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Hot Seat: Fireground Training Talk is a podcast built for firefighters, by firefighters. Hosted by Brian Moreland, this show dives into real conversations about training, leadership, and fireground experience. From in-depth interviews with seasoned fire service professionals to lessons learned from the calls that shaped us, Hot Seat brings practical insight, honest stories, and a focus on helping both new and experienced members grow in the job. Whether you're riding the front seat or just getting started, this is your place to learn, reflect, and keep getting better.
Brian Moreland Jr. (00:05)
All right, so.
All right, we're good. I can edit everything out. So today we're here with Paul Simpson. So he's in the hot seat. Paul has been a member here at Bladensburg for quite some time now. He's a paramedic in the works. He's an instructor with some local scholars, I'm sorry, colleges around in the area. let's just, Paul Simpson, you're in the hot seat.
Hey, thanks for having me. Absolutely. Yeah, this thing, this podcast is something new for those that know no realizes this is actually going to be our second episode that we have here. But this podcast is just to talk some talk and get our members on board with certain things, certain topics. Hopefully it's hopefully people enjoy it. But we try to make it not scripted and just, you know, just about fire service topics.
So let's start from the beginning. So let's start from your background. Let's talk about where you came from, why you joined the fire service, how you got involved in Bladensburg, stuff like that. Sure, yeah. so I followed this kind of, I was a lifeguard for a long time. I always think that the sort of terminal lifeguard is like.
an EMT, right, like where do you go from there? You always wanna level up to the next thing. In fact, I think that's how they get you with a lot of emergency response stuff. They're like, oh well, you do just a little more training and you get to do this other cool thing, right? So that's sort of what got me interested in this world and then had always kind of been flirting with it, kind of been interested and then.
in 2020 with COVID gave me the sort of opportunity to and impetus to make the jump into into fire and EMS. So I signed up for EMT in fall of 2020 and joined here at the same time. Finished with my EMT card in hand and was was a member here within a week of that. about. That's good. So do you feel like
Let's start. You know, did you grow up in the area in the DMV? No, I'm from New York originally, but I actually I lived abroad for 13 years in the middle of all that. So yeah, that's good. Yeah. So kind of got your EMT and then figured out, hey, maybe I want to do this Bladensburg thing. And that's pretty good. That's pretty good. So a little background. Obviously, you're you are.
teaching at a local college, how did that come about? Well, it's actually where I got my EMT. It's been a pleasure to give back to the profession, to be back in a similar circumstance to where I was at before. And I think that the...
And I kind of stumbled into that. actually started off as a simulation patient and was doing that. And for national registry testing, I was a cyclist who had been struck by a car. I played it very well. And I was working in actual formal education at the time. I was teaching elementary school.
They got to talking with them and they said, oh, well, you know, listen, if you ever want to come to each for us a little bit more, hit us up. And I did and then ended up transitioning into that full time. I've been a full time EMS instructor for the past two years now. Yeah. And that's that's pretty cool. Right. So taking that into account, especially with me teaching on the fire side at a local college in the state of Maryland. But, you know, being an instructor is such a different.
format right you have so many different things that you have to think about when you instructional delivery and Trying to gauge the audience of your students and trying to teach them and EMS is not an easy subject right it feels like years have gone by since I've started my first EMT class and EMS providers are expected of a lot more right and so that's that's pretty cool. What are your thoughts on that though? Yeah, I totally agree. I think that
I think that for people out there who are interested in teaching, would be, don't sell yourself short if you're someone who's like, I'm interested, but I don't know if I'm qualified. Because sometimes being close to school, having that kind of vivid memory of what it was like to be a new learner can be really beneficial because in,
In this field, we get a lot of people who are really salty and know a lot, but don't really know what it's like not to know, right? They don't have that recollection of being the new guy and not really knowing. So if you're in that kind of intermediate stage of having some knowledge to share, remember what it's like to not know and seek out people who look like they're struggling, right? It doesn't have to be formal education. It could be tabletop or, you know,
a debrief or something with your crew. But yeah, that's definitely a big part about it. The other thing is that I think it makes you a better provider to be constantly switched on to what's going on in education. And then being a good provider or being a current provider makes you constantly switched on to being a good educator, right? So like if you're...
If you're someone who's been out of the field for 25 years, right? And all you're doing is telling war stories from, you know, the 80s. It's not really, that's not really relatable to your students. It's not really relatable to current best practice. If it's something that you did five days ago, you know, or yesterday that you're bringing into the classroom now, it really, really helps to inform like up-to-date teaching. So I think that they work very well together.
Yeah, it's good. I feel like definitely being a relatable when it comes to instructional delivery is important. Just because, like you said, the generational differences, how people learn that plays a huge part in how you deliver that instruction. So now let's shift some gears, right? We're talking about training and how you got into it. You were a, you know, a very good cycling pedestrian patient.
when it came down to your practical stuff. As a student, let's talk the GW program, right? So for those that don't know, our listeners, Bladensburg has a very good partnership with the GW program. And we get a lot of interest at EMTs that come through our doors, I'd say over the last three years since COVID, definitely, where people have...
show that interest and the EMS membership and interest is so much higher, right? A lot of guys come to Bladensburg, particularly to run a fire or to ride fire suppression apparatus only, but the GW program has made our EMS program skyrocket leaps and bounds more than I've seen as far as diversity. So how do you, let's talk the GW program and how that came about and what your thoughts are on that.
Yeah, I mean, I think that it's a privilege to be a training site and for us to be training sort of not just in-house EMTs, but also EMTs who are going to work.
the region and even the country and for us to be able to hopefully be showing them what an effective EMS system looks like and getting them those initial first tastes of the field here. It's been really excellent that we've had a number of members who enjoyed that time so much that they got hooked, they got bit by the bug and have come back for more.
I also don't want to discount our highly committed local folks as well, Where we get people in off the street, thought it was interesting, you know, they go to a MIFRI program or something like that and next thing you know they've got three or 400 calls under their belt and they're out there really getting after it in the street.
Both of those work really well to keep the interest high in EMS for sure. Absolutely, yeah. I mean, that program combined with our local members have just, our EMS program's growing pretty big. Which leads me to my next question. When you come into EMS, feel like, especially if it's a new skill and you're not exposed to it, I feel that...
There's definitely some challenges, right? Especially with all the testing and prerequisite testing and cycle motor testing that goes into EMS. What is your thoughts on some? What advice would you give? New providers and the challenges they face when it comes to just being a provider in today's EMS society. Well. For new people who are just entering the field.
I always tell my students this so I'm going to sound like a broken record to those who know me but there are a couple things that the first is that. The information that you've received in class is. Is as close or pretty darn close to being the cutting edge. It's not necessarily truly cutting edge information, but it's very current right and some of what you've learned in class might actually be better practice than what you're seeing in the street so.
Don't be afraid to stick to your guns and do the right thing as far as what your training has told you and what, you know, and if you're staying on top of your education and you're staying on top of the latest best practices, right, you're gonna stay ahead of the game. The other thing that I think we see is that new people really struggle to thread the needle or walk the balance between like,
You know, do I, am I God's gift to medicine or are patients made out of glass and if I look at them wrong, they're gonna shatter into a million pieces, right? And we have to find a nice balance, but I do definitely caution people against overconfidence, right? If you go into this thinking, you know, I'm the baddest guy around, I get.
I can't make any mistakes, I'll do no wrong. You're in for a nasty surprise. It's not necessarily coming in your first five minutes in EMS, right? This could be something a few years in the making, but having some humility is really important. Yeah, yeah, I agree. And I think that at the end of the day, when people show up and they run these calls, understanding
that there's always something to learn and you don't know what you don't know. Yeah, 100%. And then those individuals realizing that even in EMS, I mean, in the fire service alone, legality issues amongst EMS providers are very high. And I think that, you know, like you said, it could be just how did I treat Mrs. Smith, right? Mrs. Smith, for the listeners, just being a figurative person. But
how did I treat Mrs. on that call? And then it could go all the way down to just blatant negligence, right? And I think, do you feel like in the programs today in EMS that they stress those legal issues a lot and how that can complicate matters? Yeah, I mean, I think that's something that's off and front and center in people's education, right? But when you actually get out to the field and...
it's 3 a.m. and you've got a decision to make, it can be a lot harder to do that. Or, you know, in your heart of hearts, you feel a certain way about something, but no one else on scene seems to be stressed about something like that. And that takes some courage sometimes to do the right thing there. And the other thing is that a misconception, you had asked like what I have for new people entering the field. The other thing is for people entering this field, it's not always exciting, it's not always sexy.
Right? You know, making grabs and doing, you know, working codes and, and, you know, plugging bullet holes is cool. Right? It's something that gets people excited to be in the field. But if you're just around for that and you're not around to, you know, deal with people who smell bad, people who are, you know, maybe not the nicest in the world or whatever, right? Like then you're not here to do the
because that's part of what the job entails. Yeah, yeah, I totally agree. And I think that, you know, when you're here for the right reasons, makes you, it reminds you of the community that you serve, right, and that they come first. And it also reminds you that, you know, hey, look, I might go on this EMS run and I might be away from my station for three, six hours. But at the end of the day,
I'm providing that service and there is no one else that they can call. Yeah. And just remembering that. Yeah. Like a really interesting thing here and sort of what we've been talking about a little bit here is relates in particular to things like refusals, right? If you're getting someone to the hospital, they're going to get treated like, you know, they're like they're your skills as an EMT.
As long as you got into the hospital without them getting much sicker, you probably did a good job, right? But when we don't take people to the hospital, that's where a lot of the risks happen, right? And I've been paying attention to some really interesting research right now on like the lift assist. Lift assist are calls that we run all the time. you know, simple enough, you show up, you pull granny off the floor and...
put her back in her chair, high fives all around, let's go back to the station, right? Well, there's some pretty compelling research out there that shows that as many as 40 % of Lyft-A-Sys result in a second EMS call within about eight hours, right? And this could be they're having a stroke and that's why they fell and maybe the symptoms weren't as apparent earlier, right? They're having.
some underlying cardiac problem that wasn't as apparent, or they fell and broke their hip or broke their leg or something. during that initial contact with EMS, that wasn't quite as apparent, right? And those are calls that we don't even think about. And some of those have very consequential outcomes if we're not careful. So having that degree of caution when, you know, it's
It's easy enough to spot someone who's really sick, right? Spotting someone who's middle of the road who has the potential to deteriorate is much more difficult. Absolutely, absolutely. I was on a talk with another friend of mine and we were discussing search culture. This kind of relates to the fireside, but I'm gonna tie it together in a brief moment. And we were discussing, you know, in the fire service, a lot of people...
have now had this buzz term of search culture, meaning that we show up to fires and our expectation is that, yes, we say we're gonna show up, we're gonna do everything we can, search livable space, trapped victims out of house fires. And what we've realized is that there are some departments that they're one side or the other of the pendulum. Either they never go in, right, and they say, okay, well, in the means of safety,
we're never going to enter an IDLH to search for any victim, or they fall on the other side of the fence where they always go in and they don't take that good risk assessment. And so the question that came up was, why do we think that this term search culture is now a fad? And one of the responses that we had on this talk was because we're being held to a higher standard in accountability levels by the public. So they realize,
that we got called, Mrs. Smith is trapped in this house fire. And now they realize and their legal team realizes, unfortunately, either we did or we did not follow policies, either we did or we did not follow procedures, and now we're being held accountable in today's society to a higher level. And I think that also applies to EMS. Can you speak to that? What are your thoughts on that? Yeah, mean, you know.
Everyone's got a camera on them and all these records are publicly visible. And I think that more transparency in our industry is a good thing, right? I think that if you're able to bury your wrong doings, what was it? They used to have that shirt back in the day in the 80s in PG County. We bury our mistakes, right? Yeah, yeah. And that's not really where it's at.
So keeping people honest, you don't want to create a culture of fear, right? Where people are now going out of their way to hide stuff and things like that, right? But having that just culture is a big push for the, it's called the National EMS Agenda of the Future, right? Which is EMS 2050 and it's about, you know, there's a number of things, but having patient centered care, patient safety in the center of care, and then,
not having like a super punitive culture, but having people own up to mistakes and seeking out clarification rather than trying to hide stuff is really, really important. That's interesting stuff. That's really interesting. And you hit that nail on the head. Being held accountable, in my opinion, is definitely a good thing by everyone involved. And it allows organizations to not only make mistakes, but also to grow and learn from their theory.
handle those mistakes properly. Shifting gears since we're talking a little bit about culture. What do you think if you had to talk to the listeners? What do you think that the culture is here at Bladensburg as it centers around EMS? But not just Bladensburg, but the fire service in general. What do you what do you think that looks like? I think that you know at Bladensburg, I think that we.
We like our EMS people right and. We I think that we're lucky to be in an area that that runs a good variety of EMS calls and. And so it isn't it. It's not stale right? It's something that there's always some good variety to it so. So I do think that we have that going for us. It is kind of relentless right? EMS is it's it's real work out there.
that we're putting in and it's not quite the same as going to pull ceilings or search a house or, you know, pump and hose, but spending three, six, eight hours of your shift away from the station, out on calls, running calls back to back, paperwork, et cetera, can be a slog for folks for sure.
I really appreciate the people who put in the effort day in, day out to allow us to continue serving our community there. I think that broadly, the fire service and the EMS system do have at times maybe an uncomfortable relationship and they're...
You know, it's similar, right? It's life safety as a central tenant, some of the cultures and norms and things between those agencies or those organizational histories can be different. Everywhere does this a little bit differently, right? There is such a thing, you know, the EMS department that runs fires.
isn't necessarily the best thing either, right? The fire department who scorns EMS and says, only, you know, we do advanced first aid and that's it. That ain't it. You know, there has to be something, a healthy balance to meet. Absolutely, absolutely. And I think that that challenge comes from a lot of times the culture of that organization.
And then on top of that, the leadership of that organization, right? Putting the EMS in the forefront. At the end of the day, here at Bladensburg and elsewhere, if you have some type of billing system and the taxpayers pay for that, you get some type of money back. I know we do as an individual station, a lot of organizations do, but you get some type of financial gain from that. But outside of the financial gain, look at the call volume.
The call volume where now, mean, 85 % of our runs in this organization are, you know, non suppression related runs. And so, and if you have to be on the suppression unit in this organization, EMS, you're not getting away from it. And I think, you know, fire departments were around a long time and then in the, for those that don't realize it, but.
And there was a lot of attorney age stuff in the 60s and then the 80s with EMS. But I think that.
We've become what is considered an all hazardous department and utilizing that EMS, I think doesn't get enough credit in the fire service as a whole. But I think that there are a lot of passionate people who do that. And it leads me to my next section of this. Let's talk paramedic, right? I know you're in the process of getting your paramedic and you're in class for that.
had to talk to a new individual about whether they should take that leap, what would your thoughts be on that? Before I answer that, just want to go back for one second to talk about our last thing. I totally agree about the culture and stuff like that. The big thing here is that the
you know, an analogy that I like to use is that going back to the idea of like making a grab or something, right? Like everyone I think would agree that that's something that's very cool, right? Sort of the ultimate culmination of what being a firefighter is all about, right? Well, you're not doing that very often, right? And in terms of making actual, you know, solid differences in people's lives, right? And...
making some concrete, potentially life-saving rescues, so to speak, right? That happens every day on the EMS side. It's not necessarily as sexy, it's not as tangible, necessarily, but getting someone to the care that they need is something that's just as noble there and something that we need to recognize.
as well. You didn't take as much maybe personal risk and your personal talents maybe may or may not play as big of a role there. But it is still big organizationally and big culturally. About going for Paramedic, I think that if you're interested, go for it.
was an EMT for two years prior to starting med school. I'm hopefully very close to being done now. Hopefully I'll be done within the next couple weeks. And I think that while I don't regret having a little bit more experience under my belt prior to starting, I think that it's one of those things that school itself does a pretty good job of teaching you how to move through a bunch of this stuff.
If it's something that appeals to you, go ahead and make the leap. It is really different in a number of ways from BLS education because you are, you're kind of playing with some pretty heavy duty stuff now and that can be quite humbling, I think. Going back to our conversation before about, we were talking about, know, are you,
you having some humility and knowing what you don't know and stuff. I have a much better appreciation of that now from an ALS perspective. You're like, well, there's a lot of problems out there that I didn't even know about. you know, having a better understanding of some of the conditions that we encounter frequently or some of the conditions that maybe we don't encounter very frequently, right? Or what are masks, what are mimics, et cetera.
is really great to further your understanding of this field, definitely. Yeah, that's good. And I always tell people, never limit yourself. Don't put the ceiling on your limitations. If you are ready, take the step.
to go to down that road because being a paramedic in a busy organization is not easy. It is humbling. But I think that those who have the I think when you take the leap like EMT from my perspective, I came in the county a number of years ago and I took EMT first to get it out of the way. But because that was a class that was available and I was also in an organization that required me to have it. And I think when you're looking at a
It's something pretty unique because I'm not, you know, when I took EMT, I had to take it, like I said, just because the organization in Prince George's County requires us. And that's not going away. And then I became passionate about EMS from a BLS perspective at that time.
But when you look at a paramedic route, some organizations and jurisdictions, they have to get a paramedic to promote. And so in order to better benefit their family or meet other career aspirations, that's a stepping stone they have to have. And now usually what happens is they either create a passion for it or they have a passion for it and they stay on the EMS side and not want to promote too much on the suppression side or you get those anomalies
where people are pretty good at both, and then they also are very passionate with both. But when you think of a volunteer paramedic,
That alone, that step, I think is just such a passionate step because there's nothing requiring you to do that. The passion has to be there. You have to enjoy that field and know what you're talking about and love the benefit of learning more on an EMS side just by taking that leap.
Yeah, for sure. It's you know, there's you definitely have to have some love of the game to go for it. But the other thing I'll tell people, you know, just for those who might be listening who aren't really aware of what it entails. You know, you're usually depending on your program going to be looking at about 600 hours of classroom time and then about 600 hours of time in the field and a good way to sort of flip the script on that because it sounds really insurmountable, right?
a lot of education, my god, this and that. Well, EMT for most people is around 200 hours, right? So it's just like doing EMT, but three more times, right? So if you took a three month EMT class, well, imagine that, but doing it for nine months, right? And then, you know, obviously the clinical internship side can be really, it can be draining, right? It is work, you're putting in lot of hours, a lot of time away from home.
But it's also super rewarding because you're getting a privilege to be sort of front and center and some some very unique environments and Getting to do some really cool stuff and you know in a way especially from the volunteer side this is stuff that a lot of people come around because I want to do cool things right and so you get to do 600 hours of cool stuff for school and and then
Now you've got a very, very valuable, highly transferable piece of education under your belt that you can take just about anywhere. So definitely something to consider for those who are on the fence. Yeah, definitely. And I think, like you said, that ALS BLS bridge has to be there.
the EMS suppression bridge should be there. When you think, and you do a lot of research, and that's one thing that's very admirable about you, and you look up a lot of stuff and you look at a of studies just because you have your head in the game, but if you had to think about it, what are some good ways that you've noticed in other organizations, or just from your studies, that...
build that bridge between the suppression and EMS. Or what do you think are some items that can help build that bridge in culture? Yeah, I mean, so when you look at culture, at organizational cultures in general, a lot of, and we've spent many a late night in the engine bay talking about this, I'm sure.
you know, lot of this has to do with cultural norms and cultural expectations, right? you know, what it is that you're gonna do and what it is that's expected of you and traditional firefighting organizations are very norms-based organizations. And if those norms are good, right, you end up with some really outstanding stuff, right? You know, you get...
Some people go in the extra mile making the extra push, making the grab, giving it their all because that's what the organization expects of them and that's what the culture dictates. And if the culture, if those cultural norms are not so good, then you end up with issues.
You know, think right now, I feel like we've always been in a rebuilding phase, but I do think we're in a really good part of our rebuilding phase right now for those people who are seeking to have positive impact on the culture here. It's an excellent time for that.
The other thing is that it lets you do more with less, Bridging that gap. The more people out there who are multi-role, and this also goes for EMS people who are interested in firefighting, not just for firefighters who we expect to be good at EMS, right? The more people you have who are good at both things, the more versatile your organization gets. And I'm not a very good firefighter, but you know.
I'm okay. But, you know, there are some stations in this county who have pretty small membership basis, but people do everything right. The expectations there that you'll drive, you'll take, you'll ride the back step, you'll ride the seat, you'll work on your pumps packet, you'll learn how to do aerial stuff and.
And those guys are able to punch pretty high above their weight because they they have the versatility in their ranks if you have You know, could have 600 members if none of them have any certs or none of them have any good at anything That's not really gonna move you in the right direction either. Yeah, I agree. I think I think that
That mentorship and that culture of training, I'm very big in training, but that coaching and mentorship is huge from the beginning. I always think back to a mentor of mine that would always say, if you want to ask how somebody is probably going to turn out in 15, 20 years, ask them who their first officer was. And the saying here at Bladensburg that a lot of people say is,
your rookie year, right, your first year in the fire service can set the stage for your next 20 years in the fire service. When I think back to myself, I'm very grateful for the gift of time that allowed me to grow for my first year. But that that.
Mentorship is very important and so when you talk about that mentorship and that motivation with organizational culture and bridging that gap.
What are some ways that you think that can keep people motivated even in the EMS side? mean, you just mentioned ALS takes long hours in schooling. Obviously, we all know that this can take a toll on your body and away from your family and even your mental health. But what do you think are some good ways that individuals or organizations can utilize some good tactics to keep their people motivated?
Or appreciate it's tricky. If anyone has any ideas, I would love to hear them. mean, you know, taking care of your people, recognizing that, you know, in the volunteer world, something that has frustrated me a little bit is, is, you know, folks say, people nowadays, they're just not interested in volunteering. And that's not really the case. A lot of people are very interested in volunteering. But, you know,
Cost of living isn't what it used to be, right? This isn't 1925, 26, whatever, or the 1950s where our membership really boomed. And you're supporting a whole family on a single income. You live in the neighborhood. You've got plenty of time off. And you're able to just pop over to the firehouse when the tornado siren goes off, right?
It's, the requirements are pretty hefty. the drain on people's time outside of here is very significant as well, right? You got people working two jobs, people going to school, people doing whatever.
So trying to find a way to meet people halfway, I think is important, right? There's this sort of all or nothing. You're either all in or you're...
think that ultimately in the long run in the current climate that's not super sustainable for volunteer retention. You have to find a way to meet people halfway, to meet people with sort of reasonable targets, right? And then remove as many obstacles as you can to participation. So I don't have any great ideas about how to do that, right? Some of those things cost money.
this tight always, right? So, but yeah, that's sort of my two cents on that. Yeah, and I think as organizations grow, I think one of the things that I'm starting to realize and definitely do a lot more administratively in this department, I can say, is that we should always be assessing, right? We should always assess what we're doing. Is it working?
How do our people feel? Can we take care of our people? Because, you know, for those, for our listeners, Bladensburg is a million dollar plus organization when you talk about income and expenses. But our biggest assets are priceless, right? And that's our people. And so to take care of them is, is, and show appreciation is definitely a good start and definitely, you know, what's interesting is that you look
at some of these departments and organizations and maybe they don't have the best or latest equipment, maybe they don't have the best facilities, but they keep coming back, right? And they love what they do. And a lot of that has to do with they just want to be taken care of, right? However that looks in your organization and however we can all improve, that's all they want, right? And they want to be taken care of even, you know,
A lot of times people will say, especially on the EMS side, you know, I don't care about the call volume. I don't care about my pay per se. I just want my partner to be good. Right. I to have a good partner. So, yeah, I think that that definitely takes a good look at that. Good. Oh, yeah, I mean, I totally agree. I think that having a good working environment, you know, is is a big is a huge impetus to getting people to come.
And then the other thing is retention, right? There's a lot talk about recruitment, but retention is really, really key, right? Because that's where, those are people who have had the training, they have had the experience, and if you're having trouble with retention, you lose all of that, right? And that's a tragedy, right? It's like watching a library burn. All that knowledge is just vanishing.
And that, some of that is really irreplaceable. not just getting people in the door, right, but.
getting people trained up, getting people to stick around is really key too. Yeah, absolutely. And I feel like that retention piece is almost somewhat more important than recruitment. Yeah, you could have the same department and have young brought any new people in and you got everybody. It's the same 30 people who been there for 25 years or whatever. And they could probably.
you know, smoke anyone around here. But, you know, if it's that classic, is it 20 years of experience, one year 20 times? Or is it, you know, a real...
thoughtful progression. Yeah. And I think if you fix your retention issues, a lot of organizations, they will recruit, right? Your recruitment problem can be fixed to a degree. I'd say don't be active and it gets community involved in your organization to reflect your community as much as you can. But if I fix my routine, if I keep people from walking out the door, I have more people in the room and then they're going to tell more people to walk in the door for me. Right. And so I think that that definitely helps.
When you think about that though, as we're shifting gears, where do you see?
departments and EMS going in the future. There's a lot of cutting edge stuff happening on the EMS side, ALS, BLS. I remember when I first started off as an EMT, we weren't allowed to check blood glucose levels, right? It was an ALS skill. And I remember being able to first administer Narcan. now all of a sudden, we're able to give Neb treatments in certain jurisdictions. And there are IV techs now.
So where do you see EMS going in the future with this department and just in general in the in the industry? So. The probably unfortunately it's not super sexy, but probably the most exciting thing in EMS is treatment in place, and that's where you. You don't have to transport the patient to the hospital.
and there's a way to safely render definitive care in the field. And that's gonna be a little bit beyond the scope of some of many of our BLS interventions that we do, but getting people to alternative destinations, getting people in touch with a social worker, getting that sort of stuff is certainly the kind of thing that you might encounter in BLS.
settings and because one of the big and this is all that kind of community paramedicine and a good analogy for this is like if you're a lifeguard right I was a lifeguard for eight years if you're a lifeguard and you make a save you jump into the pool and and make a save awesome you're a hero right but if every single day
The same kid is coming into the pool and drowning and you're jumping in and pulling that same kid out of the pool. Well, you're not a very good lifeguard, right? Because you should be interdicting that kid before he gets to the deep end before he gets out of his depth. So the same approach to sort of public health aspects of EMS is is really important, right? How can we intercept these calls before they even happen?
I would say a huge portion of our call volume is poorly managed chronic disease, right? It's the outcomes of poorly managed chronic disease. People whose blood pressure's really high, their blood sugar's really high, they're not taking their meds, whatever. And getting those people cared for prior to the point of this being a 911 call or getting those people in touch with resources that helps to avoid that in the future is really excellent.
In the past, this has been really out of a lot of departments' abilities because how do you pay for it, right? Oftentimes, the pay, the check comes when you take these people to the hospital. But there's no real incentive not to do that. But now with some very promising legislation,
there's been some very significant efforts to get that done in the field, right? Or to get payment for treatments that are performed in the field. And that opens up a whole new suite of telehealth, right? Of point of care testing in the field, of all these other things that allow us to ease hospital overcrowding and things like that. So it's not happening tomorrow, but in the next.
five to 10 years, those are some of the more innovative aspects of EMS. Again, it's not super exciting. It's not rock and roll, it's not lights and sirens, but it also helps to, there are a lot of folks out there who say, oh, want EMS to be about real emergencies, right? Well, you should be excited about these programs because it also,
is gonna hopefully free up capacity to really respond to those more high acuity calls and hopefully reduce some of the remaining burden of, know, if you're scraping the same guy off the sidewalk at 3 a.m. every single day, you know, let's try and get that guy some other resources so that he's not always on the sidewalk at 3 a.m. Yeah, yeah. And I, go ahead. Just the other thing is if, and for those people who are like,
You know well what if I want to do something really exciting and cool well though there are things that are coming about that are more and more interesting in terms of the interventions that we can perform in the field the types of tools that we can use. Maryland I think we have pretty good protocols were not at the cutting edge nationally but they're pretty progressive and when it comes to that. Unfortunately we're a an industry that's dominated by the lowest common denominator and.
And so we're held back by people who can't get it right. you know, you could have 80 EMTs out of 100 perform this skill flawlessly and 20 kill someone. Well, that skill's not gonna come into your scope, right? And so when it comes to those people who really wanna do exciting, cool stuff, well.
consider, again, going back to what we first talked about, education and quality assurance, right? Making sure that you are on the top of your game because the fewer errors that we have, the better, right? You look at our med box right now, you'll notice that all of the meds are pretty much a different route, right? There's one that you inject, one that you eat, one that you do this and that with.
Well that's for a reason because they don't want to give you two that you can inject in case someone messes it up right they they don't want to give us I gels in case you put it in backwards well let's avoid that risk right let's get good and the more we do that the more options we open up to to our field so we're hampered by by by folks who.
make mistakes or who don't see the value in education.
Yeah, that's powerful. That's very powerful. think if I can speak to just real quick going back, the community pair of medicine, I had the privilege probably just short of a decade ago to work alongside with the local departments mobile integrate mobile integrated health program. And my role in that was just for the listeners, my role in that was to help set up an
the EMS system for a nonprofit organization to also include some mobile integrated health. And man was that eye opening. It was eye opening to see the individuals who I know in this county, they have statistics of the individual who calls 911 for
psychosocial issues for social service issues for adult servicing issues. I think there was one statistic to where an individual called 911 over 100 times in a year after the program and receiving the resources. They called one time the next year and that was actually an emergency and sometimes it was just for a provider to come by and check on them, make sure they took their medications and they received their proper prescription.
and they had a pill bottle and stuff like that for days of the week so they knew which ones to take or sometimes just to go and check on Mrs. Smith and see how she's doing. So those are all promising things and I think they're very powerful when it comes to...
this system as a whole because sometimes what we do is even as a provider or somebody in your organization, it's hard to think outside your four walls and when you're a provider, it's hard to see anything outside that unit, right? You take the call as they come and then you transport and you get back to the station, you try to wait for the next one. But then when you look at the totality of the system overload and the totality of EMS providers waiting at the hospital and taking non-acuity calls, I think that is,
Like you said, it may not be the sexy thing that we're doing that's innovative, but it is definitely a benefit on the system. Yeah, a thousand percent. PG County, it has 950,000 residents, 125,000 EMS calls each year, right? The math isn't really math-ing there.
That's a call, one in nine people in PG County is calling 911, calling 911 for an ambulance every year, right? That's pretty darn high. That's higher per capita than New York City is, right? So how can you take some of the strain off of these folks and meet them where they're at, give them the resources that they need is really key. Absolutely.
Thinking of that as we run these calls, I know you had mentioned, we talked about on this, you know, this episode about mentorship and coaching and the system as a whole. And that's and that's pretty cool stuff. But let's shift gears one more time before we wrap it up. And let's talk about let's talk about mental health.
One thing that I want to try to do for a lot of episodes is just incorporate that because I know mental health sometimes we run these calls and and they we don't think they take a toll on us, but they do and we don't realize that and the other thing is that I did some studies and some research and myself or mental health and We all know that in this field the suicide Numbers are very high right and those high acuity calls
and decompressing after calls. Because at the end of the day, know, the pre-hospital environment sees everything, right? And you see more...
You think about it even in nursing, right? Nursing and doctors. Well, you can choose typically which floor you're going to work on. You can choose which your patients are like, whether if I'm a doctor or physician. I can choose whether I work in a pretty semi-settling environment in an office, or I can choose to work in the ER, which are vastly different. But for pre-hospital environments,
You see it all. And so if you could just talk a little bit. I know you do a lot of studies on and research on mental health and that capacity as it relates to EMS. But just just talk a little bit about that and talk to our providers and our members and other individuals, our listeners today that, you know, mental health is real and it's OK to talk about.
Yeah, mean, it's definitely a subject that's close to my heart. The mental health statistics for first responders are really astonishing. it's not just the high acuity calls, right? Sometimes it's the small tragedies out there, right?
someone who you know that you think that they're gonna enjoy their retirement or whatever and then suddenly they have a know acute medical event that is life-altering or something of that nature right or or you know encountering people in these very stressful environments can can weigh heavy on people and sometimes this it's stress that adds up you know it's sleepless nights it's it's you know
work environment and that really does chip away at people. There are a couple things for this, right? Sometimes you just need to take a break and there's nothing wrong with that. And that's in a way one of the beautiful things about volunteer systems is like you're not paying the bills with this work. You need to take some time off like.
Go take some time off, right? Like that's totally fine if you need a break and some time away from the firehouse, time away from 9-1-1 to get your mind right. It's okay to, and that might be enough, right?
Sometimes that that ain't it though right sometimes there's a little bit more to it this this could be something that needs professional assistance right and there's no shame in that either this can be something that maybe we just need to talk to our peers about right. There's no shame in that we talked briefly earlier about culture right and how culture. Can make or break an organization and I think our culture around mental health is. You know.
It's very macho, we're very, you know, we're focused on being tough, right? And unfazed, and you you could have just run some really gnarly something or other. All right, well, where are we going for food, right? And there's this kind of constant desire to just bury it deep and move on, and like.
Sometimes that's not possible sometimes stuff that that sticks with you and you need to get out and. You know talking to people who are in this field is usually you know it's having friends outside of EMS is great right and something that everyone should do but they don't always get it and having people in the field who you can talk to and. And say you know hey I ran this thing it's not really sitting right with me. You know.
talk to me, they can give you their input, their appreciation for that, it can be really helpful, I think. The last, well, maybe not the last thing, but another thing with this is that, and I tell all my EMT students this, is unfortunately this is a profession that gets conflated with an identity.
And there's nothing wrong with leaving the profession. We have some folks who were excellent in this field who left it. They walked away, they turned their back on it, and are totally unassociated with the MS. And that's fine. I would rather you be alive and successful and thriving and...
not be an EMT anymore than for you to be a dead hero, right? And that's...
And that's something that's possible, right? It's okay to walk away from this. You could have a Bladensburg tattoo, right? You could have a Star of Life tattoo or a Maltese or something, right? And it's okay to walk away from it. It's okay to walk away from it come back, right? You're not anything less. You're not a failure. You're not a coward.
You know, again, we're a tough kind of macho culture here.
man he couldn't hack it so he quit that's not what it's about right so and this these are skill sets that transferred a lot of other industries there are folks out there who feel trapped and you know all I know how to do is work you know his work IFT right.
Trust me, there's other jobs out there that you can leverage your skills on, right? You've been a 911 responder out there. There's a lot of stuff you can figure out how to do. I was a waiter. I used to wait tables. I actually have more stress dreams about waiting tables than I do about being an EMT. But the vibes are very similar. Because it's all about triage. It's all about prioritization and stuff. So my plug is always.
EMS and fire service and stuff isn't working out for you. Go work in a restaurant. It's the same vibe, right? The culture is actually extremely similar. So go become a bartender, go wait some tables. You'll probably make more money. then if you feel like you're ready to come back to it, come back to it. But don't torture yourself for that.
And then I guess my final thing, one of my instructors for paramedic school made a really good point. He was teaching us about pediatric emergencies, is something that can weigh really heavy on people, right? It's very stressful. And he made the point that...
Being good means that you did everything that you could, right? And so being on top of your game can really help to say, all right, well, we really did do everything that we could. We really did exhaust all possibilities here. And that's not to say that if you make a mistake or something that you're bad, right? That's not what I mean by that. But having a...
Having that kind of foundation of like, you know, okay, I definitely did do the right thing. It's much easier to sleep at night than questioning, did I not, know, could I have done something different, et cetera. So staying on top of your game, staying on top of what the right move is, protocol, science, et cetera, can help you to avoid kind of agonizing over some of the decisions that you've made.
Absolutely. That's powerful, Paul. It's amazing to hear people acknowledge the fact that walking away does not equal failure. I have a good friend of mine that I've actually met through Bladensburg. he served for our armed forces. And he got hired by a local department.
And he had to walk away, right, from EMS. He ended up becoming a paramedic. And he called me one day, and he said, I don't know if I can do this anymore when it comes to staying in the profession. And he said, I just feel I don't want to feel like everything I've done is wasted. And then I reminded him how many lives he's already impacted. And then I said the powerful statement of, sometimes you got to impact your own.
Sometimes you got to take care of your own. And I think that is powerful. Because like you said,
A lot of people look at this profession as an identity, and it's who they are and what they do. And in a lot of ways, that may be the case when it comes to, yes, the call comes out. We're going to stop everything we're doing, and we're going to go provide care for that emergency, for that citizen. However, and I'm not discrediting anyone that walked away from the profession or that has that mentality. So just keeping that in mind, walking away
is OK.
Let's wrap it up. Let's do what we call it. You're in the hot seat, right? Let's do a quick fire, right? This just means some quick questions, right? Some things that I just thought of. And the first thing that comes to your mind, right? just quick action, all right? First one, let's see, coffee or energy drinks? Coffee, hands down. Gotcha. I haven't had energy drinks in over 10 years. That's good.
That's good. All right. Worst piece of EMS EMS advice you've ever heard. my God. Where do I start?
I don't even know. Again, don't want to like, I know we're trying to be lighthearted here, but one of the big things here is that kind of, it is that overinflated sense of capabilities that, know, listen, you don't have to go to the hospital. I'm telling you everything's fine, right? And that's the worst piece of advice I've ever heard given to a patient, right?
I can guarantee you 100 % that everything is fine. Nah, bud, no way, right? Yeah, that's good. That's good stuff. Yeah, I mean, people...
People like to speak on things for their own agenda sometimes. And I think that, yeah, your warm bed may be waiting for you back at the station. However, this patient, when you leave, may not ever make it out of there. So I definitely get that. right. Well, then last one. If you weren't in the fire service or an EMS, what would you be doing? So. I don't really know.
You know if I had never gotten into this I'm not sure I probably would have stayed in education Something I really wanted to do before doing this is work and Part part of how I got into the field was because I really wanted to work in explosive ordinance disposal And I was working towards a bunch of that kind of stuff before
before becoming an EMT and I was like, oh, maybe these things will be synergistic. And now I'm pretty committed into this, but if this doesn't work out, I'll be hitting those guys up. There's plenty of explosives out there that need to be disposed of. Absolutely. That's actually pretty unique. That's actually pretty cool. And here we are for our listeners. We're wrapping up. We're right around that hour mark.
What with Paul Simpson here, what's next for you after paramedic school? What's next in? What's the next step in Paul's professional career? I'm not really sure. Obviously paramedic opens a lot of doors. The.
You know, it's really a qualification that you can take just about everywhere. I love my job right now. I really enjoy teaching. I'm paid very well for it. I'm always surprised and delighted.
circumstances that I found myself in. But, you know, there's always what else is out there, know, something that I've been privileged to have through my schooling. Uh-oh. Okay, no call? All right. Is exposure to lot of people from different agencies out there, right? And, you know, I would love to spend some time working in like kind of an unusual environment.
classmates are from Alaska, a bunch of them are from these really rural areas in the Pacific Northwest and stuff. And they have some really interesting perspectives on EMS care. So getting to do some kind of unusual EMS would be sort of a bucket list item for me, I think. But I really like the area. I'm pretty committed to staying here. So I don't really know how well I'll
those computing things will mesh. I'll see what I stumble into next.