Just Like We Planned, Not Quite

Friday night is my thing.  I don't know why I have just always enjoyed doing things at the end of the traditional work week.  Recently it was no different.

Many of our firefighters enjoy taking our turn on the ambulance.  It is a real opportunity to get out and interact with the community, dust off a few skills, and just maybe help someone.  I ask for open shifts because the "we live for this" calls are really drying up for the fire only set.

So we are out tonight with an Explorer in our ambulance.  We allow young high school aged students with an interest in health care or EMS to ride along as an observer and maybe help with a few simple things in the back of the ambulance.  It's a great program and the kids get credit for community volunteer work that they need for graduation.  A win win if you will with the hope that they will continue their interest and get the training to replace me in the not too distant future.

We were in the day room listening to dispatch after dispatch all around us until finally the dispatch Gods hit us for an ALS call on the other side of the middle of no where.  We were headed deep into our fourth due area.  Get out the map books!  Luckily by the time we got there the ALS fly car had secured a recall by physician and we headed back out to a non-dirt road.

Then another dispatch a mile from us, covered by the returning  local area crew.  We were thinking about  a nice leisurely trip back involving ice cream.  Then just as they say, when you least expect it, expect it.

Rescue, Engine, Squad, covering ambulance (mine) multi-injury MVC.  Car into a bridge, with ejection and...we didn't hear the rest because we had our siren on and the Turbo begging for fuel.  We were past station five before the chief responded and arrived immediately after the police.

As we arrived on scene we saw a person on the road, and others in the car.  We split and I did Mass Casualty Assessments and prioritized the three patients.  It was at this point that I began to understand how lucky we were that this particular Explorer was with us.  He already had backboards out collars ready and was talking to the police officer holding traction on my patient.  By the time the rescue arrived we had the patient on a board and headed to our ambulance.  ALS arrived and we started preparing for the arrival of a medical helicopter.  Eventually a second medic and another ambulance showed up to complete treatment on the other two patients.  Both units provided transportation to trauma centers.

This is the way it's supposed to work folks.  Efficient, expedient, effective.  Thanks to a bunch of firefighters that "just did their job" and an extra pair of hands that provided us with the stuff we needed even before we needed it lives were saved.

We missed ice cream that night. We even got back after shift but we felt good doing good.  Those calls don't come around everyday but when they do we fall back on our training and the educated help of our brothers.  It's good to know that we can all rely on each other.  Thanks.

EMS WEEK 2013

Let's take some time to review the past year.  No extravagance just see what we've accomplished:
Ah...  OK, not too much.
What about goals?

• Figure out what we're doing and take some classes to remember it.  Incompetence make all of us look bad.
• Not everyone deserves respect, but give it to them anyway.  Because if  you don't you disrespect all the rest of us trying to do a good job.
• Hold the Holier Than Thou for church.  We don't know what other health care providers are up against every day so don't dis them either.
• Driving to a call like you are at a NASCAR event?  Stop and think of the consequences, and hope you don't kill me.  So help me God, I'll come back and haunt you with back to back to back nursing home calls on every one of your shifts.
• Act like a professional and you will be treated like one.  And so will the rest of us.

I appreciate the tenor set by Rescuing Providence, Ambulance Driver, and Happy Medic.  What can you add?

Sometimes It's Simple

Don't Reinvent the Wheel

How often have we heard that statement?  Sure all of our organizations are special, diverse and autonomous but we all fight fire, respond to haz-mats, and even make EMS calls.  That makes us more alike than we ever consider.  We all need vehicles, equipment, supplies, and people.  It might just be that we deal with these in a different way than our neighbor or the larger or smaller department across the country.  But we all must meet both our needs and requirements to make things work in the best interest of our communities.This deals with all of that.

If we personally want to buy something new we can check at local merchants, ask our friends, or cruise the internet.  During the information gathering phase we get tips and tricks that help our cause and some that divert our attention from its original focus.  Yet all of it helps with our knowledge base and comfort factor and have some bearing on our final decision making process.  Why not take advantage of that process and availability of information  if we are having trouble with a specific part of our job?

I'm sure that others have faced many of these same problems or opportunities that we are now staring down.  Possibly they have posted their findings or decision making process on the internet for our review.  Or better yet they are willing to share directly with us by phone, e-mail or letter.  This shortens our process builds on our community and allows us insight into how others operate and face their own issues.

Use what's available.  Give credit to those that saved you time.  Honor the wishes of your resource if they are reluctant or unwilling to share their information.  There are often compelling reasons for their unwillingness.  Most importantly complete your due diligence and confirm the information that you find.   Along that same line, one of my favorite quotes is "You can't trust everything that you read on the internet."  by Abraham Lincoln. Although Honest Abe probably never said that,  using a trustworthy source is paramount in looking for and finding good helpful material.

What does this have to do with anything?  Well I am using my own advice to write our next installment.  Now that you have the background please check back for the real story.  Stay Safe.

I'm Just Sick. Hello Flu

Well in this case brown is not good.  The picture is from the CDC update of flu across the USA.  It indicates that it is widespread across over 80% of the country.  Get the Flu Shot!  It is one of the principle ways to fight against this annual onslaught.  I don't care what you heard about getting sick from it or somebody's second cousin's ex-wife's, child's friend that died.  Without the shot you just get to spread the disease.  Nice way to help.

What else can I do you ask?  Well how about returning to PPE and hand washing?  Great suggestions!  That may include a mask over those with a cough.  Why take a chance bringing the flu back to your family?

In addition you can clean and sanitize your equipment and ambulance.  Yeah, it's a pain in the butt, but it slows or stops the spread of the flu and many other germs.  If you can't remember the last time you wiped down the cot, seats, and walls now's a good time.  Flu can live from 2-8 hours on surfaces so cleaning and disinfecting is a big deal- even when you are busy.  Maybe especially when you are busy!

If you get the flu?  Stay home.  Drugs can slow it or mitigate the symptoms but you have to let it run its course.  That's probably about a week.  During that time every time you cough you share a little with others. Wait until you can't spread it any more.  Or better yet Get the Flu Shot!

The Collective Us

We have seen reductions in Fire and EMS.  Not to the extent that some of the very large services but by and large just as painful.  Couple this with my new found duties to run the executive side of our EMS service and you have the equivalent of another part time job added on to the work time and subtracted from the family time that was already nearly nonexistent.

Don't get me wrong I LOVE what I do.  I live what I do.  And I revel in the hey you're a firefighter (or EMS guy) can you help me/answer a question/recommend/tell me/show me stuff.  A community connection that I don't take for granted.  But the expectations are rising while at the same time we are being told to do more with the same or less resources.  For example.

During my tenure in service to my county we have added three new EMS stations, closed one, and lost a number of fire brigades due to plant closures and the like.  We have not changed the number of fire stations but now have fewer folks to man the apparatus.  Not unusual.  But last weekend when I took an open shift on the ambulance we drove by three stations that were dark.  We responded 25 minutes to the call that was covered by the fire QRS from the local station.  Apparently no one told me that only some stations man an ambulance during these low call times.

  We have seen an annual increase in the calls for our ambulance from year to year but this year has been exceptional in the quantity of calls.  So far this year, if we don't have anymore calls, we have run a record number of calls.  Each call we get in the last two months of the year adds to that record,  Our call increase is in the neighborhood of 25%.  That's a lot of extra calls.  But the biggest change in our calls is the number  outside our normal service area.  That increase was over 30%.  What's next?

Well at a fire today only one engine and an ambulance were available.  Four people to provide protection to our community.  It occurs to me that this may be the future of our service.  Provide minimal staff and hope for the best.  Relying on second, third, and further alarms to bring in a force capable of taking on the task at hand.  Something we would have done with first alarm personnel years ago.

The "Collective Us" can provide a solution to some of these problems.  But it will take working together at a level unheard of in our area.  Can we bring an ambulance staffed with one person and pick up another on scene to complete the crew?  Should we respond a centrally located unit to every call to make sure that someone gets there in a reasonable amount of time?  Stop looking at areas as mine or ours and start sharing resources   Cover for each other and possible announce units out of service during nights so other trucks are aware of what area they are really covering at any given time.  Possibly reduce the amount of equipment and increase the amount of paid staff.  It's a thought, for the "Collective Us."

Layoffs

Well, the ugliness of present day politics and financial management (mismanagement?) have finally come to roost in my office.  I have had to break the news to some of our most recent hires that even though they have done nothing wrong and quite frankly are doing a good job for us their services are no longer required.

Don't get me wrong, prior to this I have fired employees for cause and although it was difficult working with the union and meeting the requirements to terminate their employment it was a necessary evil to make the whole organization better.  I understood this and some how it seemed reasonable at the time.  Generally the employees even understood that we were following the rules and every courtesy had been extended to them.  We had quite frankly given them the rope to hang themselves.  We never left as friends but at least with an understanding that this was the culmination of decisions that were made by the employee.  I played the heavy but never really felt the pain.

I feel it now as I see my employee.  The somber shuffle into my office.  The twist of heads by their former fellow employees to avoid eye contact.   The deer in the headlights look as they sit in front of me waiting for a pronouncement.  The pain conveyed through their eyes, through their slouch, through their nervousness in the chair.  They speak volumes even prior to our conversation.  They have worked for and next to me, campaigned for staffing and financial reason, read the paper, heard and saw the news, and understood that it is the end of the line.  Last in first out.

I am truly sorry and convey that to them.  They don't acknowledge  because they are already trying to grasp the new uncertain reality that awaits them.  Some how I have failed.  It's no longer about the politicians or some far away decision maker it's only the two of us.  There is nothing else in the universe, just my spoken word and the silence that follows.  I have an acute feeling of inadequacy.  They have an acute feeling of loss. Neither one of us is willing to share with the other.  The meeting is over.  The dark cloud begins to expand from the office throughout the building and over the organization.

Planning, meetings,  adjustment of duties, new policies, and significant change at many organizational levels begins.  Almost with no time to mourn the loss.  There are today's and tomorrow's hurdles to jump.  And  then "Dad I had a great first day at school!" discussion ensues and in closing with the directness only a child possesses, " My friend said their parent lost their job.  I gave them two of my pencils."

I wonder what pencils I have to share?