Q: Describe your current role with Brewster Ambulance Service
CF: Right now I answer the 9-1-1 phones for Brewster. I sit between both of the dispatchers and help them find and dispatch vehicles, such as into a nursing home where they can take somebody else and maximize the efficiency of our vehicles out in the field. We have many different vehicles coming into Boston and we are constantly tracking their times and locations, as well as when they've completed their pick-ups/drop-offs. I dispatch the Boston tower, and I also support the other dispatchers who are dispatching the Boston tower, the Boston base and the Norwood base, which is called Division One. On the Boston dispatch tower, we dispatch all of the Boston and the Norwood area 9-1-1 calls.
Q: How long have you been an Emergency Medical Dispatcher?
CF: I have been dispatching for a year and a half, answering 9-1-1 since I first started. Since last summer, I have been back answering the 9-1-1s and covering the dispatchers if somebody doesn't come in for about a year. I started doing 9-1-1 in 2013 at Brewster Ambulance Service in October, and that February, I took my EMD course at the Hyde Park training center, and was certified as an Emergency Medical Dispatcher (EMD).
Q: Explain the difference between 9-1-1 emergency calls and scheduled transports for patient care such as dialysis, rehab or medical appointments.
CF: I like the 9-1-1 calls because I never know what's going to be on the other end of that call. It's always different and I really like the challenge that comes with that diversity. With prescheduled dispatches, we pretty much already know what's involved. We schedule those transports according to patient needs, location and the purpose of the transport, whether for dialysis, medical or rehab appointments. Right now, I support 9-1-1 emergency calls as well as dispatch for prescheduled and non-emergent transports. My position on the team is as a PSAP (Public Safety Answering Point) dispatcher. Everyone in the whole room can take these calls coming in, and we all support each other on the fly. Any available dispatcher can take incoming calls and whoever can get to the call first answers.
Q: What's involved in managing dispatched vehicles?
CF: I see where our vehicles and transports are going to be finishing their calls, who will be coming in, what vehicles can go with what patients, etc. For example, some of these transports we do because of the patient needs, you need a double male crew. So, I go into the system and re-assign vehicles and crews that I know their capabilities on these calls that have specific requirements for the patient or transport purpose. It's a lot like a puzzle, because not every transport is the same or has the same requirements.
Q: What happens when it gets busy and multiple calls are coming into dispatch at the same time?
CF: When there are a lot of returns coming in at the same time—which is usually during the dialysis hours—the returns make it quite busy. And then, when the 9-1-1 calls come in, depending on what the situation is on the other end of the line, you have to really jockey the crews and vehicles around. That can be hard sometimes because you have only so many options. But what's great about Brewster is that we all know that we have to provide the best quality experience for our patients and customers. Everyone in management and in the field works very hard to make sure we have adequate staffing and vehicle coverage, regardless. It ends up working out very well.
Q: When things get very busy in dispatch with multiple calls, how do you stay calm and collected?
CF: The dispatch command center has had moments when it's been very busy and we do get a bit stressed, but that's when our team really pulls together. We support each other even more intensely when we get busy like that. For instance, if somebody has had a challenging call, when I have the opportunity afterward, I talk to them. It's important to talk with them, listen to their questions and support them. There have been a couple that I've had where I have had to go step outside for a breather afterward. And that's okay, because we help one another get through those challenging calls when the adrenalin is flowing and we're trying to help a caller and get the crews to the people in need.
Q: How do you deal with callers who are frantic?
CF: It's like a mindset you have to have. You have to remember, "It's not my emergency, I'm there to help." If I'm freaking out, it's going to make the caller freak out, so my being calm is going to make them calm. When they call in frantic, if I maintain my calm, it helps them calm down by the end of the call. It's not going to help me or the caller if they're freaking out, because I can't get important information to help them. So having a stable, calm tone and approach works wonders when callers are a bit frantic.
Q: How does CAD (Computer aided dispatch) and EMD (Emergency Medical Dispatch) equipment works:
CF: In dispatch, we have three computer screens. One is called "ANI" (Automatic Number Identification) and the other is called "ALI" (Automatic Location Identification). These screens show the caller's source and location. We have a specific phone to answer the 9-1-1 emergency calls—the PSAP phone—and that phone connects to the ANI ALI screens which display the information from the caller. For the vehicles, the dispatchers will post the calls and there's a posting plan for the South Shore tower which include the three towns that we serve there. The posting plan lists all of the vehicles that are there at the start of the day. When a vehicle and crew goes out, they move them around so every part of the towns are covered. They adjust as they need it as we want to make sure that no matter what calls could come into dispatch, that we have the resources and backups we need to take care of our customers and patients. Because we've had so much experience with calls, we can do quite a bit of intelligent planning based on past performance. But any given day can be full of surprises, so we do our best to be prepared for anything.
Q: Do you ever get out in the field?
CF: When I first started, I did a ride-along in Middleboro. If you have a day off, you could do a ride-along to see what the crews deal with in the field and how they perform, but I haven't done one in a little over three years. It's open to us, but we're so busy.
Q: How did you get started at Brewster Ambulance Service?
CF: My friend was working in the Brewster billing department and told me that Brewster was hiring dispatchers. I applied and had an interview, and a few days later I had a second interview. Shortly after I was offered a position and started. Quality Assurance Director Danny Thomas, Lorna Venere, Division 1 Operations Manager, and Kim Cordeiro,
Director of Operations, Brockton Base, (who is my best friend and I babysit her daughter) helped me tremendously get up to speed after I first started. I definitely learned a lot from all of them. I learned a lot from Kim and she's been a big help. Danny and Lorna helped me a ton when I first started and how I dispatch now is because of how they trained me.
Q: What do you like about working at Brewster Ambulance Service?
CF: They are so family oriented! I met a lot of new people there, and I love going and meeting new people. I've become close with a lot of people there. They treat their employees very well. My career journey really demonstrates their commitment to their employees. Like, I started from the bottom and didn't know much of anything. Now I go in and they ask me questions because I've been there for so long and they've noticed. The other aspect I really enjoy is the challenge of dispatch. It keeps me sharp and on my toes and I really enjoy the team-focused culture of our dispatchers and everyone at Brewster. The family has established that culture and it's throughout the company.
Q: Can you share a story about a particular call that came in that you remember?
CF: The summer before, I remember answering a call where the caller said her husband wasn't breathing. I immediately coached her how to do CPR chest compressions. I walked her through it and she did it, and by the time our ambulance got to her location, her husband was breathing again. After you hang up, you seldom find out what the condition is, so it was really cool that I helped a caller do CPR that got her husband breathing again—all over the phone.
Q: Can you provide an example of how the team supports one another, especially new dispatchers?
CF: The new people who get EMD (Emergency Medical Dispatch) certified and join our team, I tell them, "I'm here to help you." I say, "If you're on a 9-1-1 call and you don't know what to do, I will join the call and help if you need it." They take a lot of comfort in knowing they have that backup and support when they first start. Also, when they first start answering 9-1-1 calls, I'll listen in. I'll direct them to the right EMD guidecard (standardized guides that provide EMDs with instructions that help them prioritize call response levels and provide pre-arrival instructions to the caller). They ask me after each call and I tell them they did a good job or I give them suggestions if I see an opportunity for improvement. Many dispatchers who are new to the command center haven't had the experience on calls. Some days, you're going to have some bad calls. It just happens. But because of the training we have here at Brewster, they really do a good job. We also walk them through hypothetical scenarios that we have had experience with, so when those calls come in, they have some practice on how to handle them. In the end, we all support each other equally because we work best as a unified team.
Q: What are some of the common missteps of new EMDs?
CF: With some of the guidecards we use, sometimes there are random questions on the cards that don't pertain to the situations we encounter. For instance, regarding pre-arrival instructions, if the patient is a diabetic. If they are diabetics and can do it themselves, they can have juice and sugar. If they're not a diabetic, you can assume not to include those steps on the guidecards because the patient has already informed you of their medical condition. So that step on the guidecard can be skipped. You get to used to asking questions that refine the specific situation for each caller or patient. You have to adapt to the situation as opposed to read the cards verbatim. It is tricky, however, when you're talking to someone on the phone and not there in person, and you have to really make sure that you're covering all of the applicable questions so you can provide the care they need.
Q: What do you do when you're not dispatching at Brewster?
CF: In the summer, my dad has a boat in the Hingham Shipyard and I spend time on the boat. I also have a dog and have fun hanging out with him. He's a two-year-old Labrador Retriever mix. His name is Doyle. I have a younger brother who recently graduated from the University of Massachusetts, Amherst, and he just moved back home with me and my mom in West Roxbury. He just got a dog too. So we all have a good time with the dogs, the boat and other stuff together as a family. It's fun.
To learn more about Brewster Ambulance Service EMD communications center and our approach to dispatch training, read this article here.