Ellenville EMT Suspension Causes Public Uproar And Illustrates The Lack Of Discipline Policy For Volunteer Agencies

Recently there was an article about the 60-day suspension of Ellenville EMT Stephen Sawyer from the Ellenville First Aid and Rescue Squad, a volunteer agency. To summarize the charges, a pediatric seizure call came in and although there was a paramedic who responded directly to the scene, there was no available operator for the ambulance. After three attempts to find a driver and the unavailability of mutual aid, Sawyer drove the ambulance to the scene and transported the patient, patient’s mother, and paramedic to the hospital. The problem comes in that Sawyer is 20 years old and the Agency policy is that drivers must be at least 21 years old. The Agency took action for the violation of the policy with a 60-day suspension and a demotion from being a Youth Advisor for Sawyer, who promptly resigned from the Agency on the spot. Needless to say, when the story was made public on a local Facebook page it garnered over 400 comments and 1,200+ “Likes” from a public clearly supporting Sawyer.

There are a few serious problems with this story, but I think that it also illustrates the absolute misconceptions the public has about EMS. Allow me to explain my reasoning.

NICHOLAS PIATEK/For the Times Herald-Record

EMT Stephen Sawyer
Original Photo by NICHOLAS PIATEK/For the Times Herald-Record

First things first, Sawyer broke the rules. That volunteer organization requires you to be at least 21 to operate the vehicle, and I see nothing wrong with that rule. For that matter, I often think that ALL agencies should require you to be at least 25 years old to drive. The original article takes great pain to highlight that Sawyer drives ambulances for a private company and works part time as a police officer, where it is assumed he drives a police car, but that doesn’t necessarily change is emotional maturity. Because let’s be honest for a second about ambulance accidents, the vast majority of them are preventable and are caused by the emotional imbalance of adrenaline pumping through our veins. It’s a natural biological reaction and the one that most often gets us killed in the line of duty, not to mention the people we jeopardize doing it. I have no issue with the regulation and only wish we could make the age higher without incapacitating our ability to provide service. In this there really is no debate, Sawyer is guilty.

Next, let’s talk about the penalty for the offense. Honestly, I think a 60-day suspension is a bit harsh for the infraction on the outside. One of the issues we have here is that we don’t know if either a) if he’s had prior disciplines and b) what the discipline policy is at the agency. According to the Ellenville’s Captain Gavaris in this article, there were in fact previous infractions including one that occurred that very morning when Sawyer reportedly instructed another ambulance crew to take a second call that had come in instead of waiting for the responding medic to arrive at the seizure call and decide on whether or not there would be an ambulance needed.

Discipline in volunteer agencies is a tricky thing. If you’re too heavy handed with it, you incapacitate yourself because no one wants to volunteer anywhere that creates more trouble than value. Time is valuable for people, and if you’re a volunteer agency doesn’t recognize and respect that then you’re going to have problems… like getting an ambulance driver for a pediatric seizure call. If you’re too light with it, you end up with people running amok in the community under your agency’s name and decreasing the value your agency offers in both level of care and professionalism while increasing the liability it carries with such reckless behavior. Discipline needs to be outlined clearly in an agencies policies. I am a big believer that if you set the behavioral expectations at the beginning, provide the explanation of what will happen when those expectations are not met, and then follow through with it then your agency will be far ahead of many others.

Finally, let’s take an honest look at Sawyer‘s resignation. I understand why he did it. He was hurt by the decision of the board for being punished when he did something he, and the court of public opinion agreed, thought was the right thing. For that matter, the demotion may have been the straw to break the proverbial camel’s back as opposed to the suspension. If it is more of a hassle to donate your time at an agency than its worth, then you absolutely should resign, but it should be done properly with notice and not in the heat of the moment at a disciplinary hearing. All this really showed is that he is emotionally immature as suspected, probably shouldn’t be driving the ambulance, and proved the Board’s assumptions right.

New Ebook Announcement: The Pride of the Hills (A Vollie’s Memoir)

Today I am happy to announce the launch of that manuscript as an Ebook that has been almost 20 years in the making, a true labor of love that has been a proverbial millstone around my neck whether I wanted to admit it or not.

The Pride of the Hills: A Vollie’s Memoir is now available on Amazon.com for the Kindle platform.

The ebook is available at the launch price of $.99 for this week only and will go back to it’s regular list price of $4.99 on 11/23/13 so get your copy NOW !!!

Here’s the description from the Amazon.com page:

Pride_of_Hills_Cover“She’s gone. No pulse, no breathing, and cold as an ice cube,” I replied while reluctantly withdrawing my hand.

Turning around and away from her, my eyes fell on the scene at the end of the basement. Along the wall were roughly a dozen men. All of them had their arms above their heads with their palms pressed against the concrete wall. Their feet were spread apart. Their heads were hung in either shame or fear. None of them were fully clothed. Some were missing their shirts, some were missing their pants, and one of them was completely naked….”

Lace up the boots with an authentic 20-year EMS volunteer in one of the world’s biggest EMS systems, New York City. Going from a bumpy start in the service, through to those teenage rebellion years as a new provider running on calls for help, and culminating to a point of maturity often never reached in an industry known for eating its enthusiastic young with an astronomically high burnout rate.

Ride along to discover what it’s like to be an EMS provider, plunge head first to unlock the secrets of a misunderstood EMS system, and discover the shocking truth about who’s winning the life and death struggle that human nature declares we wage in the quest for immortality.

Volunteering in EMS has been an aspect of my life now for nearly 20 years. I don’t think it often gets the credit or explanation that it deserves. Altruistic in nature, these EMS agencies are not in it for monetary gain. While the community hails them as assets and everyday heroes in public, behind the scenes the support offered to them dwindles. They are often looked down upon by their fiscally compensated counterparts as overly enthusiastic blunderers placing a higher emphasis on maintaining the moral high ground as opposed to adequate training and experience. Founded on the ideals of community participation, volunteerism, and neighbors helping neighbors in a society where the economic feasibility of that type of service is diminishing, these providers struggle to survive as agencies and as individuals. After all, it’s a matter of life or death, right?

Yeah… maybe not so much. To find out, you’ll have to read the book! Reviews, constructive commentary, and feedback as always are welcome and encouraged… especially if you get it at the ridiculously low launch price of $.99!

For those of you who like nothing more than the feeling of dead tree in your hands, the trade paperback will be most likely available in early December.

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Don’t wait to discover the convenience and joy of Kindle books,download your FREE reader software today!

On Forty Years Of Service

This last week the Forest Hills VAC celebrated held its annual Awards Night and Installation of Officers. The event also specifically highlighted forty years of service by founding member Josephine Bebirian. EMS is overflowing with brevity in careers, which is why longevity should be celebrated.

This is the letter I wrote to the attendees of the Awards Night that appears in the 2012 Awards Night Program:

Dearest Friends,

First, I would like to thank you for joining us in recognizing the service provided to the community by all the members of the Forest Hills Volunteer Ambulance Corps. It is important to recognize the service we provide and celebrate our victories because if we don’t do it, no one can do it for us.

As the Chief Operating Officer of the Corps I have the opportunity to interact with other agencies and see their operations. What I learned years ago remains true today, that our members are by far our greatest asset. As a member your value is greater than any building, vehicle, or computer system. Without you those things would simply be accessories that exist with no purpose. I thank you all for your continued service and contributions in making the Forest Hills VAC as successful as it is in fulfilling the mission of service to the communities of Forest Hills and Rego Park.

Tonight we will be specifically honoring a member who has been active with the Forest Hills VAC longer than I myself have been alive. Tonight we will honor Founding Member Josephine Bebirian for over 40 years of continued service. It is important to remember that things were very different for our Founding Members than they are for us. They did not have the luxury of two ambulances, a headquarters, or even a radio system. They were motivated not by gift cards or plaques, not by newspaper articles proclaiming their heroism or public decrees of their good work, not by fancy dinners or videos praising their achievements. They were motivated by the power to make a positive difference in the lives of others in their community through service. Josephine has been motivated for over 40 years and as much as we serve as her legacy, she reminds us of our origins and motivates us to continue to fulfill the mission of unselfish service they set forth to accomplish 40 years ago.

I would be remiss if I failed to recognize the conclusion of another piece of Forest Hills VAC history. Tonight, after 4 years, President Alan Wolfe will take the oath as Vice-President-Elect and come July 1 the reins of the organization will officially be turned over to President-Elect Ron Cohen. While Alan and I have often been opposed ideologically both before and during his presidency, there have also been quite a few times (perhaps surprisingly) when we have been in agreement. More importantly were the times we would be able to come to a compromise in order to guide the Corps forward. While we may have a difference in opinion, I believe that Alan has always served with the best intentions and interest of the Corps in his heart, and for that I thank him and I ask for you to do the same.

Remember – BSI, Scene Safety

Dave Konig


South Fulton Firefighters Let House Burn Again – Why Can’t EMS Do The Same?

Remember last year when the South Fulton Fire Department allowed a house to burn down because the owner hadn’t paid their $75 subscription fee? Rogue Medic defended the inaction quite eloquently but it raised the question about amoral policies leading to immoral actions.

Vicky Bell's Home After Fire

Well, they did it again. When Vicky Bell‘s mobile home caught fire she called 911. The South Fulton Fire Department responded and watched the home burn to the ground because she had not paid her $75 subscription fee. This policy is controversial to say the least, but more importantly raises a question most people would undoubtedly find objectionable and appalling.

What if EMS did the same thing?

What if EMS turned away from the reimbursement for service model that many feel is attributing to holding us back professionally and went to a subscription model? If you are a subscriber and you need us, we’ll take care of you. If you’re not a subscriber and you need us, we’re going to stand there and watch you writhe in pain and suffer.

EMS will no longer accept the abysmal rates from insurance companies or the government, but will set the rate according to the actual cost of service and the cost of improving that service, including adequate pay for its personnel. This is just the kind of solution to our financial issues that we’re looking for, right?

If it works for fire departments, then why not EMS? I know my reasons why I don’t think it would work (and will post about that later) but I’m curious to hear yours…

7 Things To Do When Attending An EMS Gala

This past weekend was the 40th Anniversary Gala of the Forest Hills VAC. Celebrating 40 years of service is quite a milestone for any service. This is the third such type of event I’ve attended for the FHVAC, but probably about the 12th I’ve attended over time.

Here are 7 tips for attending these type of events or your departmental holiday party:

    Kevin Chiaramonte, myself, and Kenny Ash

  • Events are a marathon, not a sprint - these type of events last awhile so be sure to pace yourself in both food and drink
  • Wear comfortable shoes - while you may have a seat, there’s not a lot of time spent in it
  • Be photo ready - cellphone cameras, point and shoots, and DSLRs will all be in use at these types of events so be sure you’re ready to smile at a moments notice… and remember that what gets photographed will most likely end up on Facebook
  • Bring spare batteries - your batteries for your phone/camera/hearing aid will die at the most inopportune moment so be sure to carry some extras
  • Bring a bag - most of these events will have coat checks where you can stow the bag during the event, and then afterwards if you didn’t take my advice about the shoes you can change into a comfy pair that are in the bag you checked before departing
  • Avoid getting into drinking games - while it may be tempting to take a shot every time a siren sounds, its going to be a lot less appealing when YOU’RE the intox taken out via ambulance… oh, and remember all those cameras? They’ll be snapping and posting as they wheel you out…

And finally…

  • Remember the defibrillator is not a jump pack - It doesn’t work trying to jump start a cab. Really

On The 40th Anniversary Of The Forest Hills VAC

This past weekend the Forest Hills VAC celebrated 40 years of service to the community. This is the letter I wrote to the attendees of the 40th Anniversary that appears in the Forest Hills 40th Anniversary Journal:

Dearest Members, Friends, and Honored Guests,

First, I would like to thank you for joining us in celebrating 40 years of service to the community by the members of the Forest Hills Volunteer Ambulance Corps. It is always gratifying when these events roll around to be able to look back and see all the good work that we have done. I also greatly enjoy the fact that while I may feel old, the Corps will always be older.

When the Corps is referred to in conversation, it usually conjures up the image of our headquarters building on Metropolitan Avenue. While the FHVAC is powered by the selfless hours donated by our members, the coordination and focal point of these efforts originates from our headquarters. The building owes its existence to the hard work and efforts of Former Captain, President, and Treasurer Judy Elliot. She worked tirelessly obtaining the property, having the building designed, and seeing its construction through to completion. Without her herculean efforts we would not be in the position of calling Metropolitan Avenue home as we do now.

Another member with a long legacy will also be honored tonight. Former Captain and President Bryce Friedman was responsible for a number of initiatives that ensured the continued financial survival of the FHVAC as we saw a shift in the community, an economic decline, and increased costs to EMS providers nationwide. One of these initiatives was the institution of our third-party billing system of reimbursement. Although Bryce faced ferocious opposition that cited tradition and being community-based, he persevered to prove his argument with fact and by doing so has without question ensured our existence for the last dozen or so years.

One of Bryce’s less known initiatives, but just as noteworthy, is holding the record for the Officer who disciplined the most members for infractions to the Corps policies. Believe it or not, Alan Wolfe is not the record holder in that area! I would be remiss if I failed to mention that the vast majority of those disciplines were issued against myself and my partner Daniel Exler. While at the time it may have seemed “unfair” or as if he were “targeting” us for prosecution, which is why we were sure he was heading to becoming a District Attorney. In hindsight, I am probably a better person but by far a better Crew Chief for it. I’m sure Danny would agree with me… or perhaps not.

As we gather together to celebrate the 40th Anniversary of the Forest Hills Volunteer Ambulance Corps providing service to the community it is important to note that the way EMS worked in 1971 is not the same way EMS works today. There are rising challenges to healthcare nationwide with a shift beginning to take place away from emergent treatment for acuities to a more preventive managed care model of service that is community based. We, as a community based EMS organization, are in a unique position to take this mission changing challenge on.

We will be successful at this because of the future Judy Elliots who will see daunting projects through from start to finish. We will be successful at this because of the future Bryce Friedmans who will have the vision to embrace change early and often contrary to the mindset of the mob. They may very well be sitting next to you, so be sure to make a note of who they are on your phone, piece of paper, or cocktail napkin. Be sure to bring that back with you and we’ll find out at the 50th Anniversary!

Remember – BSI, Scene Safety
Dave Konig

A Photo Essay: 9 Lessons Learned From #IRENE

Whenever there is an event such as Hurricane Irene we can always look and find a number of lessons that we learn from the experience to make the next time better. Rather than write diatribe after diatribe about the failures of both local and out of state mutual aid, the ineffectiveness of REMSCO, the dangers of over hyping worst case scenarios, and the double standards that exist between the public service sectors, I have decided instead to present the most important lessons to you in photographs:

Conversation: The Missing Key To Success

Problems and complaints about how an organization functions is a relatively universal occurrence. It doesn’t matter whether your agency is paid or volunteer, there is always room for improvement, and usually the first people to point this out will be your own members.

One of the biggest challenges in volunteer organizations is in getting those with the claims of inefficiency and system problems to realize that they are part of the solution. While paid organizations have the resources to place experts on the problem or dedicate time to the issue, volunteer organizations are usually more limited. The true key to resolving these types of issues, for both types of organizations, is through conversation.

Unfortunately, the leadership of volunteer organizations don’t necessarily understand the necessity of this key ingredient. Often they will hear the complaint, but not actually listen to identify the actual problem. They will view this as an attack on their performance instead of the constructive criticism it actually is will usually respond with a diatribe citing perceived accomplishments, reinforcing the fact that it is the leaderships issue to deal with, and promise some sort of resolution they have absolutely no ability to keep.

Instead of the aforementioned diatribe, volunteer leaders should take the time to actually listen to what the problem is. Engage the members in a conversation to verify that is the actual issue and harvest ideas for a solution. Then the leaders should have a conversation themselves about what the solution should be and begin implementation.

Conversation. It is too often the missing key to unlocking the solution to problems and issues.

What about your organization? Do you have conversations about the problems or are promises of magical solutions made? Do those every get delivered on? Inquiring minds want to know…

On Agency Decision Making

The vast majority if not all local volunteer agencies grew from a grass roots civic movement to provide a service for the improvement of the community. Agencies will fly the American flag and will open meetings and functions with ceremonies pledging allegiance to that flag

I am proud to live in the United States and to be able to have my voice heard in a democratic fashion. It provides me with both a sense of duty and makes me personally invested in the success of the country. I am a yearly voter for those who will represent me in the government and I am not afraid to let them know through correspondence or phone calls what I think of a topic or issue. Having the same abilities is what keeps me invested in the volunteer organizations I belong to. I think its essential, in order to have a successful volunteer agency, to maintain those same feelings and that sense of personal investment in all the members.

Unfortunately leaders of volunteer agencies who are democratically elected will often quickly forget this. They become enchanted by their new titles and unintentionally transform the mantle of responsibility that has been entrusted to them into a lust for what they perceive as power. Authoritative decision making, also commonly referred to as Executive decisions or Chief orders, are only effective when the person making such a decision possesses all the necessary information, has the required expertise, and the decision needs to be made quickly. Sadly, many times volunteer leaders lack that skill set but make these types of decisions in order to manifest their fictional authority.

It’s important as someone who volunteers to be invested in the success of the organization as a whole. In doing so it is each volunteers responsibility to select the leaders who will share that level of investment, who have the ability to learn the necessary skills, and are humble enough to understand that their election to a position is not so they can be served but so that they themselves can serve.

By electing the most popular, or the person who you are the friendliest with instead of those who are best suited is not only problematic for the organization but most importantly for the community the organization has been founded to serve. Therefore, ultimately, the mantle of responsibility for the success of the organization does not rest on the leaders but rather on the members.

With that in mind, be sure to choose wisely…

The Biblical Days Of EMS

While those of us within EMS wrestle with the relative youth and immaturity of our industry (being barely 40 years old in the grand scheme of the universe is truly not a long time), it is important to remember that the actual concept of providing medical care for an acute condition has been around since biblical times. The Parable of the Good Samaritan is an example of care being rendered to someone who was acutely injured, and then transported to a place where they can continue receiving treatment and to convalesce.

“A man was going down from Jerusalem to Jericho, when he fell into the hands of robbers. They stripped him of his clothes, beat him and went away, leaving him half dead with no clothes. A priest happened to be going down the same road, and when he saw the man, and he passed by on the other side. So too, a Levite, when he came to the place and saw him, he too passed by on the other side. But a Samaritan, as he traveled, came where the man was; and when he saw him, he took pity on him. He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and looked after him.”
-10 Luke 29-35

There is no mention of the Samaritan having completed an accredited course, passing a standardized test, or receiving a certification. The standard of acute care for that time was in fact wine and oil while the best mode of transportation was indeed a donkey. The actual basic concepts of what EMS is about are still all there. It is safe to say that The Good Samaritan was in fact, the world’s first Emergency Medical Technician… and he also just happened to be a volunteer.

…And The Afflicted Thou Wilt Save…

-2 Samuel 22:28