So, I consider the system I've spent most of my time in to be fairly lP optimal. Sure, it's not perfect, but compared to the other systems I've experienced over the past 1.5 years, it worked pretty well. For the most part, BLS calls were handled by BLS crews and ALS calls by ALS crews. Any overlap was due to dispatch and patient reporting, which is normal.
Compare that to a nearby area in which I spend a fair but of time for clinicals. While their system is similar to the one I am most familiar with, they seem to have far fewer BLS units. They also have required every recruit class in the past several years to become medics (at the least, EMT-I's). This means you have a whole bunch of ALS units running BLS calls, and a lot of medics getting burned out quickly.
And a bunch of medic students who getting a poor ALS clinical experience. In my time in that county, I can count on one hand the number of ALS calls I have had, over at least 120 hours.
Now, I know it may seem counter productive to complain...after all, if they want to pay me for being a glorified taxi driver, then by all means. And I understand the desire to provide advanced care for as many people as possible. But in this day and age with budgets being what they are, it may behoove departments to remember that our call volume is generally 80:20 BLS:ALS. It might be a better idea to have more BLS units and strategically place the ALS units to a better advantage. You may find you have better, less burnt out medics, and more money in the bank.
Then again, I'm just a student...what do I know?
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