You really want to get off on time this morning. It’s been a long night, the weather has been cold and snowy, you’ve fallen on ice a couple of times, you’re fighting a cold, you haven’t had more than a few minutes of sleep, and you just transported a 500-lb. whiny frequent flyer who peed all over your cot. You’re not feelin’ the love right now. You’ve had it with EMS up to here. It’s eight minutes until shift change, and your relief is nowhere in sight.
That’d be bad enough, but of course the alarm goes off for an MVA on the interstate, and you’re personally invited. You’re cr-r-ranky. You watch the parking lot for the relief crew’s cars, but it’s not happenin’. These two have a reputation for barely beating the clock. You pull out of the station and switch on your lights. Halfway to the freeway ramp, you pass one of them on his way in. He exaggerates a grin, and you return it with equal exaggeration (plus a few suitable syllables).
You listen for the first responders, hoping for a cancel that doesn’t come. You won’t be getting off duty for another two hours.
There’s a better way to do this, Life-Saver. It’s easy, it makes sense, and it doesn’t cost money. I think it was invented by an old paramedic named Chris Olson, back in the ’70s. Last I checked, he was still doing it. Here are the moving parts.
In 1977, Chris was one of six crew members assigned to the sole paramedic unit in Chula Vista, Calif., near San Diego. Chula Vista was a happenin’ town even then, but medic units were pretty rare. None of the surrounding communities had paramedics, so they were included in the Chula Vista service area. Nor was there any ALS mutual aid. If you transported a code and another emergency came in, you offloaded, cleared, changed your O, broke out your backup drug box and took the second call. If the call couldn’t wait or you couldn’t clear, a BLS crew took it.
Sometimes that meant a crew ran more than 24 calls in a 24-hour shift, and they were mostly patient transports. That made paramedics out of some people, and other things out of some others. But it also forced crews to find a solution for those end-of-shift calls. Chris gradually got his crewmates to agree to come in 30 minutes early for their shifts. (Well, most of ’em.)
If a crew made it back to the station and got a call within a half hour of the end of their shift, they were covered. If they were stuck offloading at a facility, Chris and his partner would meet them there and give the offgoing crew their personal car keys. (They were usually Chris’ keys, if he was coming on shift.) The crews would do a turnover, and the oncoming crew would help with the restock and cleanup. The offgoing crew could then devote as much time as necessary to charting and stuff, and return in the personal vehicle.
The payroll people pitched a fit at first, but the boss said no worries. It reduced overtime, and it kept those offgoing crews from running calls in their sleep. It was good for the crews, and it was even better for the public.
One improvement on this great idea is a staff car. People wouldn’t have to use their personal cars if a staff carƒmaybe one with a supervisor in itƒwas available for the crew exchange. That would actually facilitate all kinds of basic leadership functions.
When I was just a pup, it was easy to see cowboys as heroes. One of the things that impressed me was how they would salute each other by just touching the brim on one of those big ol’ cowboy hats. Real cowboys and cowgirls still do that, and they ain’t just sayin’ howdy. For them, it’s also a sign of professional recognition ƒ mutual respect for the pain, the awful hours, the risks, the mud, the brutal heat, the bitter cold and the meager finances that define their lives. All of which should sound kinda familiar to an EMSer. Maybe we could all use a gesture like that.
This one would do, all right.
The author would like to thank Ann Forster for her help in the preparation of this column.
Thom Dick has been involved in EMS for 36 years, 23 of them as a full-time EMT and paramedic in San Diego County. He’s currently the quality care coordinator for Platte Valley Ambulance, a hospital-based 9-1-1 system in Brighton, Colo. Contact him at„[email protected].