18 more fire fighters to lazy to keep Paramedic

[spenac]

http://www.naplesnews.com/news/2009/sep/03/tober-pulls-advanced-life-support-certification-18/ Edited September 15, 2009 by spenac

[spenac]

Tober pulls advanced life support certification of 18 more firefighters

Posted September 3, 2009 at 1:49 p.m.

NAPLES — Eighteen more firefighters are having their advanced life support certifications pulled by Collier County Emergency Medical Services.

The move comes at a time when some fire districts may soon propose to county officials that they have their own EMS licenses.

Five more North Naples firefighters and 13 firefighters from the East Naples district are no longer permitted to do advanced life support because they failed to do ride-alongs on ambulances as required, said Dan Bowman, deputy chief of EMS. Last week, 25 North Naples firefighters were decertified.

The failure to do the ride-alongs means about half of each of the two district’s firefighters are not supposed to perform advanced medical care in the field, Bowman said.

Firefighter/paramedics are required to ride in an ambulance one shift every three months to get exposure to administering advanced life support medications and doing procedures which they haven’t been doing while riding on fire trucks, evidenced by data from patient care reports kept by the fire districts, Bowman said.

For the most recent quarterly data available from April through June, the fire department firefighters almost never administered medications in the field, he said. The report shows each firefighter administered medications an average of .06 times during the three-month period.

In contrast, each EMS paramedic who swaps out and periodically rides fire engines administered an average of 12.2 medications during the same three months, the report shows.

“It is the fire departments where we get the patient care reports,” Bowman said. “They have never refuted it because it is based on their data.”

EMS paramedics who are strictly paramedics and never ride in fire engines each administered an average of 14.9 medications during the three months, the data shows.

“It’s been shown and proven they (the firefighters) have very little opportunity to treat patients,” Bowman said. “A lot of the times it is done in the back of the ambulance.”

North Naples Fire Chief Orly Stolts questioned the reports from EMS and said countywide fire district data about the advanced life support medications can be misleading. For instance, paramedics with the City of Naples weren’t administering advanced life support mediations for a while and since 2007, the North Naples fire district’s protocols for medications have been changed numerous times.

“We may not have even had access to those drugs,” Stolts said. “You can skew data any way you want to.”

In recent months, Tober has been removing unused advanced life support drugs from the fire trucks because he is concerned the firefighters’ skills to administer them are rusty.

East Naples Fire Chief Doug Dyer said his district only had 12 firefighters who were certified as advanced life support paramedics and so EMS has been casting a wide net when it decertified a 13th who wasn’t certified in the first place. Dyer said East Naples now has just three firefighters left who are certified.

“Their goal is to decertify all of us,” Dyer said.

The EMS medical director, Dr. Robert Tober, who has battled with the North Naples and East Naples fire departments over potential consolidation and complained this past summer that firefighters’ cheated on medications’ tests, instituted the ride-along rule in February.

Tober said the fire districts jointly agreed to the ride along requirement and have been refusing to comply and he’s been left with no choice but to decertify firefighters.

He has told the fire districts they should only do with patients what they do often because that is what they do best, and he says the same policy applies his own paramedics.

“Even with our own guys who are falling down in terms of frequency of procedures and drugs, we move them to a busy place to keep their experience and skills set up,” Tober said.

The fire departments have been trying to keep as many of the advanced life support medications on their fire engines as possible because they want to acquire their own EMS licenses, Tober said.

“Their motivation behind this is to declare their own EMS (status),” Tober said.

Tober said North Naples has vehemently denied this but it is now moving forward with submitting documents to the Collier County Commission to seek its own EMS certification.

Stolts said his fire board voted five months ago to seek its own certificate of need, which would allow the district to operate its own advanced life support service and have its own medical director. The documents will be submitted soon, he said. The intent is to have an EMS certification but not to do ambulance transports.

“Ours is almost ready to submit in one or two weeks at the most,” Stolts said.

Dyer, of East Naples, said his district would seek the certificate if a cooperative relationship with the county’s EMS cannot be restored.

East Naples’ first move, however, will be to make a presentation to the county commission showing that the district was cleared of any wrongdoing in an investigation into Tober’s cheating allegation . Naples attorney Donald Day conducted the investigation. Dyer petitioned to make a presentation Sept. 15.

“We want it to go on the public record and recorded that we did not cheat,” Dyer said.

[FireMedic65]

Good for him! It's a good step in the right direction he is taking. It's time some people get knocked down a peg or two. I fully support Tober!

[P_Instructor]

Who in their right mind would want to become the Medical Director for this Department? No pun intended, but I thing the FD 'burned' the only bridge they had. I would not grant anything unless all the evidence was presented, and there was a complete CQI process in place and place the service on 'probation' for a minimal of 2 years until everything has compliance. The new Medical Director better know what he is getting into, or the union may just pay under the table for one to get their wishes......easy street without having to do anything, and non-competence in the public's expected standard of pre-hospital care.

They want to be firefighters, let them. Get them out of the Paramedic field. Deny any application for Paramedic status and leave it to the true professionals that provide the competent care.

[FireMedic65]

Who in their right mind would want to become the Medical Director for this Department? No pun intended, but I thing the FD 'burned' the only bridge they had. I would not grant anything unless all the evidence was presented, and there was a complete CQI process in place and place the service on 'probation' for a minimal of 2 years until everything has compliance. The new Medical Director better know what he is getting into, or the union may just pay under the table for one to get their wishes......easy street without having to do anything, and non-competence in the public's expected standard of pre-hospital care.

They want to be firefighters, let them. Get them out of the Paramedic field. Deny any application for Paramedic status and leave it to the true professionals that provide the competent care.

Seems to be that other medical directors all across the country are letting things like what this department is doing, get away with it. This guy is taking a stand and cracking the whips. More directors need to start doing the same. It's time American pre-hospital care starts setting a standard for its self and start making things better by cutting the fat.

[aussiephil]

Another fine example of why EMS & Firs should be seperate & left that way

[FireMedic65]

Combined services is alright, but keep the duties separate. I have run EMS out of firehouse, but I had no duties on the fire truck, and they had none on the ambulance. It worked out just fine. When you start combining the "jobs" then you start having problems.

[aussiephil]

Combined services is alright, but keep the duties separate. I have run EMS out of firehouse, but I had no duties on the fire truck, and they had none on the ambulance. It worked out just fine. When you start combining the "jobs" then you start having problems.

There is everything wrong with them running out of the 'firehouse'.

EMS is & always will be a seperate profession to the hose monkeys & should be treated as such. EMS, as has been demonstrated in other posts, does more work than fire ever will. So should we rename it an EMS house? With fire controlled by EMS?

I cant see that happening so why should it happen as it does now??????

Seperate the services & make fire justify their existance on their core business if fighting fires. Then we will see who survives.

[P_Instructor]

Medical Directors NEED to take an active role in pre-hospital medicine and care. The paramedic is working under THEIR license. It is to the point now that even when taking a Paramedic class, the National Registry will soon not test anyone unless they come from an accredited institution. To become an accredited training facility, it is imperative that there is ACTIVE MEDICAL DIRECTOR involvement. This is what the country needs. Competent Paramedics that are looked over by medical leadership in the emergency field. Trust me, I know. We've recently become accredited and this was one main point in the process-------ACTIVE MEDICAL DIRECTORSHIP in training and operation of services rendered to the public, our clients that pay our wage.