When calling 911 …

The majority of people that call 911 in our region speak to an operator asking them if they want police, fire or ambulance. The various police and fire agencies in each city get calls for their community downstreamed to them, but if you ask for the ambulance, you get BCAS. We are the only game in town, and as such take a lot of requests for help from a large population.

Sometimes, when the calls are put through to us they disconnected or we lose the caller for various reasons: caller hung up, bad cell connection, etc… A coworker and friend picked up a 911 call like this early in his shift recently. When he answered the phone, “BC Ambulance Service, for what city?”, he heard a baby crying in the background and man’s voice. Then the line went dead.

Cell phones and 911 can be a pain in the @$$. All we know is the address of the cell phone tower near the patient but not the patient’s actual location. Lack of this address location information makes our jobs a lot harder if the caller isn’t able to tell us where they are. This particular caller called from a cell phone. The next step is the most obvious: call them back.

No answer. Next, the call taker phoned Telus (the predominant phone company here) to try to find an address. Telus told us it was a Telus Mobility number and to call them. After calling them the call taker was told that it was actually a Bell cell phone number and to call them. The call taker worked to find a billing address from Bell who refered him to their security department. As you can imagine, this has a low probability of success due to the ‘mobile’ nature of mobile phones. The cell phone security division provided us with a billing address and a landline phone number.

He tried a call to the landline number – Pizza Hut??? No one at Pizza Hut needed our help.

The call taker, finding this a little odd, phoned the police to have them attend at the address with us for our crew’s safety. The event was created and an ambulance is started on the way.

One final attempt by the call taker was made to call the cell phone. SUCCESS!! The voice he heard earlier answered the phone:

“Hello sir … did you call 911 and disconnected? Can we help you?”

“I was worried about my friend, but everything is alright now.”

“Alright, did you hang up on 911?”

“Yup. I hung up to go check on my friend.”

The outcome? Well, a call taker in a very busy communication centre took almost 30 minutes to try to track down a caller who didn’t need help. All he needed to do was tell us he no longer required help before disconnecting.

There is a lot emphasis placed on not making prank 911 calls. I would say that these types of calls happen far more often than prank calls. Many people don’t dial ‘9′ then ‘1′ and wait to dial the last ‘1′ to be sure they are needed. They dial up the whole number and give little thought to the consequenses of hanging up before making contact.

Please don’t hang up. We’ll try for a long time to track you down assuming the whole time you desperately need help.

The Changes Roll In

A lot of things have changed over the months I have been away.  You may be surprised to hear I have some thoughts on them.

Looming Strike Action

The Ambulance Paramedics of BC (CUPE 873) will be in a position to strike as of April 1.  Let’s not delude ourselves, strike will happen.  The hardcore members of the union will be hardcore and the conservative members will be conservative.  My job as a leader on my team is to encourage the team to do the business we need to do.

In the dispatch centre, our team has discussed the looming job action and have acknowleged that we have some core responsibilities:

1. Using MPDS, assess calls in a consistent and respectful manner.
2. Do our best to get ambulances to patients.
3. Manage ambulances to get patients to the care they need.

Those core items should not be affected by any job action.  Staffing worries on the street and in the dispatch centre may affect response times, but we can’t let the public suffer (not to mention our fellow Brothers and Sisters).  This is about the employer.

AVL

 Automatic Vehicle Location (AVL) hasn’t really changed how EMDs do business much at all.  It confirms most of the closest car decisions we make on a daily basis, but can’t be relied upon to pinpoint the locations of ambulances with 100% accuracy so, at best, it’s a nice toy for the EMDs. 

For the call takers, on the other hand, being able to tell a frantic call taker with even a modicum of accuracy that the ambulance coming for their loved one isn’t far away is a nice monkey off the EMCT’s back.

Supervisory Structure

I would say we finally have a supervisory team in place except one of our Dispatch Officers is leaving.  It’s nice to have some peers to bounce some ideas on or share some concerns with (see the next item).  Meeting a bit more often as a group would help.

Training

Holy crap there are a lot of students buzzing around.  I think we have around 19 EMD students in the centre in various stages of developement – from pupa to butterfly.  In a few short weeks, there will be a bundle of new call taker students following suit. 

I know we are short staffed, but it’s too much, too fast.  The second class of EMDs was too large for us to handle and their practicum time needs to be delayed to finish the first class off.  Who is going to precept the call taker calss?  Can you say burn out?  I can.  Watch – “Burn out”.  See?

… so what am I excited about?

I’m not sure why I am so excited about the room reorganization we have scheduled for later this month.  It seems silly.  I know it’s going to be the same shite, only in a different shape, but I’m all a twitter because of it.  The current format of the room was done without much input from front line staff.  The new layout seems to actually have been thought out rationally.  What a concept.

… I think I’ve found it.

As you can tell from my last post, my heart wasn’t in the job for a little while. Call it what you want – burn out, being disillusioned, or me being a cry baby. The fact of the matter is things are changing.

I decided to do something about my ‘bad attitude’ shortly after you last heard from me. I talked to my manager and got more involved in some of the goings-on in the centre.

We have just finished initial training in the i/Dispatcher CAD product from Intergraph. It will change how we do business in some very profound ways. While it will make some of our easy to do items slightly more difficult, most of our job will get easier. In my opinion, the good far outweighs the ‘bad’. I am helping to train on the new platform.

BC Ambulance service has finally filled the Dispatch Officer positions (sort of an EMD floor manager) that have been vacant for far too long. I managed to win one of the 5 available positions.

Next on my list, I plan to take my renewed interest and put some of it into this blog.

I am sorry for my hiatus.  I’ve taken my fibre and plan to be more regular in the future.

Setting the Scene

In the dispatch centre, I am sometimes hyper-aware of the perception the public has of the ambulance service.  In British Columbia the ambulance service is run separately than the fire service.  Ambulance is a provincial operation while the fire departments are, for the most part, municipally funded.  The fire departments have done an amazing job at PR.  On the other hand, it is often assumed that we are part of St. John’s Ambulance or that we belong to the hospitals.  Neither are correct.

As dispatchers and call takers, we are the first contact with people in need of help.  I have the ability to steer the call in various directions, including into the toilet.  I can set the tone for how the paramedics are treated when they arrive with very little effort on my part.

I stumbled on the following passage from Nathaniel Lord’s blog (full post).  I think I need to create a version for the EMD. 

“This morning, as I was stopped at the intersection of Augusta St. and Church on my way to work, an ambulance approached with sirens and lights from the direction opposite me.  In general I don’t take to much notice of an ambulance besides making sure that I pull out of the way so it can get by, but this morning as the emergency vehicle rushed past I happened to look over and for a minute catch the face of the driver.  The ambulance was driving too fast for me to really be able to see what the driver looked like but it gave me enough time to catch the intense and determined expression upon her face.  I found the expression both profound and beautiful; the urgency and purposefulness of it really hit me in the gut.  I suppose this is the way the ambulance driver has to be; intense and determined; urgent and purposeful.  The vehicle they drive moves with the goal of potentially saving some other persons life.  Time is finite.  My friend Josh, from high school, who is now finishing up Nursing School, was an EMT and an ambulance driver for quite awhile.  He told me once that while he had only been on the scene of a few serious life threatening situations as a driver every call is regarded as a possible moment of mortality.  That is why there are the lights and sirens and that is why other drivers need to get out of the way.  Intense and determined; urgent and purposeful.  And it has to be dangerous, moving so much metal at high speeds on a mission to save life, while swerving through traffic never knowing for certain whether this car or that will get out of the way.  I do not know the statistics but I am sure that every year there are a good number of ambulance accidents.  This is not ironic it is just the reality of the game.  We are a culture of speed and single-mindedness, sometimes we cannot be bothered to be aware of what is around us; sometimes this costs lives.  Yet the EMT behind the wheel of a speeding ambulance knows that in taking the risk another person may have a chance to live.  For this I have a deep respect and gratitude.  I do not know where the ambulance was off to this morning or whether it was an emergency of life and death degree.  I do know the look I saw on the drivers face and should I ever be in a situation of emergency myself I can only hope whoever comes to my aid will be driving with that same expression; intense and determined; urgent and purposeful. ”

I love this description.  The driver is even rightfully described as an EMT (rather than an “ambulance driver”) and the intensity is fantastic. 

In our world, patient care always comes first.  That’s policy number one.  I hope Nathaniel’s obervation from the street is more than an archetypal experience.