Friday, November 30, 2007

Our Tipping Factor

Lately, if you have not noticed already, I have been on a mission; the goal being pride in our equipment, our work and ourselves. Every day I am inspecting units and giving feedback to the crews while I do it. My message: broken is no longer acceptable! I believe in what Malcolm Gladwell, the author of Tipping Factor (I strongly recommend the book), had to say. The key premise goes something like this:

Social change does not occur in the smooth linear way which many people imagine.

Often social values will suddenly transition or ‘tip’ from one state into another. Social change such as crime rates and fashion can often behave in a manner which is similar to the spread of diseases.

A tip can often be achieved by the compound effect of relatively benign factors.

Too much graffiti and too many broken windows can tip a neighborhood from being a good neighborhood into a crime ridden no-go area. Additionally, the behavior of key individuals in a social group can make quite bizarre actions (such as suicide) not just acceptable in a group, but also fashionable and desirable.

In order to repair a problem, you need to perpetually guard against seemingly insignificant factors in order to effect change.

When the New York underground decided to try to clean up the crime and vandalism on the tube network, they started with the graffiti. The theory was that by cleaning up the appearance of the trains, the feel of the tube network would be improved and people would start to feel more secure and crime would be discouraged. In order to clean up graffiti on their tube network they did it in a staged and defensive manner. A small number of trains were designated as ‘clean trains’. These trains were not allowed to slip and become covered in graffiti even though other trains remained ‘dirty’. The number of clean trains was extended in a sustainable manner at the rate the tube system could cope with until the problem tipped and became controllable.

Applied to neighborhoods, the principal is that an area can hit a point at which there are so many broken windows and walls covered in graffiti that it can change people’s social values. It suddenly becomes 'OK' to break more windows and deface property, and this can move on to more serious crimes being committed once people get a taste for misdemeanors. At this point the neighborhood has tipped and will rapidly go downhill.

In order to affect change and tip a bad district back into the light, it is necessary to actively repair broken windows and clean up graffiti, because without improving the environment that people live in there will not be enough social impetus to allow the residents to control and discourage antisocial behavior.

As long we tolerate a cluttered, dirty and broken environment, we are communicating to each other that it does not matter; lost, broken, or not following the rules is not only ok, it is expected. We must be careful in the “tip” and take a cue from New York, focus and claim one area at a time and not let it slip back. I start with the ambulances. They are billboards, and they are the living space of our crews and clients. Think about it… MEMS has long stood for excellence in EMS. We have always been known for having top of the line equipment and medics. This reputation was hard fought for, and must not be allowed to slip during our tenure.

This is a group effort, fueled by pride and peer pressure! I am starting with the inspection and repair of the ambulances, but there is even more to do. We will not stop until our whole environment is one that reflects our excellence!

Let’s show our pride!

We don’t like anytime that our profession is diminished by the unwitting opinion of anyone that has no real understanding of our business, so why would we want to fuel negative perception with any poor presentation? We have pride in what we do! So let’s show some, by maintaining our work tools and ourselves the best that we possibly can – all the time!

Greg

Paddles Missing in Action???

I have been doing unit inspections all week. (For the record, no one has passed) In my looking I have noticed that several of the trucks are missing the paddles for their LP 12. Did you know that the paddle set cost $500.00? Did you know that the reason we have paddles in addition to the fast patches is for a back up. I was one of the crews that found themselves on a code and the fast patch cable did not work, if not for the paddles we would have been out of luck. It is not just good business to keep up with a $500.00 piece of equipment, but it is good patient care!

Subsidy update

Faulkner County

There has not been a final vote yet, but unofficially it appears the vote in Faulkner County will not be in favor of a subsidy. Jon and I met with the Liberty crews this morning to discuss our plans. The abbreviated version is;

The subsidy is needed to cover part of the year, so we will leave the Liberty crews as they are till sometime in March. By then we will have a better picture of the new MEMS Alert Campaign that is starting up. Should Faulkner County get enough new subscribers it may be that the subsidy request can be adjusted. If there are not enough new subscribers we will be forced to change Liberty to what we are calling a “Super 14”that is basically a 12 hour style shift with the crews working 14 hour shifts. We believe this will work in a ‘rural’ setting and not in a ‘metro’ setting. We have a few details to work out concerning pay etc.

Lonoke

Lonoke has not voted yet on a subsidy, we have notified them that we will be forced to discontinue services March 31 2008 if an agreement cannot be reached. We hope that this will not have to be the case, but by law we cannot provide services at a loss.

Maumelle, Conway, Cabot, Sherwood have all voted in favor of paying a subsidy to continue to have MEMS as their provider.

Sheridan gets a new pad

We have been looking for a station for the Sheridan Crews. The one they are currently in is needing a lot of repair and is not sufficient for two crews. We have located a brand new, never lived in duplex just across the highway from Dr.Winston’s Clinic. The builder/owner is putting in a cased opening between the units to make the building suitable for us. The building is not quite finished yet, but we should be able to move in late December no later than 1st of January.

East End crews will be moving to Sheridan. The East End station will be used as a post, until we make a finial decision as to the trailers disposition.

Monday, November 26, 2007

Saftey Changes

I wanted to update everyone who some safety changes we have made to station one.

Crash Cart

We have added a crash cart at station one. It is located just outside the east door of dispatch in the closet across the hall. You old timers will remember it as the old time card room. It is a red craftsman tool chest similar to what is used in the hospitals. It is labeled so things can be easily found. Louis Moore is responsible to keep it majored.

Restroom Locks
The restrooms at station one have had no key until recently. The fear was, if someone passes out in the restroom, we would have to break in a solid wood door, with a steel frame. We have remedied this by getting keys, and changing the locks that had no keys on all the restroom doors. They are held by any supervisor or dispatch if one is needed.

I encourage everyone to look around your surroundings for any other potential issues that we have missed. Each outlying station should have make sure that the exits are still well marked, fire extinguishers are visible etc...

Unit inspection time

I have worked on a couple of different units lately and to be frank, I was amazed at the build up “interior dirt” on both trucks. I have begun to look at other units on a case-by-case basis and found that the units I ran on are not isolated cases of poor cleanliness. I understand the argument that we are busy etc… however, if it were your family member that you were picking up, you would want the unit as clean as possible. With the recent news stories about MRSA and other infectious diseases, we cannot stand the charge that we are lazy in the area of cleanliness. I have shown a few crews that it takes hardly any time at all, to clean one more thing when out at the hospital. (a wall this time, the next wall after the next call etc..) Not only should the patient compartment be clean, the interior should be as well. When patients families ride in the passenger seat, the area around them is the only gauge they have of our equipment and cleanliness.

I am giving fair warning that we are beginning the process doing a complete fleet inspection. We will be looking at unit cleanliness, stock, damage to any equipment etc… We are also setting aside time to do a fleet wide major. I encourage you now to use your time wisely to get ready for this inspection.

Greg

Gabe Tischler celebrates his Birthday on November 29th. Happy Birthday!
Randy Barrett celebrates his Birthday on November 28th. Happy Birthday!

Perry Carlton (top) and Steven Tyler share November 27th as their Birthday. Happy Birthday!


Dennis Mitchell (top), Lee Ramsey and Ben Madill all share November 26th as their Birthday. Happy Birthday!

Thursday, November 22, 2007

Thanksgiving at staiton one


One of the down sides to EMS or any other career in emergency services, is the fact that we work on the holidays. While others spend time in their homes with their families, you work so they can have the peace of mind that "in case of emergency" you are there. It was a pleasure to spend time with those I could, I understand that Conway and Cabot had very good meals, one thing for sure, we have some great cooks. I had the privilege of spending time with Ron at station one today, that put the day into perspective for me. One writer said of gratitude:

Gratitude unlocks the fullness of life. It turns what we have into enough, and more. It turns denial into acceptance, chaos to order, confusion to clarity. It can turn a meal into a feast, a house into a home, a stranger into a friend. Gratitude makes sense of our past, brings peace for today and creates a vision for tomorrow. ~Melody Beattie

Monday, November 19, 2007

Gregory Jason celebrates his Birthday on November 22th. Happy Birthday!
Lisa Roberts celebrates her Birthday on November 19th. Happy Birthday!
Stanley Rogers celebrates his Birthday on November 16th. Happy Birthday!

Robert Darr and Floyd Kos share November 15th as their Birthday. Happy Birthday!

Saturday, November 10, 2007

The reason we push geography and map reading ;-)

Ron out of the hospital

A quick update. Ron was discharged from the hospital on Friday night. I know that he has some test coming up, but that is all I know for now. I will pass on more after I talk to him. I do understand that he came by MEMS after getting out, I don't think he left the car, but many came out to see him.

Thursday, November 8, 2007

PTO donations

I have had several ask me about the procedure for donating PTO to Ron and Chris. As you are aware they both will be away from work for several weeks and their PTO will not carry them that far. If you are interested in donating, there are forms in the paper work cabinet at station one in the supply room or see Foxtrot in Conway. The current policy is 1 for 1 meaning your one hour donated equals one hour to the donee. This is especially helpful this time, since Ron has so much seniority.

An update on Ron

Jay, Stewart, Louis and myself had the privilege of eating lunch with Ron today. He got permission to put on street clothes remove his telemetry unit and go to the cafeteria for a bit. Honestly it was a strange feeling to be with him at first. I told him that he needed to get use to people staring at him, he laughed. We talked about a lot of things, as well as went over the events of "the day". Seems he doesn't remember anything about the day, only the day before. After the initial awkwardness of the moment we learn very quickly that his sense of humor is in tack and more wicked that ever.

Ron spoke about his eventual return to work:
Stewart said “No hurry. You’ve made it quite clear you don’t want to work radio.”
Ron replied “Oh no, I’m dying to!”

It went down hill from there, he started cracking one liners about his "near" death. When I asked him what I could Blog he gave permission to share some of our laughter, for example:

When a nurse saw Ron in the BMC cafeteria and went on and on with surprise to see him and how good he looked:
Stewart: “Ma’am, who are you talking to??” And Ron then gave his best ghost impression.
Added Louis: “Ma’am, you’re the only one who can actually see him.”

When nurses, seeing the rest of us in EMS uniform, asked Ron what he does:
“I’m a paramedic too,” he said.
Greg: “He’s been a medic a lo-o-ong time.”
Stewart: “Yeah! He was even a medic in his former life!”

After questions of whether he remembered anything from the experience (lights, long lost relatives, hovering above us watching us work, etc.,
Stewart: “To the dismay of so many who have hoped against hope, can you confirm that Elvis truly did die in 1977 ?”
Ron: “That I can! He did die in ’77 and he looks the same as he did then!”

Ron, on the suggestion of sharing his experience:
Ron: “What do I say? Hello-o-o-o! I couldn't’t remember anything for days, and they say I was dead, but hey! Here I am! Hi! I’m back!”

There were tons more that I have forgotten, he mentioned maybe a "Ron was dead" contest to see who could come up with the best one liner, and offer a dinner for the winner that he would chose. I don't know about that one, maybe that is a bit far...

As you can see it was very dark and sick humor, (that he initiated) but we laughed and enjoyed each others company and forgot the utter fear, panic, loss and sorrow that we had felt just a short week earlier. Frankly I wonder what all this means. Everything fell into place perfectly that day, and the more we look at it the stranger it gets, consider for example..

When we got back to the nurses desk, Ron asked the nurse for his chart to show us the code summary from the MEMS LP 12. We looked at the fib, shock etc... when one of us noticed. The time recorded on the strip of V-Fib was "9:54" Of course that is the old number for the supervisor, of which Ron was 'forever'. The time recorded that showed his rhythm after the shock and asystole was "9:59" for many of you, you know that this was Ron's call sign. It caused a chill to run down our spines.

Again what does all this mean, I don't know. I do know that we as a group are one dysfunctional family, but we are family. The scripture says of family, "And whether one member suffer, all the members suffer with it; or one member be honoured, all the members rejoice with it." It doesn't say we should, it says we do, we are connected, that is just the way it is. Time will come and go, the freshness of this past week will fade, but may we never forget, we are family.
And on a personal note, as crazy as it gets, I am sincerely honored be a part.




Tuesday, November 6, 2007

Annual Awards Nomination Time!

It is that time of year to make nominations for Paramedic, EMT, Rookie, Employee and, PRN of the Year. This year the rules are:

  • Any employee may be nominated for the appropriate category
  • Attention should be paid to employees that have gone “above and beyond” during the year
  • Nominee must be in good standing
  • Medic is defined as Paramedic
  • EMT is defined as EMT
  • Employee is defined as any full time employee who does not work as an EMT or
  • Paramedic. (Salary/management staff are not eligible)
  • Rookie is defined as a Paramedic or EMT hired between October 1 2006 and October 01 2007. (See list)
  • Dispatcher is defined as any PRN or fulltime dispatcher.
  • PRN is defined as any EMT or Paramedic that has met the minimum number of hours (260 per year) to be compliant with our PRN policy. (See list)

Nominations will be taken from all staff with final selection from the top three made by management.

Update on Ron

We have been sending out pages concerning Ron's status. Chris said I could fill in those of you who have not received the pages, so here goes…!

Yesterday (November 5th) Ron was still on the ventilator and balloon pump, but alert and talking by writing on a marker board. Around 6PM last night, he was taken off of the balloon pump, and this AM @03:00 he was extubated.

Ron continued to ask lots of questions about why he was in the hospital. He had assumed after waking yesterday that he was in the hospital for tests and had just not gone home yet. After being told that he had “coded”, he was certainly taken aback. So far, he has no memory of the day he coded, and only partial memory of the day before. We expect that, as time goes, he likely will remember more and more.

Ron did get out of bed today and walk and, if all goes well, he may even be in a regular room by this afternoon!

This surely has been quite the miracle!

MEMS Rookie School continues to set the bar high!

The current rookie class had 15 students which included 4 from the North Little Rock Fire Department. They took their practical test a little over a week ago and 100% passed that day.

As of today 13 of the 15 passed their written the first time. This gives us a score of 87% first time pass rate. This compares to 46% national average.

These kinds of statistics come from not only a great group of students but a great training staff as well!

We are proud of you all!!

Jerry Clagett will celebrate his birthday this year in the "big sand box" oversees. Jerry when you read this, Happy Birthday man, keep your head down and hurry home!!


Neal Prince (top), Rachael Marchand and Chris Adkins all share November 7th as their Birthday. Happy Birthday!

Matt Johnson and Chaundra Townsend share November 4th as their Birthday. Happy Birthday!

Friday, November 2, 2007

Update on Ron

Being fully aware of all the HIPP laws, with permission from Ron’s wife, I write to bring you up to speed on Ron.

On Thursday Nov. 1, Ron was sitting at the dispatch position in Communications. It was known he had not been feeling well for the last few days, and in fact was up most of the night before with that he believed was heartburn. Because he had not been feeling well he almost did not come to work, but Chris suggested he might feel better getting up and around, so Ron decided to go ahead and come to work.

Ron dispatched a call in Vilonia at 09:44, and sometime after that transmission, Ron laid his head down on his console. Jay came in to bring Ron some Halloween candy when he noticed Ron had his head down. No one thought much about it at first because he had not been feeling well, but when Jay could get no response, they knew then that something was really wrong. Jay felt for a pulse and found none. At that point Jay, Joe and David Turner got Ron out of his chair and laid him in the floor where Jay started immediate CPR. Joe then called out in the hallways for help. At this same time Ralph (just by chance!) walked into dispatch carrying a monitor. Jay asked if it worked, and Ralph answered yes, just needs batteries.

There was a meeting going on in Swanson’s office involving Stewart, Greg, Tammy, and Jon. At Joe’s calls for help, the group rushed to dispatch. Upon entering, we saw Jay doing CPR and knew that we needed equipment. Simultaneously, Greg ran to retrieve an ALS pack and returned to begin ventilations, while Stewart connected the monitor for a quick-look and subsequent shock. Louis and a host of others (more on the team approach in another Blog) went to retrieving and setting up other necessary equipment. Then, as we all worked on Ron, Joe and Dana Burnett continued their duties at their dispatch positions and performed well with this all right there beside them!

Ron presented with V-Fib, and was shocked once, CPR was then continued, an IV was established etc., and within a short time, we saw occasional complexes on the monitor. These turned into a string of complexes with a pulse and respiratory effort. Ron’s efforts continued to increase as we traveled to BMC, where he was seen at the ER and diagnosed with an anterior MI. He was then sent to the cath lab where he received 3 stints. (From down time to cath. lab with vessels open @90 minutes or less)

He currently is in CCU at BCM in critical condition. This a.m. he did wake and follow some voice commands. His pressure is low but stable; his heart is a normal sinus currently. Long term looks good as long as he dose not develop any complications.

This is a brief overview of the events.

Please keep Ron and his family in your prayers during this time. I will be passing on updates as I get them.