Last week I documented the #LivesBeforeLunch Campaign launched by American Medical Response (AMR) against the EMS Worker Bill of Rights AB-263, and then admonished them for disguising it as a Community Organization when it is in fact a for-profit national business.
The campaign, launched a week ago, has only garnered 9 “Likes” and 20 people subscribed to their activity as of 10:30am EDT June 27, 2017. I happen to be one of the 20 subscribed to their activity and was notified when they started posting replies to people’s comments. I want to highlight both the good, bad, and false of one reply they posted to illustrate their flawed argument. This is a screenshot of the original comment:
[FACEBOOK USER NAME REDACTED] We have exposed the flaws in this this bill. We have asked the author for amendments to fix the flaws in this bill. They have refused. And the author declined our offer to provide amendments to require training on active shooter events or to have a work group established to create standardized training for violent patients. The author and sponsor removed the mental health treatment requirements from the bill, not providers. FACT:AB 263 will prevent or delay responses to medical emergencies:
AB 263 statesprivate EMS personnelbreaks or meal periodscan be interrupted only if they will beresponding with lights AND sirens or an unforeseen natural or man made disaster occurs.
In California, depending on the time of day and location of the operations, first responders may not use both lights AND sirens,and the county, state or the federal governmentrarely declares a disaster. In addition, in many areas emergency crews are dispatched Code 2 which does not allow lights and sirens to be used, and local fire departments are often not sent on Code 2 calls.
I can appreciate them interacting with the political leaders to address the problems they perceive with the bill. I think they could run a much better campaign highlighting those and offering solutions rather than the negative scare-tactic propaganda campaign they have chosen.
The assertion that AB-263 will “prevent or delay responses to medical emergencies” as “FACT” is misleading at best if you are operating a well-resourced efficient EMS system. AB-263 does nothing to “prevent” responses, so I am sure they are hanging their hat on the possibility of “delay”. They do FINALLY acknowledge that AB-263 does allows the rest period to be interrupted, however they are falsely stating that the rest period can only be interrupted for “Code 1” emergencies. It is the decision of the Employer as to when the rest period can be interrupted.
FACT: According to FEMA California has had 259 Federal Disaster Declarations, the second most out of any state. Texas led the way with 343 Federal Disaster Declarations, so to assert that the state or federal government “rarely” declares a disaster is false.
Code 2 calls are medical emergencies and can include events such as sexual assault, breathing difficulties and broken bones. Lights and sirens are not used because it is deemed the risk of killing or injuring an EMS employee or the public when traveling Code 3 is greater than the medical emergency presented, and Code 3 calls are reserved for events such as cardiac arrest where death of the patient has a high probability.
However, just because the call is Code 2 does not minimize the need for an emergency response.
These are calls where there is no indication an actual emergency exists and so safety is actually the first priority here. This is something which I am wholly in agreement with, but let’s be clear here about what that actually means. Lights and sirens are not used during “Code 2” calls because it is deemed the risk of killing or injuring an EMS employee or the public when traveling with lights and sirens is greater than the medical emergency presented… which means that “Code 2” calls are NOT getting an emergency response to begin with.
Let’s take an infant who was choking but as the parents are on the call with the 911 dispatcher, the child stops choking, is crying and showing all signs that she is breathing properly. The response is dispatched as a Code 2 and there is a unit just down the street from the location of the call but the crew just started their 30-minute lunch break.
Under AB 263 the crew in this scenario could not be interrupted to respond, leaving the response to the next closest ambulance that could be 30 minutes away. Understanding that in some areas fire departments do not respond to Code 2 Calls, the parents of this child will endure stress and anxiety for 30 minutes so an employee can finish their meal.
The scare tactic is in full swing here. We have a child, distraught parents, and food being placed before their well being. All these are crafted to put AB-263 into a negative light when really the problem is created by the EMS Agency managing the system. If indeed the next closest ambulance is 30-minutes away then the EMS Agency is failing at operating a well-resourced and effective EMS system. This is misdirection and reassignment of blame at it’s finest.
Let’s say that there is indeed no other ambulance able to take the call, is it better to endanger the public and the EMS employees by putting a fatigued vehicle operator to work? This campaign is focusing their wording on “lunch” and “meals, but there is not any mention of what these breaks truly are… REST PERIODS. Why? Because NO ONE WANTS A FATIGUED DRIVER! Here’s a few cases where fatigue resulted in negative outcomes for the providers AND their patients:
- EMT turns self in after being charged in fatal ambulance crash – Her attorney said she was suffering from “extreme exhaustion”
- Police: EMS provider fell asleep before fatal ambulance crash – Morey told investigators she fell asleep while driving
- EMT in ambulance crash fell asleep at the wheel – the 23-year-old Philadelphia man driving the ambulance said he had been working long shifts and fell asleep as he was driving
If AMR is able to equate AB-263 to meals and food, they distract from and hide the true danger… fatigue. It is important to remember that fatigue is caused not just by long shifts, but also by the financial need to work more than one job because you are not being compensated at a livable wage. This is why I don’t think AB-263 went far enough, because while it is providing a rest period during a shift it does nothing to alleviate the need to work more than 40 hours a week in order to support ones self and family financially.
What kind of stress and anxiety will the parents endure if their ambulance operator crashes? Are those 20 minutes worth it? I would venture to guess not… but I’m not the one opposed to this bill.
To add to the absurdity of this bill, what about the patient that approaches a crew on duty that is on their meal break. When a patient seeks treatment directly from a crew on break, who is at fault for the interruption, is that the employer or the patient? As currently drafted, the bill removes a long-standing ethical obligation to treat ALL patients. If the injury or illness presented does not require the use of lights and sirens, Assemblyman Rodriguez believes private EMS employees should not be required to provide care until their break is over.
FACT: There is no LEGAL obligation to treat ALL patients unless California has suddenly become a Duty-To-Act state (it hasn’t). The bill removes NOTHING because currently there is nothing in place for this instance. It is ironic that they are claiming a dissolution of an ETHICAL obligation when management does not meet their ETHICAL obligations to their workers by providing appropriate rest periods and compensating them with a livable wage. AB-263 looks to put that LEGAL obligation in place for the rest periods, which undoubtedly is why AMR is fighting it… because then they can be held accountable financially for failing to act appropriately when not providing or interrupting a rest period.
This campaign was demoralizing when it launched and has descended into disingenuous propaganda fueled with distasteful scare tactics. The EMS Worker Bill of Rights AB-263 was insufficient to begin with, and the attempts by AMR to kill what little of it remains helps prove the need for more legislative protection for EMTs and Paramedics.
We need to start treating fatigue in EMS for what it really is, an endemic condition threatening the lives of patients and providers. Providing rest periods as AB-263 does is a small but important first step.
You can see the original post on their Facebook page here: