Altered Mental Status

To: The Honorable Michael Bell, Mayor City of Toledo

From: A Concerned Citizen

Date: March 16th, 2010

Subject: WTF

Mr. Mayor,

I supported you. With your background in Public Safety I was sure that you could be counted on to keeps our streets safe. This is, after all, the main duty of a municipal government.

125 Police Officers received layoff notices this week. I know you consider this your “Plan B” if City Council does not pass the balanced budget as outlined by your administration. This type of strong arm tactic has no place in government. I honestly hope that you are not truly considering endangering the safety of every man, woman and child just because the Legislative Branch of our city government refuses to pass the mind numbing attempt at a budget you submitted.

Yes, the City of Toledo is facing a budget crisis. Yes, the previous administration dropped a major headache in your lap. We do need to tighten our fiscal belts and come out of this mess. WE CAN NOT DO THIS AT THE EXPENSE OF SAFETY.

Laying off Police Officers is not an option. Lets look outside the box and find solution to balancing the budget that will not have the citizens of this great city living in fear.

Granted I do not have access to the exact figures used in creating the budget. I would still like to offer some cost cutting ideas that should allow us to balance the budget without jeopardizing safety:

Police Department- Overtime for this Department needs to be ELIMINATED. The traditional 8 hours a day five days a week schedule is a thing of the past. We need to utilized System Status Management in scheduling our police force. We need to analyze the demands for police service and schedule Police Officers appropriately. We need to utilize non traditional schedules including split shifts to cover high demand hours and expanded shifts to cover  high demand days (weekends). Overtime needs to be eliminated by City Ordinance. Overtime to cover call offs and vacations is a luxury we can not afford right now. If we can not maintain minimum coverage for a given shift we need to put our Command Officers (Right up to the Chief of Police) and officers providing ancillary services (Impound lot, Dispatch, Property Room, Cold Case Detectives etc.) in a patrol car.

Eliminate the Training Division. In the future let’s require newly hired Police Officers to hold there OPOTA certification prior to applying. As for as on going training and continuing education, Owens Community College’s  Public Safety Training Center can provide these services in a more cost effective manner.

We need to focus our Law Enforcement efforts on Safety and Quality of life measures. During these hard financial times some services are going  need to be put on the back burner.

We need to practice cost control. How much money would we save annually if every police officer on the street was required to “Walk a Beat” an hour a day. Turn the car off, get out of the car and walk. I think the savings on fuel would be substantial. Do away with the annual uniform allowance. If a uniform items is damaged or worn and not serviceable the officers should be able to turn it in for replacement.  A preset yearly uniform allowances is contrary to good fiscal management.

Fire Department Overtime for this Department needs to be eliminated also. Scheduling of FD personnel needs to be based on a needs utilization assessment. The traditional 24/48  schedule needs to be eliminated. This schedule has built in overtime that needs to be avoided at all cost. Non Traditional scheduling needs to be utilized allowing higher staffing levels during historically peak service times.

As with the Police Department we need to eliminate the Training Division and require all newly hired Firefighters to be certified as Firefighters and Paramedics prior to applying for the department.

Other Cost Cutting Ideas

• During this fiscal emergency the City of Toledo needs to shutdown on Fridays. All non essential (safety) personnel will be scheduled Monday-Thursday 8 hours a day.
• Establish a City Volunteer Program. Volunteers can be used in a variety of positions. With a well run program we should be able to eliminate many positions outside of the Public Safety realm.
• Get out of the refuse business. Require residents to subscribe to a commercial refuse collection service. Charge a franchise fee for Refuse Collection services operating in the City.
• Lease the City Parks and pools to Community Organizations for $1 a year with the understanding that they will be required to maintain the parks as well as provide liability insurance for the parks. For those recreational facilities where no organization will step up and take responsibility close them
• Automate. Applications for licenses and permits. Filing of non emergent police reports. Record Requests and other services need to be automated and online.

Mr. Mayor these are just a handful of the options available to you to help balance the budget without putting our safety at risk. I am sure my fellow citizens could offer many more. We can no longer afford to do thisngs in this city just because that is the way they have always been. We need to think out side the box.

Sincerely,

Kyle D. Utz

Citizen

The EMT Code of Ethics was adopted by the NAEMT in 1978. At this time EMS was truly in its infancy. With the changes and advances in EMS isn’t it time we reexamined this code? I am providing a complete copy of the current EMT Code of Ethics below. Take some time and examine it and apply it to the job we do today. What do you think is relevant? What needs to be added?

As providers this is something we need to take ownership of. Leave you comments below or email me kyle@alteredmentalstatuscom . Once I have time to attempt to incorporate your suggestions into a workable draft I will post it here for debate. I would encourage ems related sites to take up a similar effort. Let’s present our final drafts to the NAEMT for consideration.

EMT CODE OF ETHICS (As adopted by the NAEMT 1978)

Professional status as an Emergency Medical Technician and Emergency Medical Technician-Paramedic is maintained and enriched by the willingness of the individual practitioner to accept and fulfill obligations to society, other medical professionals, and the profession of Emergency Medical Technician. As an Emergency Medical Technician-Paramedic, I solemnly pledge myself to the following code of professional ethics:

A fundamental responsibility of the Emergency Medical Technician is to conserve life, to alleviate suffering, to promote health, to do no harm, and to encourage the quality and equal availability of emergency medical care.

The Emergency Medical Technician provides services based on human need, with respect for human dignity, unrestricted by consideration of nationality, race creed, color, or status.

The Emergency Medical Technician does not use professional knowledge and skills in any enterprise detrimental to the public well being.

The Emergency Medical Technician respects and holds in confidence all information of a confidential nature obtained in the course of professional work unless required by law to divulge such information.

The Emergency Medical Technician, as a citizen, understands and upholds the law and performs the duties of citizenship; as a professional, the Emergency Medical Technician has the never-ending responsibility to work with concerned citizens and other health care professionals in promoting a high standard of emergency medical care to all people.

The Emergency Medical Technician shall maintain professional competence and demonstrate concern for the competence of other members of the Emergency Medical Services health care team.

An Emergency Medical Technician assumes responsibility in defining and upholding standards of professional practice and education.

The Emergency Medical Technician assumes responsibility for individual professional actions and judgment, both in dependent and independent emergency functions, and knows and upholds the laws which affect the practice of the Emergency Medical Technician.

An Emergency Medical Technician has the responsibility to be aware of and participate in matters of legislation affecting the Emergency Medical Service System.

The Emergency Medical Technician, or groups of Emergency Medical Technicians, who advertise professional service, do so in conformity with the dignity of the profession.

The Emergency Medical Technician has an obligation to protect the public by not delegating to a person less qualified, any service which requires the professional competence of an Emergency Medical Technician

The Emergency Medical Technician will work harmoniously with and sustain confidence in Emergency Medical Technician associates, the nurses, the physicians, and other members of the Emergency Medical Services health care team.

The Emergency Medical Technician refuses to participate in unethical procedures, and assumes the responsibility to expose incompetence or unethical conduct of others to the appropriate authority in a proper and professional manner.

So I am now 8 months out of Medic school. Back on 24/48 schedule and loving it. Really “Living the Dream” again. So what do I do? Apply for a full time dispatch position with Lucas County EMS.

Truth is I am not getting any younger. I am a damn good dispatcher. When I first saw the ad I figured there was not much of a chance I would get it but I filled out the application anyways. Great pay, great benefits and a real honest to life retirement package.

Several of my friends applied for this job also. Out of all of the people I know that applied I am the only one that got an interview.

The interview went great. They said they have more interviews scheduled and they would be making there final decision in 2 weeks. I was a little indecisive going into the interview. Wasn’t sure if I wanted the job. Now I am positive. I want this job. Gonna be a long 2 weeks waiting to hear.

It is 0200 and I can’t sleep. Until the Nyquil starts to work:

• How about a Beavis & Butthead reunion show? What are their lives like now. What do they do for a living? Married? Children?
• Is there a 12 step program for Farmville?
• Good Opportunity in my future. Should I sell out?
• When did the word promise lose it’s meaning?
• How many licks does it take to get to the center of a Tootsie-Pop
• Where did I put my keys?
• If Budweiser is the King of Beer what beer is the Queen?
• Why can’t I paramedic pink slip a patient but a cop can?
• Are the new EMT’s & Paramedics I am working with getting younger or is it just me?
• Why do we wear all kinds of clothing that says EMT or Paramedic when we are not working. How many times do you see a guy with a picture of a wrench on his shirt with the words PLUMBER walking through the mall.
• When did the Old Folks homes become Nursing Homes and then SNF’s and finally ECF’s. Whats next??
• Do we send fire trucks to medical emergencies in case the patient burst into flames?
• Why can’t Twinkies be diabetic friendly?

AND…. The Nyquil is working……

Seeing life as shades of gray is  cop out. The life is about black and white.  Right and Wrong. Doing the right thing is not always easy. Life would be easier for me if I allowed myself to linger in these ‘Gray” areas.

Truth will always be truth and a lie will always be a lie. Right will always be right and wrong will always be wrong. No matter how one may try to justify it it still comes down to black and white.

I can come up with a reason to support every poor decision I have ever made and every untrue statement I have ever uttered. On many occassions I have done just that. I am by no means claiming innocence here.

If you say you are going to do something do it. Without our word we have nothing.

You have haunted me for years. I just tried to help. You changed my life, yet I was helpless to save yours. In the deep darkest corner of my sleep I still see you. I still hear your dad yelling for me to do something. The nightmares still come but not as frequent. I held you in my arms on the median of the road. Where in the hell is the ambulance? What is taking them so long? Maybe I shouldn’t have moved you but I didn’t know. You looked at me with faith and trust that help was there. I was lost. I didn’t know what to do. I was trained to Protect and Serve. Your trusting eyes haunt me. I felt helpless that day. I vowed never to be helpless like that again. You put faith in me and I let you down. The medics took you from my arms, but I k new it was to late. I saw the life drain from your eyes. The trust in your gaze turn to emptiness. I felt the life go from your body and felt you go limp in my arms. Where in the fuck is the ambulance? This wasn’t suppose to happen. this was a 30 day TDY. 3 Days left and back to the real world. Back to studying, back to school. Back to learn everything I could about Law Enforcement because I thought I would be able to help, to make a difference. I hear the siren. They will know what to do. A second patrol car on scene. What the fuck? The siren from the ambulance is going the wrong way. the wrong street. “A17 Comm. the rescue turned down the wrong street. I need them to expedite, I need them here now” Okay stop and think. CPR you learned this in MP school not to long ago. Check for breathing. No breathing. Why are your eyes still open? Looking at me? Tilt the head. Maybe if I had known about the jaw thrust but I didn’t. Try to breathe. Thank god the squad is here. I ran as fast as I could. I met them at the back door. They took you from my arms. The door closed.

Not that it helped but I got the guy that did this. I honestly don’t remember but I am told I pulled him through the drivers side window. We’ve got him they told me. Stand Down.

Then I heard your Dad. The same voice I had heard pleading wtih me to do something. He was talking to the medics taking care of you. Is she is going to be okay? I need to know whats going on with Beth. A name. A name to go with the face. A name for all the times you would come to me in my dreams in the future. I name for the girl that changed my life and a name for the girl that would haunt me for all these years.

Beth, you came into my dreams last night with those trusting eyes. I don’t know what more I can do. I kept my vow. I learned the skills I need so I would never feel that helpless again. I have been able to help a lot of people. What do you want from me? Why did you come back. I thought the dreams were over. Long since hidden away is a fold of the brain. Memories with me but repressed. The feeling of helplessness gone. I couldn’t help you. I tried. I didn’t know how. There is nothing more I can do for you. Everyday that I go to work and help people is an atonement for that day. I know I let you down. I betrayed the faith you had in me. Why do you keep haunting me? I know I can’t make it right but what more can I do? When will you leave me alone?

Beth had just turned 12 years old.As a pretty green MP, I was first on scene for this MVA on post. The details don’t matter. This is why I do what I do now.

I vowed I would NEVER do it again. I would never go face to face with Right CAD again.  I belong in the back of the squad. In the center of the action.

Well, that vow lasted a little over a month. It is 0342 and I am halfway through my first dispatch shift at Big Potential EMS.

Why you may ask? Truth is I have an addiction I have to feed. I am addicted to having a roof over my head and food on my table. On more than a few occasions I have been accused of being an overtime whore seeker.

Truth is pulling a shift or two in dispatch is not all that bad. I am still on my 24/48′s. Still Living The Dream once every 3rd day.

In my last job I dispatched 5-6 days a week and tried to fit EMS shifts in between. I burned myself out on dispatch. The thing with dispatching is I am damn good at it. And here at Big Potential EMS I actually get to dispatch again. Unlike my last job at the Big Green dispatchers are trusted to have independent thoughts and think outside the box to get the job done. It is refreshing to be able to do the job with out Big Brother (or Sister) over my shoulder. If an issue arises I can go to the source, call the LT or the crew and fix it without having to go through 3 layers of supervisors.

I plan on being on the road for a long time to come. I worked  hard to become a Paramedic.  Too hard sit behind a computer screen 40-60 hours a week listening to the radio while others live it. That being said I can defnitly see myself picking up more shifts in dispatch. And not just for the money. This is a nice change of pace and I really do enjoy being allowed to DISPATCH again.