Turning Paramedics Into Firefighters

As fire departments continue to handle an increasing number of medical calls, more and more departments are recruiting paramedics and EMTs and training them to be firefighters.

The math is simple: Turning a firefighter into a paramedic means taking the firefighter out of service for nine months or more, which means additional expense to the fire department to pay for training and overtime to cover lost shifts, plus a temporary loss of unit cohesion. However, turning a paramedic into a firefighter costs the fire department less, takes no one off the line and takes less time.

The solution does not come without challenges. What hurdles—physical, mental, emotional or otherwise—will a medical professional experience when crossing over to the world of the firefighter? What can paramedics do to improve their chance of success? What can fire departments do to decrease the rate of training attrition and help paramedics through the program?

The North Metro Fire Rescue District, located just north of Denver, CO, has trained both paramedics and civilians to become firefighters for over 50 years. The district covers 115 square miles with a population of 90,000+. It encompasses parts of five counties, two cities and the state’s fourth-busiest airport. There are 67 full-time firefighters, along with special hazardous-material and wildland teams. Of the 6,700 calls last year, 71% were for emergency medical services. That’s a very good argument for hiring paramedics.

Recently, the district graduated its first all-paramedic class. And not all of them made it. EMS Magazine went along for the ride with the fall 2003 all-paramedic fire academy class.

Starting Out

It’s the first week of training, and they’re already in trouble. Five trainees, all paramedics, sit in silence in the training room as punishment for their infractions. What did they do wrong? Their lead instructor, firefighter Larry Williams, says this group already committed the most common trainee crime—they have an attitude problem.

“We can teach anyone to throw a ladder,” explains Williams, “what is harder to teach is attitude.”

The trainees are not a bunch of wet-behind-the-ears boot camp recruits. They are all seasoned paramedics, with anywhere from five to 10 years in the emergency medical response industry. However, respect within the fire department is a finely drawn line. Failing to stand up when a lieutenant, a captain or worse—the chief—enters the room is seen as an egregious error by the cadre. Williams stresses that the paramedic must fit into the fire department, not the fire department into the paramedic. This is one of the hardest lessons to learn.

Among the class is Clint Fraley, a five-year EMS veteran with experience at Denver Health Medical Center; Charles Gross, a former ski patrol member at Keystone ski resort in Colorado, who also worked for eight years for the Summit County (CO) Ambulance Service; Jeff Tipton, previously a firefighter and paramedic with the Pullman (WA) Fire Department; and Randy Nelson, who is being trained by North Metro, but will return to the Mountain View Fire Protection District in Longmont, CO.

As training begins, they are all excited, with some nervous anticipation. Not only do they have to learn many new procedures, they must also learn how to fit into this new culture. Going from a two-man ambulance crew to a five-man fire crew, and part of a much larger department with multiple fire crews on-scene, is a considerable challenge. Firefighters have to rely on each other for their own safety and protection. This attitude of mutual support must also be instilled in the trainees.