Times Are a-Changin’

A friend of mine recently sent me an article discussing the rising demands of EMS in urban areas with large populations of homeless and
impoverished citizens. One of the firefighters interviewed expressed his discontent with the overwhelming number of medical calls; in short, he signed up for the fire department to fight fires, not to be a nurse.

I can remember this same sentiment being expressed back in the early ’90s when I joined an organization that was making the transition from limited priorityone medical responses to paramedic engine companies. Despite the voiced frustrations of a few, the organization made the transition and now boasts about being an all-ALS department with paramedic engine companies and in-house transport services.

The article touched on one department only, and I’d venture to say that for most departments, the importance of and support for fire-based EMS is well understood. Like it or not, our mission is to save lives and protect property–in that order. Never once have I read a mission statement that states, “only those lives that are threatened by fire.” With EMS constituting 75—80 percent of most departments’ workloads, we’re well beyond any justifiable argument of opposition toward EMS.

If we’re going to argue about fire-based EMS, it should be about the problems inherent in a system that allows blatant abuse of EMS response. Most firefighters are driven by the action-oriented calls–fire or EMS–but one facet they’re not excited by is the “frequent flyer” who calls three times after midnight seeking treatment of a bellyache or stubbed toe. We do ourselves a disservice when we voice opposition to fire-based EMS
without being specific about what isn’t working in the current system.

Another point of contention in the fire service: our less-than-aggressive efforts in the field of fire prevention. Although prevention, too, is listed as a high priority in most departments’ mission statements, our actions (at all levels) have been reflective of a far lesser priority.

What division is the first to be cut when budget reductions are imposed? Why haven’t we expressed a higher degree of opposition when administrators fail to adopt an aggressive fire code or sprinkler ordinance that directly affects firefighter and civilian safety?

Our mission is to save lives and protect property, in that order. Never once have I read a fire department mission statement that says, “Only after the building catches fire will our life-saving actions be employed.”

I fully understand that priorities will differ from person to person and organization to organization, but the priorities of life safety and property preservation have been and always will be the top priorities of the American fire service. Although we may struggle to agree on a common model for the provision of fire/ EMS services, the one item that bears no debate is that PREVENTION (proactive) is a far better model than
response (reactive).

In every corner of the fire service, we stand united in our efforts to improve firefighter and civilian safety, but we’re far less united in our efforts to support aggressive fire codes, public education and sprinkler ordinances.

The importance of response cannot be overlooked or underestimated. Regardless of our efforts in the field of prevention, we’ll always have a need for a response component; therefore, we must make every effort to properly staff, train and equip our departments to safely mitigate
the diverse list of emergencies that will inevitably occur.

In the next few years, however, many departments will be retooling after a long bout of cutbacks and reductions (in all areas of emergency services). There’s no better time than now to reevaluate the services we provide and the priorities we set. Regardless of our efforts, our goals remain the same. How we do it with limited dollars and fewer personnel is something we must all begin to consider (and in some cases debate).

The stark reality: Our response component will likely never see the same level of support as it has in years past. The public has made a conscious decision to reprioritize and so too must we.

We can no longer rely on response to meet our priorities of firefighter and civilian safety; instead, we must heighten our focus on public education coupled with aggressive fire codes that draw on the latest in engineering technologies to protect against the threat of fire. We
must seek to enlist an aggressive code enforcement contingent that’s strongly supported by elected officials and political appointees to avoid the acceptance of variances that impose unnecessary risk to firefighters and civilians alike. And lastly, we must continue to strive to maintain
a strong and prepared response component capable of providing the highest quality of services within the confines of safety.

Our mission may not have changed, but the means by which we achieve it are destined for an overhaul.

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