Ched has 20+ years of experience in education, fire and rescue services. He has a B.S. in education, is nationally registered as a paramedic and fire fighter, and has over 30 certificates as an Instructor I – III with the Alabama Fire College. His expertise in industrial safety and rescue allows us to provide strong hands‐on courses, such as permit required confined spaces, “hot work” permit programs, hazardous materials response, and crisis management.
As a first responder of 27 years, I have been exposed to a wide variety of challenges. No event has been as challenging as the COVID-19 pandemic. As you might imagine, there are numerous causes, the least of which has been the sustainability, longevity, and the rapid spread of the virus. Most aspects of our profession have been drastically altered by the virus including our living arrangements, shortage of personnel, and even our traditional holiday celebrations (i.e.- Christmas Eve Santa routes on the fire truck). However, there are 3 affected areas that may not be as obvious:
- patient transportation options,
- personal protective equipment (PPE) issues, and
- our new role as the good guy or bad guy, depending on the situation.
One expectation of first responders and emergency medical services that is often taken for granted is the transport of patients. COVID-19 has put a strain on many aspects of the pre-hospital and hospital care, but perhaps the most significant strain has been placed on the transportation of patients to the hospital. Along with all the other challenges faced, transport services are often waiting 2-3 hours at the hospitals before care is transferred. Due to these extended wait times, fire departments and rescue services are waiting longer than ever for transport vehicles to arrive and deliver their patients to emergency rooms. Much like the proverbial snowball, the wait times get longer with no solution in sight. Organizations as well as the individuals that make them up have been forced to adapt and present other options. Paramedics have refreshed their knowledge on drug algorithms to ensure proper medications and dosages are given to patients as extended wait times for transports have forced longer on scene care. First responders have educated patients and families on what are truly emergencies, often suggesting that families drive their loved ones to the emergency room themselves when the situation allows. Finally, departments have been encouraged to work with other departments who provide public transport services in order to provide the best possible service to the patients.
PPE, PPE, PPE! 18 months ago, a select number of people worldwide knew what PPE referred to in the pre-hospital and hospital setting. Today, the average person discusses N95 masks, face shields, and latex gloves as if they were common household cleaning products. First responders have always “dealt” with the inconveniences of PPE, but COVID-19 has greatly increased this and the need to properly wear and maintain access to the appropriate PPE. More importantly, the increased PPE required to be worn has reduced our ability to communicate with patients, hospitals, and even colleagues. The use of non-verbal communication such as a simple smile or facial gesture has limited communication with younger children, special needs individuals, and elderly patients with dementia or Alzheimer’s. Something as simple as a face mask can bring significant confusion to someone with the aforementioned impairments. This challenge has encouraged us to learn to verbally communicate better. By using tone and inflection, our hidden smiles can be seen with a softer, more empathetic voice. Our descriptions take on a more vivid nature such as describing in detail how an IV is started to a patient in order to get consent. In the past, a family member or close friend may have assisted with this, but with the pandemic, many families have been forced to separate themselves from the patient during treatment.
Our profession has long enjoyed an incredibly positive and friendly relationship with both patients and their loved ones. Traditionally, when a firefighter, paramedic or EMT shows up at a home or business, people are relieved that help has arrived and are generally cooperative with our requests. COVID-19 has ended this honeymoon. With the spread of conspiracy theories and rampant misinformation, we are often caught in positions where we may have to insist that someone wear a mask or step out of a room, or at worst, separating a patient from a loved one outside an emergency room or in the back of an ambulance. With the added delays from transport services we can quickly go from hero to zero in the mind of our customers. Again, the snowball effect of the client being upset, first responders being upset (because we aren’t being shown the love), and the emergency room nurses and doctors being stressed at an unprecedented level for the duration of COVID-19 has become part of our existence. How have we as first responders adjusted? We try to put our egos on the shelf, recall our own experiences with loved ones being sick, and have learned to be more empathetic. We have been forced to relearn and emphasize compassionate communication. Lastly, we have had to learn to grow up and be the bigger person in a contentious situation. It has been tough for everyone. Everyone has a story. We have learned to put aside our feelings and understand that people are mad at the situation and not necessarily at us.
So, what is the answer to all these challenges presented and the hundreds of others we have been faced with in the last year? There is no one answer. Our circumstances vary from city to city, state to state and from one business to another. However, a common theme that can be disseminated through all circumstances and professions, is that of a strong, positive attitude that includes a willingness to adapt and meet challenges one at a time. At this point, hopefully, we have seen the worst of the pandemic. We all have made mistakes, made some great decisions, made some poor decisions, and have learned more than we ever wanted to know about infectious diseases, PPE, and social distancing. By gathering lessons learned, networking and learning from the mistakes of others, we can build on our knowledge and minimize mistakes during the next challenge we are forced to confront. Should history ever repeat itself, we hope the lessons learned means we are better prepared.
