| How
did you get into nursing and fire service nursing?
I’ve always wanted to be a nurse and started
out with my LVN. An instructor told me to get into the
RN program, so I did.
I became a PA in 1981 thinking it would improve my
job prospects, but they weren’t using PAs that
much, so I started working at the Santa Monica Hospital
ER as the pre-hospital care coordinator.
I was responsible for paramedic radio communications
as well as continuing education for nurses, paramedics
and EMTs. That put me in touch with the fire service.
Fire service nursing is an emerging field for nurses.
Two things are bringing nurses into the fire service:
one, there’s a decreased availability of CE for
paramedics at local hospitals. Many base hospitals have
closed as a cost-cutting measure, which is where they
previously obtained CE. Two, there are now regulations
that fire departments do quality improvement and nurses
know QI very well.
What do fire service nurses do?
Our primary role is networking and providing training
mechanisms for all fire service personnel that are charged
with EMS delivery. We can be involved in a number of
tasks, from health and wellness advocacy to risk management,
communicable disease programs, public education, TB
testing and concurrent review while riding along with
paramedics on calls.
Fire service nurses are able to teach all topics in
the EMT and paramedic curriculum, such as BCLS, ACLS
and PALS. We also do a lot of experiential teaching
and hands-on demonstrations, working with mannequins
and skills apparatus. That’s the best kind of
learning.
One interesting thing we are involved with is “fire
ground rehab.” We treat the firefighters when
there is a big or a long-term fire. We’ll check
vital signs and monitor for hydration/dehydration and
hyperthermia, among other things.
This fire ground rehab can take place in fire camps
or even the site of burning buildings in a populated
area. Some departments automatically utilize fire service
nurses when they have multiple patient incidents.
Who are the fire service nurses? Where
do they work?
The EMS system configuration is different all over
the state because of these differing groups. When you
call 911, in most places, you get the fire department
and most firefighters are at least EMTs. Many are paramedics,
which requires more training and an internship. They
are all part of the EMS system and nurses work with
all parts of that system.
Many fire departments, large and small, in California
have nurses working for them in some capacity. Los Angeles
County Fire Department recently hired 11 nurses. L.A.
City Fire Department has four nurse educators. Orange
County Fire Authority employs five nurses.
What’s different about being
a fire service nurse?
There are many differences, but one of the things I
enjoy is going out on calls. This is a very different
culture from my prior nursing. Going out on a call,
we talk about the situation almost immediately afterward,
review the case. What was good about it, what wasn’t.
This is real-time learning.
Another thing is that we’re always current in
what we’re teaching. We spent an inordinate amount
of training time on smallpox and then SARS and then
HIPAA (Health Insurance Portability and Accountability
Act). HIPAA has to do with patient confidentiality.
Where we used to be able to follow up on hospitalized
cases that we’d treated in the field, that’s
not as easy these days, thanks to HIPAA.
We see a lot of automobile accidents, industrial accidents,
burns and pediatric seizures. Some of the top complaints
that we see are chest pain, shortness of breath and
altered level of consciousness [diabetic reactions,
strokes, drug ODs].
Our challenge in teaching is also to keep the students
excited about what they do. The nature of the work can
be hard and demanding.
These EMS providers are our professional colleagues
and such things as waiting in an ER can be long and
tedious and it makes them unavailable to respond to
other calls.
Anything you’d like to add?
Yes, I totally enjoy this work. I can set my own schedule
to a great degree and I love the independence of contracting
for myself and being my own boss.
|
