By Tom OConnor, Treasurer
|On the suppression end of business, things seem to be looking
promotional exams appear to be close, the overtime crisis of
months ago seems to have dissipated and staffing numbers have
increased (with more classes on the way). Those nasty rumors about
firehouse closures have disappeared, and firefighters are even
back to getting IDVs on a regular basis. Firefighters now not
only have adequate protective gear, but the department was just
recently fitted with a second set of turnouts thanks to Dorothy
Tuepel and Chief Dan Sullivan. The department has even come out
with a seniority list that includes paramedics.
Now, on to the EMS side of the department our frontline paramedics are treating patients with the very best of care, while behind the scenes our EMS leadership careens downhill on a path of no return. More firefighter/paramedics are relinquishing their positions and reverting back to the H-2 rank and more laterals are leaving the SFFD to head back to their old departments. Their reason? The empty promises from the Presidio that they would all be riding engines anytime soon. With the next two classes of firefighters scheduled to come out of the Tower, the department will be approaching nearly 200 probies leaving absolutely no room for medics on any rigs at all. Now, how this is factored into the H-3s non-existent training program is anyones guess. It has now been four years since the DPH/SFFD merger, and the ALS engine vision is just that, a vision.
According to our leaders at the Presidio, the whole ALS engine program is contingent upon the dreaded one and one ambulance (one paramedic and one EMT). Accompanying the 1 + 1 ambulance on every run would be the ALS engine, with a paramedic/firefighter on the rig. Unfortunately, there are innumerable flaws in the program. Any time there is a full box, the supply of ALS engines in a battalion drops to approximately zero. Any time there is a building alarm box, the supply of ALS engines in that particular neighborhood drops to zero. Any time there is a greater alarm, the supply of ALS engines in that particular quadrant of the City drops to zero. Any time there is a well, you get the picture. The 1 + 1 system is full of flaws which will lead to diminished patient care. And this is the whole model upon which the Presidio seeks to integrate medics onto the engines as fast as possible.
Perhaps the department should just slowly put the H-3 rank through a probationary period, with at most ten designated engines, and keep the ambulances staffed with 2 paramedics. All the while, the Presidio should just keep training firefighters to be paramedics, gradually increasing the number of medics we have. Once you reach a critical mass of medics, then you can fully implement the ALS engine program and maintain adequate patient care with 2 paramedic ambulances. Most major cities have abandoned the 1 + 1 ambulances, with the National Fire Protection Agency (NFPA) also about to come out with a recommendation for 2 paramedic ambulances. Why wont the Presidio join this trend?
That would seem to make sense, but a lot of things that make sense have been ignored by the Presidio Just recently, Chief McCallion emphatically stated to several medics that the H-3 training would not include truck training ever. So lets get this straight paramedics will be cross-trained to be firefighters without ever setting foot on a truck and then what happens when promotional exams occur? Will H-3s be considered trained and eligible to take a promotional exam having only learned half of the job? Or will they be forever stuck in the paramedic caste run by the Presidio wise men? Is this part of the long term vision of the Presidio, to keep all paramedics under their control with an intentionally dead-ended career?
As long as were on dead ends, lets look into the dispatch system that the Presidio and EMSA wont let go. Just recently, an EMERGENCY medical system ambulance bearing the SFFD logo was used to transport a patient between medical facilities, code 2. Transport between facilities? Is this what the EMS segment of the SFFD has in mind for our already overworked medics?
And lastly, the whole issue of run volume still needs to be addressed, with greater balancing between medical units, or more floating cars staffed by H-1s in the downtown corridor and the Mission district. But again, these suggestions just reek of common sense, and that appears to be an unwelcome smell in the Presidio