get around for every hospital in the country. States can further restrict that but unless the hospital wants to get shut down they're stuck. That's kind of funny because most of my intubations have come from working ED. We intubated in Cath lab and ICU occasionally too. Our RTs would never be allowed to intubate, and we had a few ED attendings who were family med trained. So I was friends with a couple who never intubated and would pass tubes off, and a few EM docs who were medical directors that loved helping us keep our skills up.
I was just laid off of a stand alone ER. I was hired as a medic and was allowed to do my full scope of practice. The Er was owned by 12 ER doctors. It was a concierge hospital and therefore really catered to the patients. The doctors chose to not take any federally funded insurances (Medicare/medicaid, triage) if you had those it was self pay. Because of that we didn’t take ambulances so there were very few emergencies. All that to say I didn’t get to do my scope of practice. I gave meds, IV’s, the docs were even teaching me how to do sutures. I couldn’t assess the pt, do the acuity, or discharge the patient. I did everything else for 2/3 the pay. I made $26 an hour. It was aggravating and very frustrating to be doing almost the same job as them but get paid less. I even went to them asking for a raise to $35. Nurses were getting $39. It wasn’t the same as them but close. No go. I was laid off because I was the only medic there and they didn’t have a use for me. Side note- I understand why I couldn’t do those three things. The nurses have it locked down. I was very aggravated with EMS representation. I want them to push more for us outside of the ambulance. Give us more opportunities besides the truck. A person shouldn’t have to work 30+ years on the ambulance then retire. In my area there are very few promotion opportunities. The community paramedic thing is a bust here. We can do almost the same jobs as nurses, the need to be lobbying for more rights for us. I understand why. If the do that and succeed there will be a massive migration of medics to better paying jobs. I guess it’s a catch 22 but medics shouldn’t really have to change careers to make money.
Our jobs are very different than the nurses. We don’t really serve a roll in the hospital. Well, we do, but can’t be utilized to our full potential because of the nursing lobby. Oh, and they pay — they won’t pay us for an increased scope.
That’s what I was saying.
Emt or paramedic (they don’t care they just want experience with 911) in the ER with your phlebotomy goes for $39/hour. Starting medic wage on a box is $31.41
where
Kaiser
I see them advertised @ $17-$19/hr quite often in my area, IFT service in same area is $28/hr
Yeah don’t do that. There are some places that hire basics and medics to do the same job. It’s great for basics who can expand their score a bit. It’s terrible for medics. Both wind up emptying bedpans.
Both those listing are for paramedics only. Pretty screwed up imo.
Yeah, I don’t know what kind of quality they expect from that but freaking yikes
I did that for a few months and it was basically the same experience. We struggled to find a place. I didn't see the benefit to either me or the ER having a few paramedics floating around. I couldn't give meds without orders, RT and residents handled airway stuff, so really all I did was start IVs, do 12-leads, and get blankets.
In my area, ER medics make anywhere from $19-28/h base. Those numbers are split between the 3 major hospital systems in my area and the experience you have. The one I'm at, Medics are literally just cheaper RNs since we do almost everything the RN does in the ED. We can intubate second after the ER MD, we can do breathing treatments but its usually RT's job. We are part of the trauma team if available along with doing tech-duties like bringing patients back, labs, campus transportation, etc. We also occasionally take care of a number of patients but on paper, their care is under an RN.
My base rate in a pediatric ER was 28.50
Sounds about right. On the road you have a far wider scope. Which is why most medics I know take education bonuses and become Respiratory therapists and such.
Started at $20/hr a year ago, but I hear I’m at one of the lowest paying hospitals in the area.
$48/hr
Current full time ER Paramedic at a busy Level 2. I make $21.24 per hour plus $1.00 per hour shift differential for afternoons. Our top out wage is $29.80. We are assigned in triage or floating for the day. I have all the same medication access as the RNs, can transport anything they can, and unlike the RNs I am allowed to do needle decompressions, and EJs. We do have intubation privileges as well, can push RSI meds, and can even push TnK. You’ll also need expected to assist with central line placement, and understand how to run the rapid transfuser. We are allowed to admin blood products as well. Ultrasound IVs are also within scope. Basically everything the RNs can do skills/meds wise plus some more invasive extras. However, I can never take a patient assignment and I’m not supposed to discharge people. It’s a great job where you’ll get massive amounts of exposure to tons of serious patients more than I’d ever get elsewhere around me, just the pay is terrible. I’m either going to get my RN, or try to fly as a medic at some point, or just leave EMS altogether at some point. I still have yet to make up my mind what the heck I truly want to do.