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Guest Editorial: 'I'm Fine'

“I’m fine.” These words have been uttered and heard many times over our careers when we’re asked how we’re doing. Our employees have said them, you have said them, and I have said them. It has become a standard answer, but what does it mean? 

Obviously, it means that we’re all right, copacetic, OK, or good. We have no concerns, problems, or issues causing us to be distracted, agitated, or troubled.

I have been saying “I’m fine” a lot lately. And I think I am, but I’m also wondering about it. I love my work, and I believe it’s a vocation to minister. I am a public-safety lifer from right out of high school and have been involved in community service since my early teens. I enjoy my job and appreciate my medics and staff. 

Those women and men continually exhibit their courage, resilience, and dedication to serve our community every day without hesitation. In this era of pandemic, they, like others on the front lines, have extra challenges, and they overcome them with grace. 

It is my job to make sure our department has what it needs to meet our mission—an excellent corps of personnel, comprehensive logistics programs, and a solid fiscal policy. In normal times there are obstacles to success, but we press ahead and overcome them. 

Ensuring an excellent corps of personnel means we recruit the best candidates. Not only do we need people with the cognitive skills and psychomotor proficiencies, we need our candidates to have the appropriate affective attributes. Recruitment used to be difficult because we had to compete with other public-safety and healthcare professions. Now it seems more about competing with misconceptions about our work and a high degree of social apathy. 

The pandemic creates hiring challenges. Local and state coronavirus mandates, physical distancing, facial barriers, hands-free processes, and symptom screenings pose obstacles to effective assessment and interview practices. A vital component to ensuring excellence is education and training. We will continue to work through training and simulations that meet our needs and achieve high-quality programming. 

Ensuring a sound logistics program is challenged as well. Everything from PPE management to equipment disinfection and sterilization to vehicle cleaning has taken on new dimensions. 

What’s the best disinfection process? UV, ozone, peroxide, bleach, purple tops, gold tops? What hand-sanitizing solution is least toxic for your staff? Do you have the MSDS appropriately displayed and available? Each process has a degrading effect on equipment. So we ask, what did we miss? What’s left over to harm our patients or crews? These concerns should always be on our minds, not just during a pandemic, because Clostridium difficile and hepatitis B are still a thing. 

Of course the interruptions in supplies and equipment cause us to rethink things. Drug shortages have become typical, but nitrile gloves and hand sanitizer and BVMs…who’d have thought? 

I cannot speak for our police, fire, and emergency communications colleagues, but many in the EMS and ambulance realm have seen significant reductions in responses and transports. That translates to reductions in revenue. And since local tax subsidies vary across the country, some services were hit harder than others.

A reduction in revenue, if sustained, often means a reduction in services. CARES Act funds provide a cushion for finances but add layers of administration to ensure compliance with grant provisions. In many cases these are layers some of us don’t have, so it creates extra work and takes time away from managing other priorities. 

It is not my intention to dampen spirits or complain. My intention is to talk about the things on my mind and challenges I’ve heard from colleagues and friends. As public-safety administrators and commanders, regardless of the discipline, we seek to do the right thing for the public good. 

We stand with our medics, police officers, firefighters, dispatchers, and staff to ensure we meet our mission to serve our communities. Some of us are having rocks thrown at us by the very people we’ve chosen to serve and protect. Our heroic employees find themselves in harm’s way more often than they used to, yet they remain unwavering in their commitment. 

Our residents, employees, elected officials, and managers expect us to be strong—physically, mentally, and spiritually. Our families expect the same from us and for us to protect them, now more than ever.

However, we must not forget we’re human. We encounter challenges; we get frustrated and short-tempered. Many times we fail. But we did not get to this point without being resilient. Our success comes from the ability to recognize the opportunities our challenges create and the willingness to learn from our failures and adapt. 

The next time someone asks how you’re doing and you reply, “I’m fine,” spend some time reflecting on that statement. What does it mean to be fine? Are you coping well? Perhaps you are and everything is good. But if you find yourself experiencing extraordinary unresolved challenges, don’t hesitate to reach out to a trusted peer. This work can be daunting, but it doesn’t have to be disheartening or devastating. 

I wish the very best for all my commander colleagues, medics, and staff.   

J. Paul Davis is director and chief of EMS at MED-ACT EMS, Olathe, Kan.


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