Accountability for Providers

“I’m just a volunteer EMT.” Have you ever heard anyone say that?  Neither have I.  Just about every volunteer provider that I have encountered in my career, regardless of how long they have been doing it or what their dreams and aspirations actually are take a ton of pride in serving their community.  As many readers already know, I come from a family full of volunteers and an area that up until about ten years ago, the area that I grew up in was almost 100% maintained by volunteer EMS.  Sadly, volunteerism is on a decline, and there are many, many reasons for that.  A few weeks ago, EMS 1 reposted an article and tried to tackle some of those reasons with a few really good articles. One article cites expanded EMT training for lack of volunteers.  EMS 1 Editor in Chief Art Hsieh then wrote what I feel is an excellent reply pointing out a lack of change and evolution as the culprit.  Both stories make some excellent points. In the past, I have written rather candidly about the problems as I see them that the New Jersey State First Aid Council presents to EMTs in my home state.  Their organization demands different standards for staffing a volunteer ambulance than a paid ambulance to try and keep volunteer EMS alive.  Essentially, they are trying to create a new level of care that is specific to their services resulting in them keeping the EMS system in New Jersey on life support. In many states EMT students are expected to learn more than they have ever been asked to before.  They are asked to expand their assessment skills, provide more invasive treatments, and give medications that previously were reserved only for paramedics.  To be able to properly understand how those medications work, a greater knowledge of body systems is also required. Enough is enough.  Sure, obtaining an EMT certification takes more time now than it did even five years ago, but there is a good reason for that.  No one is trying to circumvent the volunteer system in any state.  The changes instead are in place to improve the level of care that patients receive...

Bad Publicity and Saving Face – Your Comments

Read the original post and the comments it generated: Bad Publicity and Saving Face In my two years of blogging, I have seen what I considered to be a few “big” days.  A post goes up, it generates some buzz, and I get a decent amount of hits, usually a few hundred.  This past Monday though, any previous numbers I had seen were blown out the window.  In the first 24 hours that my post about Joshua Couce and the Newton First Aid Squad was up, I saw almost 4,000 visits to my site.   I received a number of comments about this post, and I thought that I would take some time to highlight some of them for you. First of all, I would like to share with you a few comments from Newton FAS members: Member of 15 years: “It is an unfortunate situation that has come about by someone that has been mentored by some of the finest EMT’s around, yes I am a member of the NFAS and I have to say yes Josh made a bad decision by over indulging in the truth, I believe that youth plays a big role in his decision making process. I am in NO WAY CONDONING his behavior or how he portrayed himself and the squad however there is not one person out there that has not made a bad decision weather it be in the professional sense or the personal sense, and unless your back yard is completely clean maybe people should reach out to Mr. Couce and help him grow and mature within the EMS community rather then hanging him out to dry along with the rest of the squad.” Debora Baldwin Phillips: “Mr Kier, I thank you for your insightful post. Some of the points you address are valid. We, as the squad are aware of them. I will not address them in a public forum. However, I, as Captain of the squad, assure you, and anybody else concerned the issues are being addressed. Deborah Phillips, CT1” Thanks to both of you for sharing your thoughts, especially you, Captain Phillips.  Believe it or not, I wish you well in your future...

Bad Publicity and Saving Face

Late last week Kyle David Bates posted an article from the Ithacan, a paper from Ithaca, New York about EMT Joshua Couce from the Newton First Aid and Rescue Squad in Newton, NJ.  In the article Justin describes such events as “driving over 100 MPH” in an attempt to beat the “golden hour” and being covered in a variety of patients’ bodily fluids.  The outcry and comments on the from EMTs, some of whom know Couce personally, are mostly filled with disdain for the way the article painted EMS professionals as a group as an unprofessional group of adrenaline junkies more concerned about what they are able to accomplish with a heavy right foot than the outcome of their patients. The response of the Newton First Aid and Rescue squad was to post a message on the department’s Facebook page denouncing the article, stating that Joshua Couce had been suspended and disciplinary action was being taken effectively hanging Justin out to dry to take full blame for the statements and quotes within the article.  It stated that the article was written “without the consent of the squad and its officers.”  The only problem with that is, as KDB so aptly points out, the squad’s 2nd Lieutenant Rick Wahlers was quoted in the article as well. To read the article for yourself, follow THIS LINK. The entire course of events is a real comedy of errors, the fallout of which is far reaching.  Not only have personal reputations been effected, but the squad’s integrity has been brought into question and potentially the values of EMTs everywhere could be brought into question. 1.  The Newton First Aid and Rescue Squad – First of all, a full admission of what knowledge of the article prior to its publishing needs to be explored and put into public record.  I am basing this off of the squad’s swift stroke of the virtual pen in putting the entire burden on the shoulders of an 18 year old kid. Also, it would be wise for the First Aid Squad to take a closer look at how it mentors its junior members.  Throughout my time doing EMS in New Jersey, I encountered...

More on New Jersey EMS

To read all of my posts about the New Jersey State First Aid Council, and the struggles of EMS in New Jersey, just click here. For more information on the NJSFAC click here. Earlier this month, I had a friend from New Jersey send me the latest information sheet put out by the New Jersey State First Aid Council in regards to State Bills S818 and A2095.  While the bills are slowly gaining momentum with the current vote on Bill S-818 resulting in 21 “Yes” 15 “No” and 4 “Not Voting” as an official for the NJSFAC stated in a recent email, “The fight is not over.”  EMTs and paramedics that live and work in New Jersey need to understand the true fabric and importance of these bills. The First Aid Council’s intention was to share their views which are in the form of oppositions to many of the amendments that were recently made to the bills.  Here is my rebuttal to a few of their arguments.  Please take a good look at this, especially if you are a New Jersey EMT. FACT: The New Jersey State First Aid Council opposes the establishment of a new lead agency for EMS.  For some reason, the NJSFAC opposes this amendment because it would give “. . . complete control over and all facets of EMS in the state including some that are already overseen by other groups. . .”  My question to this is: what’s the issue? EMS is a fragmented profession, and New Jersey is no exception to this.  In fact, in many aspects the fragmentation of EMS is magnified in New Jersey.  In some states, differences exist in counties.  In New Jersey, the unique setup of each EMS system right down to staffing and equipment varies from town to town and squad to squad.  Rules and regulations vary depending on whether or not you are a volunteer ambulance service or a professional one.  In New Jersey, an ambulance is not an ambulance and an EMT is not an EMT. Establishment of a lead agency for the state would create one entity for everyone to answer about everything.  Standardization could be developed.  Studies could be...

EMS in New Jersey – A Call for Action

Almost a year ago, I wrote a post about NJ State Bill S-818 which was set to change the landscape of EMS in New Jersey.  In the year since that article was written, the bill and a second one also making its way through the New Jersey legislature have been revised, but the opposition has remained. I got my start in EMS at the Jersey Shore on a small volunteer first aid squad.  We ran, on average, around 400 calls a year, pretty busy for a town of our size.  Often times, it was not uncommon to have two or three, or sometimes even four EMTs standing in your living room in my town ready to render you emergency care.  The communities around us were no different than we were.  We all took pride in what we did, and knew that we could deliver better service than any paid provider who came into the area because we held ourselves to a very high, very professional standard. To this day, I am still proud of my accomplishments as a volunteer.  I was an active member of two excellent services, and the staff of those services taught me to be the caring, compassionate, knowledgeable provider that I am today.  My roots in New Jersey run deep, and I have been very troubled by what I have been reading lately. As time has progressed, and the political and economic climate in this country has changed, volunteer EMS has taken a turn, and is not as prominent as it was even ten years ago.  Families are working harder to support themselves, and the call volume and expectations of care have grown and evolved.  Some might say that these factors spell the end of volunteer EMS, and I hope every day that it isn’t the case.  It’s not the time to expect less from our volunteers; it’s time to expect more for our patients. Sadly though, the New Jersey State First Aid Council seems content with the past.  Their staunch opposition to Bill S-818 has taken the focus off of where it needs to be: the patient and put their stress on what EMS is about on the provider. ...

I Couldn’t be More Proud. . .

Back in the 1970’s, my dad decided to take his shot at getting involved in the town’s First Aid Squad. When I was born in 1978, he stepped away from hit to be a father. In early 1992, he began working on getting his EMT Certification Recertified and rejoined the Island Heights First Aid Squad. Island Heights is a very small town at the Jersey shore. Approximately a mile by a mile, it has a year round population of 1,500 people, and gets a little higher in the Summer Time. Throughout the late 80’s and most of the 90’s, the majority of the EMS Runs the Island Heights First Aid Squad had were during the day, Monday thru Friday in neighboring Dover Township, now known officially as Toms River. Annually, they would run around 500-600 calls a year, about 150 of those in town. My dad was involved in EMS for about 6 months when my mom got tired of just sitting around listening to the pager go off all day. She decided that she would give this whole “EMS thing” a try. Her first year was very tough. She lost 15 lbs, and on some early mornings would cry when the pager would go off, although she probably wouldn’t admit to that today. She scaled things back a bit, and started running more abbreviated hours, and then decided that EMS really was for her. Through out the 90’s, my parents became more and more involved in EMS in the town. They both served as Captain, my dad spent time as Squad President, and they’ve both been the most active members of the squad for the last 18 years, and most importantly, they’ve been an inspiration to me. I got involved in EMS at the age of 15 as a Cadet with the Island Heights First Aid Squad, following in the footsteps of my parents. Say what you want about young people in EMS, but I think I handled myself the right way and learned how to be the right kind of EMT because of my parents, their involvement in the squad and their involvement in my early years in this field. They supported...

John "Big John" Glowacki

As you all know, I got started in EMS at a very young age. The area of New Jersey that I grew up in is rich with a long, distinguished history of Volunteer EMS and Fire personnel. I remember being in my EMT class at the age of 16. It was taught in a large auditorium filled with about 75 people. Every Tuesday and Thursday night, we’d sit there enjoying lectures, or break up into groups and run skills stations, with the ultimate goal of adding all of us to the long, distiguished list of graduates of Community Medical Center’s EMT program. That was where I met a man by the name of “Big John” Glowacki. He was a man whose reputation as a gruff, hard nosed, demanding yet professional person preceded him. John was an EMT Instructor, one of our dispatchers, and Life Member and Captain of the East Dover Volunteer First Aid Squad. It was impressive that had accomplished all of this by the age of 30. When I turned 18, John approached me and asked me if I would be interested in riding with him on his Tuesday Day Duty Crew on his squad. I wasn’t a member, but a lot of us who rode days down in Dover Twp (now known as Toms River) worked together to do what we could to get as many trucks on the road as possible. At some point during my career down there, I rode on a rig from five of the six Township departments. For the next three summers, and starting in the afternoons when I was in high school, I would come home, call John, and let him know I was in service. During that time, I learned a lot from him, not only from a patient care stand point, but also from an attitude and professionalism stand point. John wasn’t as mean as some people made him out to be. Sure, he was demanding and authoritative sometimes, but there are few people who I have encountered in my career who were more dedicated to the field. I never saw John lose his cool on a call. He was always so calm,...

The Revision of EMS in New Jersey

As some of you may or may not know, I got my start in EMS in the state of New Jersey, and more specifically at the Jersey Shore.For the first 8 years or so I was an active member with two different Squads servicing Ocean County.I still have family and friends in the area who are very active in the EMS Community. New Jersey possesses some unique issues when it comes to Pre-Hospital Care.A large amount of the system State wide is still Volunteer based at the BLS Level.ALS Services are limited, and must be hospital based or hospital affiliated, and largely participate in prehospital care as non-transporting units. While there is a State EMS office, it is often rivaled by the New Jersey State First Aid Council which advocates for what it feels should be beneficial changes to the EMS system in the state to keep Volunteer EMS alive.Membership in the NJSFAC is not mandatory, but they expect departments affiliated with them to maintain the minimum standards they set. As time goes on, more Volunteer departments are having a tough time getting rigs on the road to care for the sick and injured.As a result, many municipalities are starting to turn to paid ambulance services or Municipal Third Service or Police Department affiliated EMS systems.The NJSFAC’s solution in response to this problem though is to lower the required level of care on most ambulances within the state from a mandatory 2 EMT staffing to one EMT and one First Responder/Driver. Paid ambulance services, municipal or not however, are required to have a minimum of 2 EMTs on each truck. While speaking with family today, I was told that they had a conversation with one of our New Jersey State First Aid Council representatives who voiced his displeasure for pending state bill S-818, seeing it as something that could potentially destroy the Volunteer EMS system in the State of New Jersey.Intrigued, I decided to take a look at it for myself. NJ State Bill S-818 was developed in response to a state-wide EMS study that was conducted in 2006 and released in 2007.It is a 150 page document that outlines the accomplishments and short...