The Real Difference 

Between Police, Firefighters, Sanitation, Nursing and EMS

It takes a special person to be a first responder. There is a great deal of real danger involved in a job where a person is asked to drive and run towards an emergency that the majority of people are running away from. We compensate first responders for the readiness for that danger. In the case of EMTs and Paramedics, the city and state have basically refused to. The difference between an EMS provider and a Cop or Firefighter is not the risk involved, as Mayor DeBlasio has claimed. The real difference is rooted in demographics and failure of the EMS workers to unite and engage in industrial action as a unified group.

The New York City Council has just passed a non-binding resolution calling for parity with Police and Fire. We need to organize and lobby for such legislation to bear fruit.

EMS is a fully diverse service, the majority of which is composed of Blacks and Latinos from the city’s most underserved districts. Its members and officers are over ⅓ female with many openly gay, including the FDNYs EMS Bureau top Chief Lillian Bonsignore. Muslims, Asians, Jews and new immigrants make up a large percentage of the workforce. Approximately 13,500 Emergency Medical Technicians and Paramedics divided in four sectors and over 100 responding agencies, the FDNY being the largest unified group of 4,300.

But the real difference lies in three distinct variables. EMS daily saves human lives. EMS turns a huge profit. EMS is overwhelmingly people of color.

The real “difference” between EMS and all other services is that we are actually worth way more, though we have been bullied and self censored from declaring it. Everyone says “the very worst enemy we have is ourselves”. There is always some truth to that statement. But, we also have a great deal of actual external opposition to our call for parity and justice. Pushing against our members are an array of powerful actors that by action and inaction purposefully block our progress to parity. 

That opposition can be isolated into the following groupings. The FDNY Management, the Firefighters Union, Hospital Management, the Nursing Unions, the ownership of all private ambulance companies, the political establishment of the City and State, the current Mayor DeBlasio and very importantly our own unions which perpetuate the status quo through a “management of expectations”.  With the exceptions of FDNYs 2507/3621 and the IAEP/SEIU none of the other unions are actually dedicated to or specialized for EMS workers. In the end we are divided amid nine separate unions each negotiating for limited possibilities.

Of course the nurses, firefighters, cops and sanitation workers are completely essential. Vital and important. If not for all those heroes, and we don’t say that tongue in cheek, the city would probably come undone. Of course each of their unions and PR machines would like to sweep away the memory of the times each went on strike, repeatedly over the years. The Nurses of NYP, Montefiore and Mt. Sinai NYSNA nurses with start pay around $97,000 voted to go on strike just last year. Time and time again our heroes paralyzed the city and threatened the lives of New Yorkers for exactly the kind of normative middle class wages and benefits we in EMS are asking for today. Of course EMS would never go on Strike for so many different reasons. Most importantly because people might actually die. But make no mistake every other group of heroes has put their economic well being before their service to the city at some point or another, repeatedly.

Nurses are the integral workhorses of the entire Healthcare system.  Like a Nurse, EMS members need to understand concepts of medicine and are supervised by a doctor. In some precise ways our Paramedic skill set is on the practical level is above the  level of a nurse. Nurses definitely do not intubate people or interpret EKGs, or administer medication autonomously. Nurses work very, very hard, but they do so in controlled situations with a great deal of supervision, guidance and support. During a 1998 nurses strike at Maimonides Hospital Paramedics were used in the ER, with beyond adequate performance. The Nursing unions would like to make sure we are never allowed in an ER again. The nurses unions quite actively work to prevent any clear bridge from Paramedic to RN or PA because it would lead to a realization that people paid half what they make, with a different  background can do their job just as well on the ground. When people start whispering about an ambulance strike, which is also against the law, people say “So cruel, selfish and nearly evil, people could die.” But a nursing strike seems to be as American as apple pie. Could it be that in all the previous Nursing strikes, no one died, no one sued? That was because even higher paid nurses were bussed in to temp for them. 

“Without the Department of Sanitation a plague would overtake this city. Or at the very least trash would pile up high, the city would stink and rats would have field day.”

Like a Sanitation worker, EMS members operate a large vehicle in cumbersome urban traffic and all weather conditions, with near total disregard from the public, especially in the Bronx. We must get through the streets making pickups while the public blocks streets with their cars, darts in front of our vehicles and basically flip out when a street is blocked for an emergency. Like sanitation, we have to lift and carry,  albeit not in a rapid repetition. Sanitation doesn’t have to carry 125 Ibs of equipment up six flights of stairs and carry down people around 250 pounds or more. In some ways, like sanitation, a pause in delivery of service will potentially cost lives. Like when Sanitation went on strike during the Blizzard of 2010. “New York’s Strongest used a variety of tactics to drag out the plowing process — and pad overtime checks — which included keeping plows slightly higher than the roadways and skipping over streets along their routes.” Although the Department of Sanitation has a logo somewhat similar to EMS, and is engaged in a vital part of public health, they have regularly blackmailed the city with strikes and slowdowns. The DSNY went on Strike for 9 days in 1968. In the DSNY today after 5½ years, the salary jumps to an average of $88,616 dollars. They have a 20 and out pension.

Like Nurses, EMS members practice medicine. Like Sanitation workers we pick things up and we put them down. But EMS isn’t at the educational level of an RN or engaged in the physical rigor of a Sanitation worker. Parity is thus pegged to Cops and Firefighters. The two most similar jobs,  we basically share a navy blue uniform with and see them on the majority of our calls.

The real difference between Cops, Firefighters and EMS is not only $50,000 in wage disparity, but in what we all actually do on the job. As well as the physical and mental toll it takes to constantly be around death, dying, sickness and trauma. What our job actually results in, not theoretically, is a daily struggle to keep people from dying. A daily struggle to promote health and wellness. The police protect a system of law and order. The firefighters protect property. EMS protects human life and well being.

The police spend the vast majority of their careers fighting quality of life crime and taking reports.  111 NYPD officers were killed on duty between 1980 and 2010. Another way to think of that is 4 per year. A total of 331 NYPD employees have died in the line of duty since 1950, 5 per year. Deaths peaked in 2001, when 23 officers died in the 9/11 terrorist attacks, but the effects are still being felt today. 206 NYPD officers have died from 9/11-related illnesses, which are separate from the 331 officers who died in the line of duty. Police work is still on the 16th most dangerous American job, but decreasing in the number of deaths and injuries per year.

The job of the Police department is “to be a deterrent to crime and enforce the laws”. Statistically speaking they do not get in that many fire fights and they also do not save that many lives directly, except in a noble indirect way by keeping human tribalism and criminal instincts at bay. In 1971 the NYPD staged a Work Stoppage occuring for five days between January 14 and January 19, 1971, when around 20,000 New York City police officers refused to report for regular duty. While officers maintained that they would continue to respond to serious crimes and emergencies, they refused to carry out routine patrolling duties, leading in some cases, to as little as 200 officers being on the street in the city.

In 2014 the NYPD held a work “slowdown” for about seven weeks as political conflict between protesters, Mayor Bill de Blasio and the city’s police unions intensified. Legally, police officers can’t strike, but for 7 weeks the NYPD arrested no one except in violent crimes. For the week of 22 December, citywide traffic tickets dropped 94% from the same period in 2013. Court summons for low-level offences, like public intoxication, also dropped 94%. Parking tickets were down 92%. Overall arrests were down 66%, as well. Nobody noticed.

Though their publicists and the writers of their many TV serials would like the general public to think they do save many lives, “get the bad guys off the streets” and risk their life every single day, they really don’t. Mostly they write reports, hand out quality of life crime related fines and make quota quality of life crime collars. To justify what amounts to a highly respectable middle class wage a Salary after 5 ½ years of  $85,292 which include holiday pay, longevity pay, uniform allowance, night differential and overtime, police officers may potentially earn over $100,000 per year. 

The public didn’t even notice the Police were on strike in 2014. It had almost no impact on violent crime or quality of life. It was as if their main job was needless fines and upholding a “broken windows theory” now widely discredited. But sometimes they do get executed in their squad car, they do get shot at by criminals and they do die. And while being a cop is hard work, it sure doesn’t directly keep people alive. It doesn’t seem to slow any link between quality of life crime and descent into anarchy and most importantly, quota based policing it has led to mass incarceration, illegal/unconstitutional racist methods of policing like “stop and frisk”, and contributed to the deaths of around 1,200 people of color in police custody or killed during arrest in America each year. 1 in 100 Americans are behind bars, on probation or parole.

The NYPD has a clear resentment to the FDNY Firefighters, who are paid more to do a lot less. 95% of FDNY calls do not involve the risk of actual fire fighting. 

The Firefighters after 5 ½ years earn around 110K, they have 20 and out pensions, they work 2 days a week and they have the enduring love and admiration of much of the public. 

As they should, because encountering flames in close quarters is dangerous and risky. Although it is something done mostly by volunteers across America and tens of thousands are on the FDNY waiting list. There is also a strange macho ideology called “interior attack” which worked its way into FDNY methodology, not used anywhere else in the country. Fighting fire inside a building of a working fire instead of dumping water on it from the outside. They proudly claim this is about “saving lives” but it is actually about endangering working class people to protect property. However, because of building codes and modern technology fires make up only 5% of their total call volume. 

The FDNY Firefighters have lost 421 members in line of duty deaths since 1980. 343 on 9/11 and 222 more of lung disease and exposure later. Adjusting this in the same way NYPD deaths are arranged, that is 10 deaths a year factoring out 9/11, that number would be 2 a year.

The International Association of Firefighters says cancer is now the leading cause of death among firefighters. While thirty years ago, firefighters were most often diagnosed with asbestos-related cancers, today the cancers are more often leukemia, lymphoma or myeloma, officials say.

On Nov. 6, 1973 for five and a half tense hours, most of the city’s 10,900 firemen (they were all men) picketed outside their firehouses or simply watched as some 80 fires burned citywide, chanting ”Scab! Scab!” at makeshift firefighting crews.

Today, 95% of the time the FDNY and fire houses across America respond to medical EMS type assignments. Engine company CFRs show up on priority 1 to 3 EMS jobs, just a little bit before the ambulances because they get the call 30 seconds before. The “enthusiasm” they have for battling combustion in the shadow of 9/11 is not translated into an enthusiasm for medical first aid. It is very well documented by now that firefighters leave calls without being released or even assessing patients, firefighters not giving even the most basic report before asking “if you guys got this” to EMS, as well as firefighters abandoning EMS crews before anyone even knew the status of the patient.

Firefighters do sometimes give oxygen and do CPR, in varying combinations of one or two hands, which is to say they don’t do it well a great deal of the time, they do give “lift assists” and they vary radically in level of respect by fire house. They do anything they can to get off the scene as fast as they can. Although they have around 48 hours of CFR training, and some of them are or were EMTs and Paramedics, they don’t ever take vitals. They rarely if ever give any meaningful reports. Then, they remain out of service for 30 to 40 minutes after the release of care. It is also very expensive to send 5 firefighters to participate in this insulting charade. By the hour the same cost would fully fund 4 or 5 entire BLS ambulances. Thus also ending the excuse of their wider geographic distribution.

During the Covid 19 Pandemic they were released of these responsibilities for the worst 2 weeks. For the next worst 4 weeks they slowed down and regularly abandoned EMS crews in the field. 

They had so much time on their hands they took to feeding nurses on television and turning out for the daily public clap. During the course of the pandemic over 30% of the FDNY went out sick. Over 1,000 EMS members and over 2,000 firefighters. The rapidly overwhelmed 911 system had to call in hundreds of the very same private ambulance EMS providers they so regularly denounce and make life difficult for on a  daily basis. That is because the FDNY was unable to manage the pandemic response, as it is unable to manage the normal daily call volume.

9/11 type terrorism, Superstorm Sandy or pandemics aside the FDNY only manages to staff ⅔ of the 911 ambulances. It’s EMS members resign after just 4 years from poor conditions and low wages. It is also the lowest paid 9/11 employer in the City of New York.

There are of course many very brave firefighters, no one begrudges them their good wages and benefits, but they don’t treat EMS workers very well, especially not the 4,300 FDNY EMS workers they share a uniform with. On every conceivable level of abandonment, FDNY firefighters use a combination of the 9/11 legacy and the leverage of their political weight to force an inefficient model of response on the taxpayer. We are literally paying for a loud and nearly useless show since there is no reason that 2 EMTs and 2 Paramedics and a Lieutenant with a Lucas automated compression device cannot manage a cardiac arrest. There is no reason to have 11,000 firefighters when 95% of the calls are EMS calls. There is no reason the FDNY cannot pay its members a living wage in their city.

The realization that our workforce is also a billion dollar operation means that not only do we get exploited, we are propping up the establishment which exploits us.

Parity is a justice whose time has come for people who serve this city. We deliver your babies, we bring back your dead, we carry your wounded off the bloody streets. We check on your grandparents, we bring the ER into the homes of the poorest and most vulnerable, we head to the fires with the firefighters, we careen with ungodly speed towards the shootings of police and gangsters alike. We are there when you are born and when you die. It takes an unknowable toll on our bodies, minds and souls.

Amongst ourselves we must defeat ethnic, garage, agency, union and sector tribalism. No single faction or group has enough members to win this fight. The cops, the firefighters, the nurses, the sanitation workers, the teachers and bus subway operators. They have all used their “essential nature” to bargain for better wages and workplace rights.

EMS will never strike. Because people will actually die, because every day in big and small ways we actually are simply essential. So we are left with two strategies moving ahead and we need to unite 13,500 strong around them. First, we need to tighten the belt, unite the ranks across all sectors and step up the hearts and minds game in all districts. Second, we need clear concise united demands backed up by escalation of industrial action.

If the City Council is allegedly now behind us on parity and the public knows how hard we grind for them before and after Covid 19. We must look our mayor,  managers, unions, institutions namely the FDNY Management, the Hospital Groups and the CEOS in the eyes. We need to say in one voice, “As long as there is blood in our eyes and there’s pain in our backs. As long as we can’t afford the good schools. When we can’t afford to live here and you are unwilling to help us advance our lives! We won’t turn our backs on the public ever, but we can hit you in the pockets. And the public will approve.”

Never forget that the price of one ambulance ride is billed from $724 to $4,000 and that our median wage is $18 an EMT and $25 a Paramedic per hour. Never forget that we do over 4,000 911 calls and 2,000 private calls per day. Never forget that we are completely essential. The time for Parity and Justice is now.

By Walter Adler | Paramedic