When I hear anyone suggest that the merger of fire and EMS is a mistake because “firefighters lack the skills to provide paramedic care”, I am highly insulted.
When I hear the ex-chief of a metropolitan department regretting decisions to bring medical providers and fire services together, I wonder aloud how he can continue to stomach the fact that it isn’t the inmiscible nature of these professions that caused the problem but the culture that the “leaders” of these organizations permitted to continue and encourage.
I admit that I know people with what could be termed the “fire” mentality and those with the “EMS” mentality. But these individuals seem to be the minority now, rather than the majority. Fortunately, I work with a lot of people who have the “Fire & EMS” mentality; people who are open to the belief we can do both well, we can exceed at the skills, we can meet our customers’ needs, and we can enjoy the diversity that having two “jobs” rolled into one provides on a daily basis.
I happen to work in an organization that merged fire and EMS together in 1993. Prior to that, the two fire departments provided first responder service to our community to supplement the response of our local rescue squad. Ultimately, with the merger, we took all three of these agencies and combined them into an outstanding example of emergency medical service delivery. EVERY line employee is required to be at the MINIMUM a nationally registered EMT-Basic and of those personnel, over 40 of them are National Registry Paramedics as well. This doesn’t count each of our chief and administrative officers who were all certified EMTs as well, and also doesn’t count our Training Division officers, who are both NREMT Paramedics as well. Our organization provides a highly-recognized service to this world-class resort community and has incorporated 12-lead ECG monitoring and interpretation along with telemetry to reinforce our STEMI recognition program, among other programs like Island-wide AED promotion and education, public CPR and First Aid programs, car seat installation, and many, many other efforts. I honestly work with some of the most outstanding EMS personnel in the nation and I’d be honored to let them work on anyone in my family, which is good, because I live in this community as well.
I have had it with anyone who suggests that EMS should be the exclusive domain of the third-party providers, especially since, with rare exception, a good number of these “non-fire service” providers don’t seem to provide any better of a service than the fire department EMS providers. In fact, I know that our agency is an excellent EMS provider and is right now striving to be more than just excellent, but to be “state-of-the-art”. With leaders like Lt. Tom over at the EMS 12-Lead ECG Blog, and Pete at the Star of Life EMS legal blog, we have a very good chance of putting ourselves in the position of being innovators and setters of the gold standard.
I would never suggest that fire-based EMS is the ONLY solution, but there are a few dinosaurs out there who continue to insist that EMS can only be effectively provided by non-fire department providers. Apparently, stuffing themselves in their too-tight BDUs and hanging out at the local donut shop has occluded some sort of cerebral perfusion. I hope they are watching carefully as the rest of us, the people who desire to have community-based EMS delivered by competent and caring providers, regardless of agency affiliation, kick them to the curb.
Your agency can only be as good as the personnel you retain; if you continue to recruit people who can’t do the job, the community shouldn’t be surprised if the situation won’t work. Volunteer or career, you get what you pay for, and if the community doesn’t invest in good training, good equipment, good leadership, and good methods of keeping personnel, they shouldn’t be surprised if all they get is a crappy EMS system.