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Years ago, I represented a client, a firefighter/paramedic, in an administrative trial after he had been terminated for allegedly providing patient care that was below the department’s established standards. One central issue was the ongoing, on-the-job training firefighters/paramedics receive. Throughout the trial, senior officers of the department, including the Chief himself, preached and bloviated on and on about how the department is committed to providing only the best patient care and how their paramedics are held to a higher standard; how they are committed to serving the community with the highest level of blah, blah, blah. On cross examination, however, I asked each of them about how many hours a day each provider spends drilling or practicing firefighting technique and equipment. Each of them answered proudly that every firefighter/EMT and firefighter/paramedic, regardless of assignment, spends at least three hours each day practicing firefighting skills and/or rehearsing the use of various firefighting equipment; hoses, ladders, saws, and other firefighter equipment. Ok, that’s great. Through testimony, we determined that, based on a 10-shift work month, each firefighter/paramedic, regardless of assignment, spends at least 30 hours per month drilling, practicing, and/or rehearsing firefighting skills & equipment. That’s at a minimum of 360 hours per year of ongoing, on-the-job firefighter training. Outstanding. When the smoke is showing and the flames are roiling, they will be ready. They all displayed the same proud grin at how well trained their people are. For each of them, however, that smug grin quickly turned when I then asked about the number of hours per day each firefighter/paramedic spends drilling on or practicing patient care related techniques, skills, and tools. Every one of them squirmed as they responded with the truth that the department only offers three hours of patient care related education per month. That’s roughly a maximum of 36 hours of paramedic training for the entire year. It got worse when further testimony showed that patient care related calls account for more than 80 percent of their call volume and fire related calls less than 20 percent, I could see each of them deflate on the witness stand when I asked how they could truthfully say they were committed to providing the best patient care when barely 10 percent of their training addresses patient care, which constitutes over 80 percent of your department’s calls. The answers were more disjointed and nonsensical than a White House press briefing. Of course, across America the 10:1 ratio of ongoing firefighting training to EMS training is pretty consistent, which begs the question: Don’t they get it? Excellence is the product of practice. How can any rational person look at a 10:1 training ratio and declare themselves committed to the highest level of care? How can an agency neglect training on the most significant aspect of the business and then be surprised when issues of negligence and liability arise? Once again, it seems that old-school culture leaves EMS stuck in the mud and the law is not going to wait for agencies to figure out that living in the past compromises the future.
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David Givot (Sirens, Lights, and Lawyers: The Law & Other Really Important Stuff EMS Providers Never Learned in School)