The picture will make sense by the end of the post….honest!
Ive been listening for quite some time, gathering information as best as I can, and participating in more than a couple of discussions about one topic in general. One which doesn’t affect me in my role over here (yet!), but one which seems to be a bit of a hot potato in the states.
That of Firefighter Paramedics…
If you have been reading my blog for more than a month you will know all about ‘The Project’. If not, then click here to read about what is going to be a great learning experience and hopefully a chance to share ideas and maybe even change some practices when I go over to work with The Happy Medic, and when he returns to the UK to work with me.
(just a quick side note, we are still awaiting final approval from my employers for this to go ahead, but with my Chief Executive and Director of Ops backing the exchange, I can only hope that it will get the green light soon)
I was reading Happy Medics blog the other day when I came across this post. HM is going to be losing the ambulance that he usually works on, so will loose the opportunity to complete a full patient episode from call to the ER. From now on he will remain an ALS paramedic, but will only respond as an initial response before a standard ambulance crew arrives and takes over care of the patient. If you read his blog, you will know how passionate he is at being a paramedic as well as a firefighter (which apparently isn’t that common amongst firefighters).
Which brings me to my point and question.
Should EMS and the Fire Service be joined? Should there be a joint qualification of a Fire Fighter and a Paramedic, or should the two professions remain separate?
I am straight away going to set my stall out and say that I am writing this now so that I can have my opinions down to reflect on after I have been out and worked with HM (whenever that may be). I have just finished listening to last weeks episode of the EMS Garage, where they have a brilliant discussion on the merits (or not) of having a fire based EMS system. I would advise everyone to go and have a listen, It really is a very interesting discussion.
So, what are my thoughts?
There has been a long standing discussion and some trials in the UK for Fire Services to ‘co-respond’ for the Ambulance service. In these instances, they would attend certain categories of medical or traumatic emergencies and act as ‘first responders’ to deliver immediate Basic Life Support and basic interventions until a Paramedic arrives on scene. Even though this has been tried, it has apparently failed due to the Fire Brigade unions fighting against the change in their practices.
Personally, I would love to have my colleagues in the Fire and Rescue Service help us out, as ultimately it is my patients that will benefit. The ambulance service is a very busy service. Certainly, on my station, all of the crews tend to be out for the majority of the shift, with many occasions out of our primary area. The residents of my community then have to rely on crews from farther afield to provide cover which of course brings about longer response times. Wouldn’t it be great if the two Fire appliances at my station were then available to plug the gap for cover for life threatening emergencies in my own area?
My stations Fire Fighters are very quiet. they tend to get a full nights sleep most nights and rarely go out during the day much. It appears that this would be the same in America if you took away the medical calls, with Fire Departments having a split of 80% medical calls compared with only 20% for Fire/rescue stuff. As Fire Prevention continues to improve, then the Fire Service in this country will continue to be relatively quiet and could be a great resource for assisting the very stretched UK ambulance service.
So, to clarify – Yes to Fire Brigade First Responders!
But, what about Fire Fighter Paramedics?
I have had a number of conversations with two close blogger friends from the states. One has very strong views about splitting the two and making them independent of the other, the other can see the benefit in being duel qualified, but maybe that is because he is one of the few(?) who work as hard to be an exceptional paramedic as well as an exceptional Fire Fighter.
I cannot see that ever happening over here, and I can honestly say that I don’t think that I would want to see that in the UK. It takes all my time and energy to ensure that my medical skills, background knowledge and current and future practical knowledge are up to date, without having to think of learning another completely different career. One which has its own problems and training needs to deal with.
The other questions is, do the two different careers attract the same type of people anyway? If not, is it possible to have a good firefighter be a good paramedic and vice versa? Im sure it is in some cases, but is this the minority or the majority?
I am intrigued to see how it all works over in the States. I cant wait to get the go ahead and just get over there and see if my preconcieved ideas are right or completely wrong.
What do you think?
Should it be a Fire Service and an Ambulance Service or should it be the Fire&Ambulance Service?
Whoops, almost forgot….The picture…..
During my initial Advanced Technician training, one of my Instructors gave an analogy of what was happening to the UK paramedic back then. At the time, we were changing dramatically, new skills were coming on line every year, greater responsibility for referring onwards, respond not convey training, autonomous thrombolysis for MI etc etc etc. He said that we were becoming like lego paramedics, and every year we get more ‘bricks’ added on. One day the lego paramedic will fall over with the pressure and instability of all the bricks!
If thats the case with paramedics, how many more bricks would be added if you turned us all into firefighters as well???