There are a lot of good clinically focused blogs out there on the Internet, and mine certainly isn’t one of them. That’s not to say that I don’t feel I’m a sound, clinical paramedic, because really I do, I just don’t write about the medical topics. “Being a provider” and the challenges that we face as an industry interest me more. I do, however, feel the need to talk a bit about Quality Assurance and Quality Improvement and what they mean to me. I came from very humble, small EMS Beginnings. Growing up in Suburban New Jersey, most of the BLS 911 work was done solely by Volunteers. While my clinical experience was great, my knowledge that went into documentation and the feedback that I saw from it was almost non-existent. Although we would provide what I felt was excellent care, when we got to the Emergency Room, it seemed to me that the care started over. Run forms that were written were poorly written at best, some as short as one or two sentences that attempted to sum up the events that led to the patient landing in the ER. Fast forward now a few years to my freshman year of college. I didn’t know any better from what I learned in New Jersey. I thought that was “the way” to write a run form. I participated for four years in our Campus EMS Department, and in my freshman year, our advisor brought in a Lawyer to review our run forms and let us know how we were doing. I’ll never forget it; mine was one of the ones that ended up on the overhead projector: “Patient fell during a flag football game and injured his ankle. Patient refused treatment.” That was it. Two sentences and I was done. There I sat, a young 19 year old EMT, raked across the coals by a lawyer pointing out all of the problems with documenting like this. I quickly learned my lesson, and put 100% into my documentation, both at college and at home in New Jersey. Now, here I am, 13 years later, working in a busy urban system as a Supervisor and ten...

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...

11 years ago right around this time, I was spending every free moment that I had studying for my Paramedic Class Final. It had been 11 long months of work, where I had sacrificed time away from family and friends to help achieve a dream that I had: to be a Paramedic. That 250 question final was staring me straight in the face, and after that, it would be off to my Clinical and Field time. I had learned a lot in those 11 months, and had also learned a lot in my 4 and a half years that I had been an EMT prior to that. There were still plenty of lessons that were waiting for me on the road ahead throughout my career. If someone was to ask me what I thought some of the most important qualities that a Paramedic should have, some buzzwords that come to mind are “caring,” “compassionate,” “clinically competent,” and “hard working.” That would be my politically correct answer though. There are some other qualities that lie under the surface that are rarely discussed with the public that people should know about and be ready for if they choose to make EMS their career: Strong stomach — During your career, you will see and smell things that no person should ever have to. When you encounter them, you will be expected to keep a straight face, stay calm, and act like it doesn’t bother you one bit. Able to work independently — There will be times when that other truck, or even your partner might not be near by. You may have to work a cardiac arrest by yourself. You could pick up the radio and ask for another truck and hear those terrifying words: “No units available.” Above all else, be ready for as much as you can with little to no help. Innovative — In EMT and Paramedic class, you will learn about algorithms and what to do for a patient quiet often in the best case scenario, but remember what Murphy’s Law teaches us: “Anything that can go wrong, will go wrong.” You need to be able to think outside the box and adjust...

It’s Thanksgiving. The fire is burning in the fire place, football is on the TV and the bird is in the oven. I’m in New Jersey with my family, and all is well. The way would not be complete without talking about and recognizing the people and things that I’m thankful for. My Family — As some of you may know, I’m an only child. Shocking, right? As a result, I am extremely close with my parents. Over the years, they’ve helped me become the person that I am, taught me to be the best EMT and Paramedic that I can be, and they have supported me through every decision I’ve made in my life, good or bad. Joe and Amy Francis — Joe was my roommate in college for three years, and I have considered him my best friend ever since. He’s helped me through many, many crises in my life, and shared some of my best memories. Three years ago, he and his wife Amy brought into the world their son Thomas. They were the first in our group of friends to have a kid, and he was, as a result, adopted by all of us. I don’t know where I’d be without Joe and his family. Emily — A few of you have met her. She’s one of the strongest people I’ve ever met and she doesn’t realize it. Although she might not be at her best right now, I am proud of her, and will always stand by her no matter what. There are few people that I care about more than her. Natalie — We’ve both been through some tough times over the last couple of months, and frankly, I couldn’t imagine dealing with any of it without her friendship. She always brings a smile to my face, and always knows the right thing to say. She’s a strong, beautiful woman with a huge heart. I’m proud to call her my friend. Ted, Justin, Mark and the whole Chronicles of EMS Team — Never in my life would I have expected to be part of a community lead by a group as strong and amazing as these guys. They’ve...

During our careers, we all make mistakes. We’re human. It happens. What really matters is what you do with the lessons that you learn. The only thing that is more difficult than accepting that you made a mistake is admitting that you made one, so I thought I would share one here. I started out my EMS career working the weekend overnights. Every Friday and Saturday night, I spent my time flying around the city while everyone else seemed to be enjoying themselves. Well, thankfully, I was enjoying myself too. I looked forward to going in every night. I had a great partner, and a great group of coworkers who I became very close with. Everyone had everyone else’s back, and as afar as an EMS environment goes, it was exactly how I hoped it would be. Every Saturday morning, the core of the group (about 6 or 8 of us) would head out for breakfast and drinks together at our local watering hole. We’d swap stories and talk about the experiences we had the night before, and then head to bed to ready ourselves for the Saturday night that was ahead of us. Occasionally, we would repeat this ritual on Sunday mornings. Sadly, our usual spot was closed on Sundays, so we would randomly pick another breakfast nook somewhere in the city. The Saturday night before the morning in question was a particularly busy one. We hadn’t seen much of each other, so a little quality time with the group was welcomed by all of us. As we sat waiting for our breakfast, the topic of conversation turned to two patients that we had encountered the night before. One had called us three times, the other twice. This was not an uncommon occurrence for either of these individuals. The three time caller, we’ll call him Fred, was our most notorious of frequent fliers. He was a lonely alcoholic who would take trips to the ER just to have someone to spend time with. On this night though, the ER didn’t want anything to do with him, so each hospital discharged him quickly, put him in a cab, and sent him home. The other...