Good News Article about Paramedics
In the last two years, Greg Wilson lost his seniority, his six weeks' vacation and took a nearly 50% pay cut. Believe it or not, he couldn't be any happier. Twenty-five years as a paramedic, the 47-year-old father of two says he jumped at the chance to pursue his first love -- firefighting -- in September 2003.
"When I quit working the ambulance and I'd come home, my wife said, 'Look, your shoulders are back down where they should be,'" he says, noting he's among some 30-40 former medics now working for Ottawa Fire.
While he certainly respects the job of a paramedic, the working conditions and lack of professionalism in the burgeoning organization are what really got to him.
He echoes the concerns of those still in the paramedic service -- forced OT, missed meal breaks, the battle for time off for a wedding or family matter.
The final straw came two years ago when Wilson's 10-year-old son fell ill at school while his wife was out of town on business. He'd been complaining of a severe headache and his teacher asked that he be picked up immediately.
Wilson called dispatch to say he had a family emergency and needed to be taken off the road, but by the time he got back to the station his supervisors were freaking out.
GROWING PAINS
"I said, 'Listen, I'll be damned if I'll stay at work and look after the sick here when my own are at home sick and there's no one to look after them,' " Wilson says, noting he ended up spending the evening at CHEO.
"I never worked at a job, when I worked at the ambulance, that took so much and gave so little," he says. "Fire looks after you. Everything that's bad and wrong in the ambulance has been corrected and is right in fire."
Neither paramedics nor firefighters like to admit a certain animosity exists between the two emergency services. But living in the shadows of the well-oiled machine that is the fire department can be difficult for the paramedics which is, by comparison, an organization in its infancy.
Not only are medics struggling for both professional recognition and public understanding -- one sure way to piss them off is to call them ambulance drivers -- they're also fighting politicians who'd rather send firefighters to medical calls than, until recently, hire more medics.
While they often cite the great respect they have for one another's job, the rift is undeniable.
As a paramedic, Wilson always had a good working relationship with firefighters even though others didn't. Since becoming one, he's seen firsthand the hostility medics harbour for firefighters and blames it on fear.
"A lot of paramedics think fire is out to take their jobs. That's not the case," he says. "I knew that the whole time I worked on the ambulance. They're not there to take my job. They're there to help me with my job."
But Danny Cyr chocks up much of what's wrong with the paramedic service to growing pains. He, too, spent three years as a paramedic before switching to fire at the same time as Wilson, only to return to his first love less than a year later.
He always knew he was destined for emergency services -- his late father was a police officer and his uncle worked as a firefighter in Montreal -- but he was torn as to which way to go.
He worked as a volunteer firefighter in Cumberland and Navan, but eventually his love of biology and science led the recently married 29-year-old into the paramedic service.
The significant cut in pay when he transferred to fire was also a major factor, but Cyr says it was the fast pace of the paramedics job and autonomy that really reeled him back.
"Downtime is nice. It's nice to be able to have a meal together as a group and do things like that, but for me I found the downtime a little slow," he says of the fire service.
During his eight months as a firefighter, Cyr says he fought one structure fire and attended a few medical calls but noted the bulk of fire calls involved alarms ringing.
While he admits paramedics stationed in rural Ottawa could go a day without any patient calls, Cyr says it was common to have a day or a week go by with no calls in the fire service.
Wilson says much of that downtime is spent doing on-the-job training and maintaining equipment, but Cyr says he ultimately missed the type of critical decision-making paramedics are required to do on a daily basis.
"I like being very, very involved on calls," he says. "It's necessary we be critical decision makers, fast thinkers because when we assess a patient on scene, it's an emergency scene.
LIFE AND DEATH
"You have to be able to have a working diagnosis of what's wrong with the person within two minutes to decide what course of treatment as a medic you're going to do."
With only yourself and your partner to answer to on scene, there's a lot of autonomy, he adds.
But the paramilitary, hierarchical approach adopted by fire that Cyr rejected is exactly what appealed most to Wilson.
"Fire management, the job itself, from start to finish. They're there to look after you," he says.
In the fire service, everyone knows their positions and there's always a captain on scene to take charge of the situation and delegate responsibility.
Although Ottawa paramedics answer to the city, the Ministry of Health and the base hospital physician who licenses them, Cyr says paramedics, ultimately, must make life and death decisions on their own.
Fire and police, who carry automatic defibrillators and are trained in CPR and first aid, are generally tiered to car accidents and medical emergencies in which vital signs are absent or patients are unconscious -- about 1% of all calls.
Similarly, paramedics are tiered to structure fires, HAZMAT calls, high-risk warrants and any time the police tactical unit is deployed to support their colleagues in risky ventures.
But there has been a drive to have fire respond to all Code 4 potentially life-threatening emergencies -- about 54,000 calls a year. Already authorized to assist patients in taking their own medicine, some in the fire service would like to take it a step further and provide symptom relief -- in essence, carrying common drugs like ventolin for asthma and glucagon for diabetes.
Medics argue firefighters don't have the necessary skills to handle critical medical emergencies and can't transport patients to hospital. Some also suggest it's merely a way to boost call volume to justify their comparatively huge budget.
While the two organizations are structured very differently -- EMS operates in a constant state of emergency while fire is staffed to readiness -- the stats cannot be overlooked.
The paramedic service currently employs 295 medics to the fire department's 989 full-time and 425 volunteer firefighters, has a budget nearly 21/2 times smaller than that of fire and a call volume more than 31/2 times larger. And, if you remove nearly a quarter of those fire calls which were medical in nature, the paramedic call volume is actually six times greater.
'EXTREMELY VALUABLE'
While street medics are quick to point out the incongruity, Paramedic Chief Anthony Di Monte is more diplomatic.
"Our peers and colleagues we work with are extremely valuable," he says. "Police services has a mission to prevent crime and bring the perpetrators of crime to justice. That's their role and they need resources to do that.
"The fire service, I think, as a society, are there because we've put infrastructure in place and they're there as an insurance policy. They're the service of last resort. They've got lots of manpower. They've got lots of capacity."
The fire department, he suggests, is staffed the way it is because there's a certain number of buildings in the city that would need a certain number of people to put out a fire if one started.
Fire Chief Rick Larabie believes the paramedics are understaffed but agrees getting firefighters to do their job isn't the best solution. He maintains his department is only interested in responding to medical emergencies where his staff can be of use and isn't interested in artificially inflating its figures.
"We don't staff for medical calls, we staff for fire protection and to respond to motor vehicle accidents and all the other things we do that are part of ... our core business," Larabie says. "We have different services. They have the ability to rove around. We don't. We have to stay in a geographic area because we need to be within a certain range of striking distance to respond out of the stations."
Dr. Martin McNamara is an emergency room physician in Midland and former paramedic who's done research on the concept of tiered response and the usefulness of firefighters in medical emergencies. He suggests it's time for society to re-evaluate its priorities.
INSURANCE PRESSURES
"I think the fire department has done a wonderful job since the 1960s on fire prevention and petitioning politicians to pass bylaws to make buildings safer and I think it's time we reap those benefits," he says.
Noting insurance companies are largely responsible for the birth of the modern fire department, McNamara suggests the fear of skyrocketing insurance rates is what's keeping our fire departments beefed up, despite the fact there are fewer fires and fire deaths now than 30 years ago.
According to the Ontario Fire Marshal's office, there were 97 fire fatalities last year in Ontario compared to 277 in 1975.
Meanwhile, the most recent local statistics show that in 2003, eight people died in fires in Ottawa. And of the 843 cardiac arrest calls Ottawa paramedics responded to that year, only 6.6% of them survived.
"Even if you spend another $50 million in fire prevention, the most we're going to save is 100 deaths a year, whereas if you put those monies in cardiac prevention or diabetes prevention, you're saving millions," McNamara says, noting Ontario should perhaps invest in training all licensed drivers in first aid and CPR.
Investing in the fire department while neglecting the paramedic service, he says, shows that as a society we value property more than human lives.
Larabie dismisses the idea of scaling down the fire department, noting "the job is ongoing" and the number of fire deaths is still considered quite high.
Besides, he admits, downstaffing would result in a "false savings" as the insurance industry would begin raising its rates as fewer firefighters means longer response times.
Many, including Larbie, Di Monte and McNamara, reject the idea of a joint fire paramedic service, which has gained popularity elsewhere in North America, Winnipeg is the largest Canadian city to embrace the idea in an effort to maximize its resources.
The goal, says Robin Alford, a spokesman for the Winnipeg Fire Paramedic Service, is to better utilize its resources, eliminate duplicate dispatches and ensure medical experts are available when and where they're needed, regardless of what truck they arrive on.
While EMS had been managed by the Winnipeg fire service for years, during the last seven they've taken it a step further hoping to be able to use firefighters and paramedics interchangeably.
During the last three years, all new hires have come certified as both primary care paramedics and Level 2 firefighters and many stations are equipped with fire trucks and ambulances.
You need a minimum level of staff for fire suppression, Alford says, yet the number of fires has "flatlined" over the last two decades.
'UNTAPPED RESOURCES'
"We've got a resource there, why not utilize some of that capacity that's gone untapped. That's what we're doing," he says. "We have an obligation as civil servants to make sure the taxpayer gets the best bang for their buck and make sure that we hire the most capable of folks to do the job that needs to be done."
Alford says the system will ultimately be managed in such a way that staff aren't just theoretically capable of doing both jobs, but will actually be doing both jobs.
Keeping up their skill sets is imperative, he says, noting obviously not every fire medic will be battling blazes one day and treating heart attacks the next. Those who specialize in technical rescue, hazardous materials or advanced care paramedicine aren't likely to do both jobs, yet ultimately, everyone will be able to at a basic level.
Ottawa's former fire chief, Gary Richardson, advocated in 2001 for a merged system, suggesting an amalgamated service could save $3.5 million a year by eliminating the need for two separate management structures.
Before coming to Ottawa, Richardson was in Winnipeg and that city based much of its merger on Richardson's report.
He called for a system in which firefighters and paramedics would learn each other's jobs and use smaller, more economical vehicles that could be used for both fire and medical emergencies.
At the time, Ottawa was trying to amalgamate six EMS systems and nine fire departments. It couldn't even begin to fathom the idea of merging the two.
Larabie says the fire paramedic system model doesn't work well and it's not for Ottawa.
"It takes a lot of effort and time and skills to keep paramedics at their level and it takes a lot of time for the firefighters to get ready for their core business," he says. "We can train to a certain level, but we can never train to the level required to be a paramedic."
Still, the merger in Winnipeg has done a lot to ease the tension and animosity that exists between the two services.
"If everybody understands each other's job, you don't have to perform it," says Alford. "But if they understand it, you work better as a seamless team and you mesh together well in a street environment."
"When I quit working the ambulance and I'd come home, my wife said, 'Look, your shoulders are back down where they should be,'" he says, noting he's among some 30-40 former medics now working for Ottawa Fire.
While he certainly respects the job of a paramedic, the working conditions and lack of professionalism in the burgeoning organization are what really got to him.
He echoes the concerns of those still in the paramedic service -- forced OT, missed meal breaks, the battle for time off for a wedding or family matter.
The final straw came two years ago when Wilson's 10-year-old son fell ill at school while his wife was out of town on business. He'd been complaining of a severe headache and his teacher asked that he be picked up immediately.
Wilson called dispatch to say he had a family emergency and needed to be taken off the road, but by the time he got back to the station his supervisors were freaking out.
GROWING PAINS
"I said, 'Listen, I'll be damned if I'll stay at work and look after the sick here when my own are at home sick and there's no one to look after them,' " Wilson says, noting he ended up spending the evening at CHEO.
"I never worked at a job, when I worked at the ambulance, that took so much and gave so little," he says. "Fire looks after you. Everything that's bad and wrong in the ambulance has been corrected and is right in fire."
Neither paramedics nor firefighters like to admit a certain animosity exists between the two emergency services. But living in the shadows of the well-oiled machine that is the fire department can be difficult for the paramedics which is, by comparison, an organization in its infancy.
Not only are medics struggling for both professional recognition and public understanding -- one sure way to piss them off is to call them ambulance drivers -- they're also fighting politicians who'd rather send firefighters to medical calls than, until recently, hire more medics.
While they often cite the great respect they have for one another's job, the rift is undeniable.
As a paramedic, Wilson always had a good working relationship with firefighters even though others didn't. Since becoming one, he's seen firsthand the hostility medics harbour for firefighters and blames it on fear.
"A lot of paramedics think fire is out to take their jobs. That's not the case," he says. "I knew that the whole time I worked on the ambulance. They're not there to take my job. They're there to help me with my job."
But Danny Cyr chocks up much of what's wrong with the paramedic service to growing pains. He, too, spent three years as a paramedic before switching to fire at the same time as Wilson, only to return to his first love less than a year later.
He always knew he was destined for emergency services -- his late father was a police officer and his uncle worked as a firefighter in Montreal -- but he was torn as to which way to go.
He worked as a volunteer firefighter in Cumberland and Navan, but eventually his love of biology and science led the recently married 29-year-old into the paramedic service.
The significant cut in pay when he transferred to fire was also a major factor, but Cyr says it was the fast pace of the paramedics job and autonomy that really reeled him back.
"Downtime is nice. It's nice to be able to have a meal together as a group and do things like that, but for me I found the downtime a little slow," he says of the fire service.
During his eight months as a firefighter, Cyr says he fought one structure fire and attended a few medical calls but noted the bulk of fire calls involved alarms ringing.
While he admits paramedics stationed in rural Ottawa could go a day without any patient calls, Cyr says it was common to have a day or a week go by with no calls in the fire service.
Wilson says much of that downtime is spent doing on-the-job training and maintaining equipment, but Cyr says he ultimately missed the type of critical decision-making paramedics are required to do on a daily basis.
"I like being very, very involved on calls," he says. "It's necessary we be critical decision makers, fast thinkers because when we assess a patient on scene, it's an emergency scene.
LIFE AND DEATH
"You have to be able to have a working diagnosis of what's wrong with the person within two minutes to decide what course of treatment as a medic you're going to do."
With only yourself and your partner to answer to on scene, there's a lot of autonomy, he adds.
But the paramilitary, hierarchical approach adopted by fire that Cyr rejected is exactly what appealed most to Wilson.
"Fire management, the job itself, from start to finish. They're there to look after you," he says.
In the fire service, everyone knows their positions and there's always a captain on scene to take charge of the situation and delegate responsibility.
Although Ottawa paramedics answer to the city, the Ministry of Health and the base hospital physician who licenses them, Cyr says paramedics, ultimately, must make life and death decisions on their own.
Fire and police, who carry automatic defibrillators and are trained in CPR and first aid, are generally tiered to car accidents and medical emergencies in which vital signs are absent or patients are unconscious -- about 1% of all calls.
Similarly, paramedics are tiered to structure fires, HAZMAT calls, high-risk warrants and any time the police tactical unit is deployed to support their colleagues in risky ventures.
But there has been a drive to have fire respond to all Code 4 potentially life-threatening emergencies -- about 54,000 calls a year. Already authorized to assist patients in taking their own medicine, some in the fire service would like to take it a step further and provide symptom relief -- in essence, carrying common drugs like ventolin for asthma and glucagon for diabetes.
Medics argue firefighters don't have the necessary skills to handle critical medical emergencies and can't transport patients to hospital. Some also suggest it's merely a way to boost call volume to justify their comparatively huge budget.
While the two organizations are structured very differently -- EMS operates in a constant state of emergency while fire is staffed to readiness -- the stats cannot be overlooked.
The paramedic service currently employs 295 medics to the fire department's 989 full-time and 425 volunteer firefighters, has a budget nearly 21/2 times smaller than that of fire and a call volume more than 31/2 times larger. And, if you remove nearly a quarter of those fire calls which were medical in nature, the paramedic call volume is actually six times greater.
'EXTREMELY VALUABLE'
While street medics are quick to point out the incongruity, Paramedic Chief Anthony Di Monte is more diplomatic.
"Our peers and colleagues we work with are extremely valuable," he says. "Police services has a mission to prevent crime and bring the perpetrators of crime to justice. That's their role and they need resources to do that.
"The fire service, I think, as a society, are there because we've put infrastructure in place and they're there as an insurance policy. They're the service of last resort. They've got lots of manpower. They've got lots of capacity."
The fire department, he suggests, is staffed the way it is because there's a certain number of buildings in the city that would need a certain number of people to put out a fire if one started.
Fire Chief Rick Larabie believes the paramedics are understaffed but agrees getting firefighters to do their job isn't the best solution. He maintains his department is only interested in responding to medical emergencies where his staff can be of use and isn't interested in artificially inflating its figures.
"We don't staff for medical calls, we staff for fire protection and to respond to motor vehicle accidents and all the other things we do that are part of ... our core business," Larabie says. "We have different services. They have the ability to rove around. We don't. We have to stay in a geographic area because we need to be within a certain range of striking distance to respond out of the stations."
Dr. Martin McNamara is an emergency room physician in Midland and former paramedic who's done research on the concept of tiered response and the usefulness of firefighters in medical emergencies. He suggests it's time for society to re-evaluate its priorities.
INSURANCE PRESSURES
"I think the fire department has done a wonderful job since the 1960s on fire prevention and petitioning politicians to pass bylaws to make buildings safer and I think it's time we reap those benefits," he says.
Noting insurance companies are largely responsible for the birth of the modern fire department, McNamara suggests the fear of skyrocketing insurance rates is what's keeping our fire departments beefed up, despite the fact there are fewer fires and fire deaths now than 30 years ago.
According to the Ontario Fire Marshal's office, there were 97 fire fatalities last year in Ontario compared to 277 in 1975.
Meanwhile, the most recent local statistics show that in 2003, eight people died in fires in Ottawa. And of the 843 cardiac arrest calls Ottawa paramedics responded to that year, only 6.6% of them survived.
"Even if you spend another $50 million in fire prevention, the most we're going to save is 100 deaths a year, whereas if you put those monies in cardiac prevention or diabetes prevention, you're saving millions," McNamara says, noting Ontario should perhaps invest in training all licensed drivers in first aid and CPR.
Investing in the fire department while neglecting the paramedic service, he says, shows that as a society we value property more than human lives.
Larabie dismisses the idea of scaling down the fire department, noting "the job is ongoing" and the number of fire deaths is still considered quite high.
Besides, he admits, downstaffing would result in a "false savings" as the insurance industry would begin raising its rates as fewer firefighters means longer response times.
Many, including Larbie, Di Monte and McNamara, reject the idea of a joint fire paramedic service, which has gained popularity elsewhere in North America, Winnipeg is the largest Canadian city to embrace the idea in an effort to maximize its resources.
The goal, says Robin Alford, a spokesman for the Winnipeg Fire Paramedic Service, is to better utilize its resources, eliminate duplicate dispatches and ensure medical experts are available when and where they're needed, regardless of what truck they arrive on.
While EMS had been managed by the Winnipeg fire service for years, during the last seven they've taken it a step further hoping to be able to use firefighters and paramedics interchangeably.
During the last three years, all new hires have come certified as both primary care paramedics and Level 2 firefighters and many stations are equipped with fire trucks and ambulances.
You need a minimum level of staff for fire suppression, Alford says, yet the number of fires has "flatlined" over the last two decades.
'UNTAPPED RESOURCES'
"We've got a resource there, why not utilize some of that capacity that's gone untapped. That's what we're doing," he says. "We have an obligation as civil servants to make sure the taxpayer gets the best bang for their buck and make sure that we hire the most capable of folks to do the job that needs to be done."
Alford says the system will ultimately be managed in such a way that staff aren't just theoretically capable of doing both jobs, but will actually be doing both jobs.
Keeping up their skill sets is imperative, he says, noting obviously not every fire medic will be battling blazes one day and treating heart attacks the next. Those who specialize in technical rescue, hazardous materials or advanced care paramedicine aren't likely to do both jobs, yet ultimately, everyone will be able to at a basic level.
Ottawa's former fire chief, Gary Richardson, advocated in 2001 for a merged system, suggesting an amalgamated service could save $3.5 million a year by eliminating the need for two separate management structures.
Before coming to Ottawa, Richardson was in Winnipeg and that city based much of its merger on Richardson's report.
He called for a system in which firefighters and paramedics would learn each other's jobs and use smaller, more economical vehicles that could be used for both fire and medical emergencies.
At the time, Ottawa was trying to amalgamate six EMS systems and nine fire departments. It couldn't even begin to fathom the idea of merging the two.
Larabie says the fire paramedic system model doesn't work well and it's not for Ottawa.
"It takes a lot of effort and time and skills to keep paramedics at their level and it takes a lot of time for the firefighters to get ready for their core business," he says. "We can train to a certain level, but we can never train to the level required to be a paramedic."
Still, the merger in Winnipeg has done a lot to ease the tension and animosity that exists between the two services.
"If everybody understands each other's job, you don't have to perform it," says Alford. "But if they understand it, you work better as a seamless team and you mesh together well in a street environment."