Always on call: A day in the life with Port Angeles Fire Department in Washington, US
The 24-hour shift is just beginning when the first call rings out in the station. Just like in a TV drama, someone shouts, “There’s our first one!” and Port Angeles Fire Department’s B Shift springs up from the kitchen table and heads down the stairs to the truck bay. Unlike the screen theatrics, the firemen’s pole, although remaining as a symbol, is no longer in use here; the stairs are safer. Rosters haven’t been officially set for this recent Thursday, so there’s a bit of confusion as to who’s taking the call. But this team has done this before and paramedic Tyler Gage and senior EMT Todd German hop into Medic 11 to assist an elderly man who had fallen from his bed. During work and outside of it, fire fighters/paramedics are trained to see and respond to emergency situations. They put hours upon hours into learning what to do and when to do it when a person is in distress during their time in EMT classes, paramedic school and fire academy.
Captain Kelly Ziegler, who has been with this department since 1995, said it’s not uncommon for crews to get 20 or more calls in a 24-hour shift, which is what each crew works: 8h00 to 8h00. “I was a union officer for almost 20 years and I’ve prepared contracts over that time and I’ve never found a department that’s close to us that runs more calls per fire fighter than we do,” he said. “We’re busy.” Calls can be broken into two types: BLS, short for basic life support, and ALS, advanced life support. If transport is needed, PAFD calls upon Olympic Ambulance for assistance per contract. ALS calls are transported to the hospital by PAFD. Just like any other business in the country, the department has times of being short staffed. “It’s hard to hire people,” said Gage, who has been with the fire department for two and a half years. “A lot of people are retiring and there’s not enough [trained people] being put out from the paramedic schools. It’s hard to find people because there’s more jobs than there are paramedics.”
But on the upside, PAFD is willing to put EMTs through paramedic school and fire academy. Its latest full-time recruit, Tyler Wildeman, started as an EMT and PAFD sent him to fire training academy. “Willing to invest in good people,” he said, the department sent him to paramedic school. “The biggest thing they stress is teamwork,” he said. “They told me when I started, ‘We can teach you to be a fire fighter. We can teach you all the skills you need. But we can’t teach you to be a good team player.’ ” Through a bit of time, teasing and work, Wildeman has become part of the department’s line up.
After assisting the gentleman who had fallen that morning, known as a ‘lift assist’, Gage and German explained that such calls are probably the most frequent type they get. “This is a situation where if we saw him three times in one week for the same thing, we would refer him to Dan Montana,” Gage said. Long-time fire fighter/paramedic Daniel Montana was taken off his regular duties with PAFD last year to become a dedicated community paramedic, part of a city program that began in early 2019. Through referrals from fellow fire fighters, police or partner agencies, Montana provides a range of services to heavy users of the 9-1-1 system.
He is able to check vital signs, provide wound care, administer medications, assess general health and living conditions, review medication regimens and make referrals for needed services. In the case of this call, “Dan would come out, meet with him, talk with his primary care doctor, talk with Medicare and try and get more resources set up for him, like a ramp to the outside just so he can get to his doctor, stuff like that so he can be more productive and have more mobility in his life,” Gage said.
There’s also the emotional aspect of these types of calls. “It’s definitely sad,” Gage said. “It’s kind of one of those things where it’s one of the processes of life. … It’s interesting to think about because if 9-1-1 didn’t exist, he probably wouldn’t be able to get up.”
On this day, Ziegler took the opportunity to run a few practice drills with the crew after discussing coronavirus protocols and doing rig checks. Out at the old Rayonier site just off the Olympic Discovery Trail in east Port Angeles, B Shift had a car, donated by Peninsula College’s automotive technician class, set up to simulate a patient entrapment scenario, Ziegler said. “That’s a pretty common event for us,” he said.
“We’ve had two incidents probably within the last year, year and a half … that we’ve had critical patients that were trapped in a vehicle and pinned.” He explained that it can take over 45 minutes to get an unconscious person out of a wreck without causing more harm. It’s a low-frequency, high-stress situation, Ziegler said and the crew needs to practice when they can.
After placing a dummy in the car, the team chose the ‘lighter’ dummy with no legs, at about 160 pounds, everyone got into place to start the drill. Using the Jaws of Life and other heavy-duty equipment, they worked together to extract the patient, communicating needs to each other from around the vehicle. The crew also worked out a few other scenarios with car, removing the front end, the other doors and opening the trunk with only manual tools. “It’s a lot of fun for us,” Ziegler said.
The second drill, a ladder rescue, took place on the stairs of the old water tower at Rayonier. Paramedics Doug Eaton and Lt Jeremy Church were the ‘first on the scene’ and worked to assess the patient and ready them for the rescue from several flights up. On the ground, Gage and paramedic Mike Ingraham readied the basket while German manned the ladder. After a successful transfer of the patient from the landing to the ladder basket and when everyone was safely back on the ground, the drill was deemed a success, with a time of just over 45 minutes.
Always on call
After taking three more calls, a minor crash on the Tumwater Truck Route, a lift assist (this time by a frequent caller) and another lift assist at a retirement community, the crew settled into the later portion of the shift. It was Wildeman’s turn to make dinner for everyone and as he prepared stuffed peppers while others helped to keep things tidy in the kitchen, B Shift discussed the trying parts of the gig. “We appreciate that our community has afforded us the opportunity and the personnel to make our jobs easier and help make our communities safer,” Gage said. “We’re still human, so there’s definitely those calls that affect us emotionally. We go see something terrible and come home to our families. … That’s the hard part of the job, that it’s not all fun and helping people. There are hard calls and sad calls.”
After the difficult calls, Church said, the teams are debriefed with other partner agencies. Sometimes that helps and sometimes it doesn’t. An example from Church was his arrival on scene where he did his part of the job and was more or less fine with what had happened. But at the debriefing, he heard others’ experiences with the situation and that painted the whole, sad picture for him. The full narrative made it harder for him to deal with what had happened.
Other debriefings help, though because everyone shares their stories and how a call had affected them. “We take care of each other,” Gage said. “We check in on each other at home.” Church said it’s about finding a balance. “At the end of the day, we’re going to go out and do the best we can with what we got,” he said. “That’s what we spend a lot of timing doing, helping people who can’t help themselves, to be frank. Those aren’t the most glamorous parts of our job and the way we get through that is just by people recognising and appreciating it and you feel like you made a difference because of that.”
Source: Peninsula Daily News