"My name is ________________ and I am with _________ Fire Department. My long term goal is to be a full time firefighter and I will need my Paramedic to get hired."
This Mad Lib is what circulates the beginning of every classroom during the first semester of paramedic school. With the majority of fire services unable to sustain a career viability from shear fire calls, EMS has been a vital component of assuring an income to support budget demands of a full time service. The engines in some cities even respond to more EMS assignments than fire. It would only make sense that incorporating fire & EMS together would logically be the smartest thing to do.But let's take a look at what mindset we are subscribing to when we create a two for one package.
The Mindset As an EMS instructor I have to admit that the majority of the students I see who take an EMS course, echo the statement in the beginning of this article. Now I will openly agree that this is not always the case, and there are still students who primarily are interested in emergency medical services. The problem is that that depending on where you live, it is very difficult to make a career out of a "non fire" EMS job. This creates individuals who are either forced into fire or EMS to make an acceptable income. When you tell a die hard bartender he has to cook in the kitchen occasionally, he will only cook as well as he tries. If his mind and priorities do not desire this position, it will be very difficult to maintain efficiency. "No man can slave for two masters: for either he will hate the one and love the other, or he will stick to the one and despise the other." (Matthew 6:24)..... sorry I had to!
"All new firefighters HAVE to put in their time on the box before they get bumped to an engine or ladder." This is a statement that was expressed to me by a local career fire chief. The statement helped me appreciate that "the box"on some services, is a less than desirable position. It is no question that the ambulance will leave the station twice if not more often than a fire apparatus. This means more calls, transports, and reports for the crew that is assigned to ambulance duty. We now have an individual who desired to be a firefighter running the majority of his shift as an EMS provider. While not every fire dept makes new firefighters earn their keeps through time on the box, the reality is the majority of firefighter's will spend most of their career on an ambulance.
A Broad Brush I will agree that many of the statements and view points above are painted with a broad brush. I have seen many fire services that openly admit they are an "EMS service who occasionally run fire calls." One of the departments that stand out to me is Hilton Head Island. My friend Tom Bouthillet is one of the most progressive leaders in resuscitation. He spends countless hours assuring that his staff is putting a huge emphasis on medicine and the logistics that surround it. I believe that the desire to "be better" in EMS is driven from the top. If your Chief and budget don't make room for consistent EMS training and quality improvement, neither will your providers. Lead From The Middle If you have read this far and are a career firefighter paramedic, you are probably the exception. You are maintaining a current knowledge of best practices in EMS, and constantly looking for ways to improve. This article unfortunately will never see the other side unless it's printed and taped to the coffee pot. It is very hard to change the mentality described in this blog if leadership is not on board. Leadership is typically filled with seasoned veteran providers who feel "things are just fine the way they are." It is up to you to lead from the middle and show that they aren't.
We designed a "Department Evaluation" for you to examine how your service prioritizes EMS.
Go down the list and add points for each category that aligns with your current service.
(3 Points) Performs quality monthly EMS training.
(1 Point) Does not routinely transport patients on a long board.
(1 Point) Has an FTO system for new hires.
(2 Points) Does not remove patients from a ventilator and bag them for interfacility transports.
(1 Point) Utilizes Video Laryngoscopy.
(1 Point) Carries an IV pump.
(1 Point) Progressive QA System.
Your Score
1-3 Knuckle Dragging Basement Flooder
3-5 Average
6-8 Above Average!
8-10 Progressive!!!!