Monday, May 7, 2012

Should Firehouses be used as health clinics?

The fire chief of my old department has ventured forward with a new mission for the fire service. He is trying out a notion of using fire stations and firefighters as neighborhood health clinics.

The idea is that in some neighborhoods during specific and limited hours citizens can come by their local firehouse and have some simple health checks preformed by a combination of firefighters and volunteer health providers.

So if you live in one of these neighborhoods and suffer from perhaps a chronic health problem like diabetes, high blood pressure or maybe a heart condition, you can drop by the ole FD and get checked out.

These firefighters are already trained to the minimum standard of EMT basic and go all the way up the EMS food chain to the level of paramedic. They have all the latest technology in emergency medical care that is available to man. Fire trucks anymore are virtual mobile emergency rooms.

So this idea I think is very progressive and admirable. My experience with citizens with persistent chronic medical conditions tend use our services regularly anyway. When they are having difficulties with their health they call 911. So why not give them and us the opportunity to intervene early?

Well for me it would take away the excitement of riding around on the BRT with all the bells and whistles blaring and who wants to do that? Boring. Secondly it’s a firehouse, our house it’s where we live and we don’t care for visitors most of the time. If you need us let us know and we will come to you, it is what we do.

It is an inconvenience and that I believe is one of the problems with acceptance of the concept.

The idea isn’t without controversy. As far as I know it has never been tried before and anything unknown can cause anxiety and apprehension. The detractors I have heard are in two camps it seems.

The first is the firefighters themselves. Many in my former department have a feeling that they are already doing one hell of a job and that this additional service will increase their burden. I agree they are doing one hell of a job, just look at the apartment fire they fought this weekend, great job.

They also feel underappreciated; there hasn’t been a raise in their pay for many years now, with a steady increase in their out of pocket expenses for health care and retirement costs. In essence they are not only not gaining in salary they are losing real net income. They are doing more than ever and getting paid less than ever and now comes this.

The new chief wants to add even more work and responsibility to their daily existence. It feels unfair and I can see their point. Firefighters aren’t nine to five employees banging it out in a factory or entombed in an office cubicle. They live in a dynamic and very stressful environment.

I have never been a fire chief, all I ever was, was just a fireman, and that is what I know. My experience was that a chief can get so involved in being an executive they forget their roots. What I also learned over the years was that a simple “good job guys” can get a lot of firefighters to the other side of an issue.

Nobody likes having their routine changed. I think as firefighters we see on a daily basis the worst possible outcomes of poor decisions by others, it becomes the norm. For me I think it eventually lead me to a place where all I ever saw was the worst possible outcome of any situation in life.

My thoughts became corrupted and I lost my ability to envision a best case scenario. So change for me was viewed through this prism, and maybe it is how other firefighters view it as well.

The second group of naysayers are concerned citizens that see a risk or an exposure to the taxpayer with this project. They see another type of worst case scenario. They are the “What-iffers”, what if someone stops by the firehouse and gets bad information or bad advice? What if they then leave the fire station, suffer some catastrophic event and the family then sues the department and in fact sue the taxpayer?

Who will be responsible, who will be blamed and who will ultimately pay? Good question. I will leave answers to those questions in the hands of people far better qualified than me.

Since my retirement from the service aside from writing I have looked for employment. I teach at the University of Colorado but not every semester. I am a staff writer for a fantastic magazine and have refused work as a paramedic.

Finding a job is no simple task for anyone these days and when your resume pretty much says you were good at tearing stuff up and putting out fires many employers don’t seem to feel that qualifies you for their kind of work.

I understand the urge to complain about a change in work assignment. It is one of the most universal skill sets you’ll find in a fire station. All I would suggest is take a moment to be grateful for a job, a really cool job that very few people get to do.

It is honorable work, important work, and rewarding work. I haven’t found many fellow travelers that can say that about their source of income. I know I have no right to tell anyone how to feel about anything in their lives. But I can’t help myself it is in my nature.

Good luck Chief, I will be a curious observer of your grand experiment. Just remember your decisions today will be the legacy by which you will be judged in the future. Right now that opinion is being formed right in front of your eyes.


Sandra Tyler said...

Great idea, Tim. I'm sure people would flock to it. So many people now need all the help they can get, where they can get it.

Jo said...

Never having been a firefighter or lived where I work, I would have thought this a great idea to reach out to your neighborhood and offer help.
Seeing it through your eyes, I'm not sure the firefighters will be able to put on the helpful face they are so known for and do the good the program would be designed to provide.
Kind of sad, really. The paramedic training is something that many who cannot pay could benefit from and there it is right in their fire house.
Great piece Tim, but I sincerely hope you are not right and that this program actually fuels their heroic tendencies and those in need get the help they cannot afford.

Fireman said...

Thanks Sandra and Jo. Yeah Sandra I agree and this could help out the burden on ERs as well as helping people before they call 911, any time you roll a BRT emergent there is a chance of an accident, another plus.

You were never a FF Jo? Hhahahaha, you know Jo these firefighters will bring it and anyone who visits a station will get great caring help. they may not like it, but the general public will never know that from the experience they will have. Firefighters are consummate pros.

Firefighter/Paramedic said...

A very similar project is in the works at my department. The clinics at our stations are supposed to be staffed by a medic and either a PA or Nurse Practitioner. There's even talk of someone from the county doing follow up visits at the homes of these patients.

While it's not what the fire service started out doing I think we are uniquely positioned to help out in this situation. We are, after all, public servants.

Fireman said...

Hey FF/Medic I agree with you, our guys will be doing the follow-ups when they are out in their districts. I hear a lot of guys are not keen on this but hey when I started there were many things we didn't do that we did later. We help people that's what we do.

Jenn said...

Well-- I have a thought or two on this. Kinda a pro/con kinda thing. Definitely--the fire house is probably not the place to do this--unless it was big enough to have a room outside of where you live to do it. I thought back to when we used to vote at the fire station. Long Long LONG lines and if they got a call it was just a disaster out in the parking area. Anyway, my thought there would be to set up a mobile station (like they do with blood mobiles). I don't know...I'm just thinking aloud so to speak.

I think the pro to this sort of thing would be--the citizens near you would get to know some of the firemen and women and vice versa. And when the real call came in to go to them-- you might remember that this particular older lady had diabetes and maybe her sugar is too low-- or maybe this gentleman had high blood pressure, etc. Not saying you'd memorize files--but the interaction might help in some cases. Maybe not. And on the flip side--these people upon seeing you respond to their call might be comforted by the familiar face... Again just thinking allowed.

Something to think about for sure!! Cheers, Jenn.

Fireman said...

Thanks Jenn, I think this will be a good program, one thing is for sure, we will see most of these people one way or another anyway. The fire service has been very good at teaching about fire safety awareness now they can do the same with medical conditions.

November Rain - k~ said...

I'm not sure I have anything intelligent to add, but I wanted you to know I AM reading ;-)

Fireman said...

Thanks Rain I have been sick and so have the kids so I'm hoping to get back to posting tomorrow.

Sandra Tyler said...

Interesting! Like you're behind the scenes but also in the action?