Jun 5, 2017

Any time I peruse the pages of EMS related articles I will inevitably come across some service that is trying to take over another service’s area.  Diving deeper into those articles usually reveals the same usual arguments.  Imagine my surprise when I clicked on an article about the East Longmeadow Fire Department’s move to take over EMS response in the town of East Longmeadow. I should first point out that what I am about to write is meant to represent my own personal views on the state of the industry.  I have not inquired about anything having to do with the current staffing of ambulances and volume.  What I am reflecting on is the article and just the article coupled with my years of experience in the greater Springfield area. Just to give a little bit of background here, I used to have a dog in this fight.  As many of you know, I was a 12-year employee of American Medical Response, the last seven of which as a supervisor.  I participated in contract bids for the town, and saw service improve as the requirements of those contracts increased.  AMR currently provides EMS service to the towns of East Longmeadow and Hamden free of charge.  The service is paid for by those who use it.  They respond to more than 2,000 calls a year, and AMR or its predecessor companies have served the town for more than two decades. The East Longmeadow Fire Department is currently a part time department covering daytime hours only, with off hours supported by call staff and volunteers.  Their Chief, Paul Morrissette, has spent his entire career in East Longmeadow.   The East Longmeadow Fire Department does not provide EMS first response in town and even if they did, the ambulance would most likely beat them to virtually every call because they are deployed from street corner posting, quite often from the same area where the fire department is located.  To put it briefly, neither Chief Morrissette nor the department currently have any experience operating an EMS service. In an article recently posted in The Reminder, a regional online publication, Chief Morrissette is quoted as saying, “AMR isn’t always familiar...

As the days tick past American Medical Response draws closer to going “live” with their new public/private partnership with the District of Columbia Fire and EMS Department.  After a story posted earlier this week about a traumatic cardiac arrest that sat for close to 30 minutes without a transporting unit being available, it is clear that the time is now for something to change in the nation’s capital. The coming months are going to be very telling for the future of EMS not only in DC but throughout the country.  From a personal stand point, I am very excited to see in what direction everything goes.  There is a lot of influence in the AMR DC operation from my old stomping grounds in Springfield, Massachusetts.  Their Operations Manager, a guy by the name of Mark Nuessle, was one of my first supervisors when I hit the streets back in 2000.  About a half a dozen people who are being brought in from around the country to help with the hiring and training process of close to 200 new employees have some sort of tie to Springfield as well.  It really speaks volumes about the system that I came from. With the involvement of national resources, I also think that this partnership says a lot about AMR’s ability to strive for success.  Often seen as the biggest of big business in prehospital medicine, when AMR steps up to the plate like they have recently on the east coast, they deserve a lot of credit.  Some critics of private EMS will speak of the “lost jobs” from the closing of companies like Transcare or like Falck’s recent move to pull out of Pennsylvania but AMR has been there to pick up the pieces.  Closures like this do not mean that jobs are going away.  People still have to do the work, it just means that a company with a better ability to operate in today’s health care climate are stepping up to the plate to provide the service.  In fact, AMR is adding close to 200 jobs to the Washington, DC market in particular, and that is a huge step forward for the private sector. I cannot...

Aug 20, 2014

I was really happy when I started seeing chatter on twitter from Cherise Leclerc from CBS 3 after she read my original post Best in the Country that I put up on Sunday.  They were interested in Roy and Nick’s story and wanted to do a piece on it.  Over the course of the day on Tuesday, the whole thing was recorded, the interviews were done, and footage from the competition in Colorado was obtained.  I have to say Julia Leonardi did an excellent job with the story.  Have a look for yourself. . . CBS 3 Springfield – WSHM These are the kinds of stories that we as an industry need to make sure are told.  It shows the true clinical ability that service is capable of because Nick and Roy are a product of the environment that they are surrounded by.  Although people do not always get to see and hear about it, the staff at the Springfield Division of AMR does one heck of a job.  They are professional, they are competent and they bring a level of experience both collectively as field providers as well as a service provider in the area that cannot be duplicated.  A piece like this gives people an inside look into what happens after the time stops on the response time clock that so many people like to say is so important when it comes to EMS. To add to the press coverage of this story, Masslive.com reporter Conor Berry did his own piece based on the CBS 3 story.  Check it out here! Although Roy and Nick did not place, they had one heck of an experience in Colorado and I am proud of both of them and I know that I am not alone.  Well done, guys.  And thanks to Julia Leonardi, Cherise Leclerc and the team over at CBS 3 Springfield for telling a story that had to be...

Aug 17, 2014

Every year, American Medical Response holds a nationwide skills competition amongst their divisions.  Tryouts are held regionally and eventually the top six divisions in the country who scored the highest in the preliminary competition are sent to Colorado to compete for the right to brag that they are the best in the country.  For the second year in a row, the Springfield, Massachusetts division is represented in the finals.  Last year, it was a pair of paramedics Erin Markt and Kim Arnone who represented my old stomping grounds.  This year it is a pair of paramedics Nick Chirekos an Roy Rudolph who will be representing Western Massachusetts. The event is held in a large “simulated” city where a crew is given a fully stocked ambulance and asked to respond to calls in this mock setting where they are heavily monitored and thrown curve balls around every corner.  The stories that Kim and Erin told me last year were great.  It sounds like such a fun experience, and each of them took something from the competition. First of all, I want to to say how great it is to see AMR holding an event like this.  As the largest ambulance company in the United States, it rests on their shoulders to also strive for clinical excellence.  Putting their divisions in the spotlight like this is a great way to showcase just how good the company has become clinically.  While I am not surprised to see Springfield heading to the finals yet again, I feel like it is something that deserves quite a lot of attention. With the brewing turf war in Holyoke, Massachusetts with their fire department, and past investigative “reporting” on the division’s performance in Springfield that revolved around response times this is yet another example of how great the clinical care being provided in the greater Springfield area really is.  While some will complain about AMR as a corporation and their motives in the medical field which are occasionally driven by their need to be a profitable company for the stakeholder’s sake, the motive for the street personnel has and always will be to deliver the best patient care that they are capable...

I’ve struggled with how much of this I should post as it gets rather personal for me in a number of ways.  My final decision is that I should, and need to, lay everything on the line.  I may offend some, others might roll their eyes at some of this but this is my story, like it or not, take it or leave it. Over the last year and a half I have been asked by a number of people in my new system, “Why did you come here?”  My usual answer is “I don’t have enough time to explain it all, which is partially true.  The truth of it all is though that most of the reasons that I left Massachusetts revolve around my tipping point which took place during the first week of June in 2012.  I think it’s time that I set the record straight.  Any statute of limitations I would potentially be violating should have lapsed by now, right? In April and May of that year there was some major restructuring done to AMR’s Northeast Division.  The regional manager was let go and was replaced by a former manager at Rural Metro.  At first, it did not seem to have much impact on us, but I remember being at a training for my part time job at Six Flags and having to step out for an “emergency conference call” to announce the change.  It came as a surprise, of course, but a subdued one at that.  The next few weeks it was “business as usual” in my operation. The first week of June had been a particularly turbulent one in 2011 when I dealt with the worst natural disaster that Springfield endured during my tenure with the tornado that hit on the first, so that week already carried a lot of memories for me.  During those first few days of June of 2012, it seemed like it was just about all that we talked about. The first of June was a Friday, and that day passed rather uneventfully.  I worked the day shift.  Many of us swapped some stories, and we all went home that night feeling good about ourselves....

Fifteen years ago I was just getting ready to wrap up my first semester of paramedic class.  We started in January and ran straight through to December with most of our summer dedicated to ACLS.  My teacher, Gary Childs, was tough on us through the first five months, but once we started getting it, we looked at it less as him being critical and more so of him challenging us.  Many pushed to get in his practical station first and as CJ Bartone, one of my classmates often said, “If you want the bull, you’ve got to take it by the horns!” Through the first two semesters of class, I started a list of what would go on to be known as GAC’isms.  G.A.C. were Gary’s initials, and that is what he put on any check sheet a student might have when they went walking out of class.  This list comprises some of the more common statements he made in class as well as some of the more noteworthy and less frequent ones.  Many of my readers might not completely understand this but I feel like there are many out there that have encountered Gary, either as one of their head instructors at Springfield College, or as a lecturer in some other CEU class.  Enjoy! 1. Then we’re going to turn around… 2. Does this sound like… 3. Do you see where we’re going with this? 4. You’ve got to make the soup. 5. Do you need to know if you’re putting the sugar in the bath tub or in Island Pond? 6. Chase the lion or be chased by the lion. 7. Chase the PVTA bus or be chased by the PVTA bus. 8. Palpate, auscoltate and inspect. 9. A P-Wave… 10. Harley’s going to do his ET(O2)IVMONITOR… 11. That’s a snowball thrown at the police cruiser. 12. Eating the Lion and celebrating eating the lion. 13. The TV set doesn’t know what the cable company is. 14. I want to watch Sipowitz on NBC. 15. We’re hitting the ground running. 16. Its all coming together now. 17. You’ve paid the cable bill. 18. Does this patient need to go to Cooley Dic...

Aug 30, 2013

Every EMS system in the country, and most likely the world, has their share of “regular” patients.  It was brought to my attention via Facebook that Springfield lost one of its most well known patients who was a frequent user of the ambulance service there for close to 30 years.  No one, however, has been able to find an obituary, so I decided to write one for him. . . Donald Spittlehouse (1945 – 2013) was called by his own personal higher power sometime in the past two weeks.  While the exact date of his passing is unknown, his loss was felt far and wide throughout the EMS community in the greater Springfield, Massachusetts area. While much of Donald’s background is unknown, his reputation was legendary and the kind of thing that fables are made of.  Some said that he was a simple machine worker who spent most of his life in New England.  Others, however, said that he was an ill fated former MIT professor who fell into a deep state of depression after having his heart broken.  Donald was known by many names, and would occasionally be referred to by the code name “Mr President.”  Some would also say that he could single handedly be credited with keeping the pay phone market alive in Springfield. Donald was most well known for his affinity for trivia, especially when it came to geography.  He could recite without hesitation the capital of each of the United States, and many countries throughout the world.  He was a skilled at crossword puzzles and would often contribute to clues that would commonly stump many amateurs while waiting for the arrival of his “extended family members.”  While some might have been frustrated in their interactions with them, Donald was also the recipient of the kindness and generosity of the medical community in the form of breakfast sandwiches, coffees, and the occasional shower and shave. It is unknown if Donald left any family behind.  He was, however, predeceased by many who had a similar place within the EMS community, namely such legends such as Stephen Donahue and Zoya Shaw.  He is, however, survived by countless paramedics, EMTs, nurses and doctors...

I have been giving some thought to the recent events in Springfield involving an ambulance being struck by bullets, and a rather real looking BB gun being pulled on a tech in the back of an ambulance.  That, along with the law passed this year in Delaware got me thinking, and i figured I would pose a question of the readers. If an EMT or paramedic is assaulted, where should the responsibility of filing charges fall?  Should services have a zero tolerance policy regarding violence against their employees?  Should they be encouraged to strongly advocate for their employees with law enforcement and encourage their people to file charges, assisting them along the way?  Or should they take a hands off approach and leave the decision and procedure of pressing charges to their individual employee? So, what do you...

A lot has happened over the last two years during this first week of June.  I was thinking back and reflecting on it the other day, and I realized how much I have been through during this time, as well as my career. June 1, 2011 was quite the day.  I have written about it a lot since the days that followed it, but the Springfield Tornado was one of the craziest days of my EMS career.  Two years later, Springfield still looks different.  All one needs to do is just take a drive down Island Pond Road and look at the lack of trees to realize how much the landscape has changed.  The rebuilding that has taken place over the entire region has been remarkable though, and people deserve to be commended for the work that they have done. This picture is from the evening of June 1st, and I think it might be the first time I actually got to sit down and take a break that night.  We were holed up a convenience store on Island Pond Road just blocks from one of the most severely damaged stretches of streets in the city.  Our dinner that consisted of whatever we could get off the shelves of the store, most of which was bought for us by now retired Springfield Fire Department Captain Stan Skarzynski. Looking back at our choice of where we set up, it probably was not the smartest place to park our 15 ambulances.  At one point during our time there, we received a “take cover” order over the air.  We looked around and realized we really had nowhere to go except for maybe the back cooler in this glass front convenience store.  We got lucky though, and moved on to our next staging location unscathed. June 2, 2012 was the day that I was motivated to aggressively start looking for a new job.  A couple of days later, I posted this post talking about the intersection in my life that I found myself at.  What followed was a very long six months of testing, classes, and worst of all sitting and waiting.  The end result one year later...

It is not difficult to figure out where many of us out here in the blogging world get our material from.  Some of it is derived from frustration, and some of it from lessons we have learned that we feel the need to pass on to others.  With this blog more than three years old, it doesn’t take a rocket scientist to figure out where some of my material comes from.  It is from my past, and from MY experiences in the years that I worked for AMR in Springfield and frankly, I could not be more proud to say that Springfield was where I spent the first twelve years of my career. In a meeting Thursday night held by the City of Springfield’s EMS Commission, the five commissioners voted unanimously to recommend American Medical Response to handle the 9-1-1 contract in their city for the next five years.  Last night I posted on my personal Facebook page that this decision was a “. . . much deserved and expected victory” for the staff at AMR Springfield, and now that I look back on it, and look back on the decision, I do not feel that statement fully describes the impact of the EMS Commission’s recommendation to the city. The real winners in this situation are the citizens on Springfield because they are getting the best care that they possibly could by having the paramedics and EMTs of AMR Springfield to respond to their emergencies.  AMR has had the opportunity to be in the lime light a few times in the past couple of years with the tornado of 2011 and the gas explosion of 2012 to name just a few, and while those calls were very high profile and visible, they barely make up a chapter in the story of AMR Springfield. The things that are really important are the things that happen every day.  It is not the multitude of trucks that I had sitting in our staging area on Worthington St that night, it was the other ambulances that were out still answering the “routine” emergencies that made the difference.  It was not just our crews going to door to door...