Team Profile: Emily Abraham, paramedic, brockton

 Erika Apicella, Nichole Alden and Emily Abraham

Erika Apicella, Nichole Alden and Emily Abraham

Q: What is your current capacity with Brewster Ambulance Service?

EA: Currently I'm a paramedic out of Brockton, so I work Brockton 911 full time. Before that, I was working Plymouth 911. I've been with Brewster Ambulance Service for six years. I started as an EMT, got my medic and worked my way up through the different levels at Brewster.

Brockton is my full time home now, and I've been here a little over a year. I came over from Plymouth last October [2016]. I loved working in Plymouth, and it was time for a change of scenery. They are two very different towns, but I love them both. There is nothing I have done in Brockton that I haven't done in Plymouth. It can be just as busy. As a new medic, it was a phenomenal place to work—I would not have been able to succeed in Brockton were it not for the people in Plymouth.

I started working on the Brewster team when they got the VA contract. They had an open house and that's when I applied. I spoke with Mark [Brewster] and Danny Thomas and, God bless them, they took a chance on me. They take good care of us.

 

Q: What was the path you took for your ems education?

EA: I got a bachelor's degree in journalism with a minor in economics at the University of Pittsburgh. I grew up in Cambridge, but I wanted to get away from the area of the schools that I got into. Pitt was the one I was happiest when I visited, and I absolutely loved it there.

For my EMS education, I was an EMT for a year before I started medic school, and then medic school was a year and a half. It split pretty equally; three years an EMT and now a medic a little over three years. I went to New England EMS Institute in Manchester, NH. When I first came to Brewster, EMTs did a lot of VA transfers, dialysis, medical appointments, and every once in a while a nursing home emergency call came in or a back-up call for Boston EMS. There was a decent amount back then around 2011.

 

 Emily and Erika Apicella transported "a fantastic and brave little girl, Abby," to Mass General.

Emily and Erika Apicella transported "a fantastic and brave little girl, Abby," to Mass General.

Q: What is it like being a paramedic for Brewster in the City of Brockton?

EA: The people of Brockton have a lot of needs, and unfortunately it's tough to see that many don't really take care of themselves or know how to do it well. There is a lot more handholding of citizens, and the public education aspect is significant versus other areas.

For example, there are things that you and I would assume everybody knows, however some of the citizens have never heard of it before, such as, "Did you know that antibiotics make you nauseous?" That's a thing. They make you nauseous. You have to help them and explain nicely that they are not having an allergic reaction and to keep taking their medication. It would be beneficial if they had some education around how their medication works, it goes a long way.

Another example that surprised me was that there are people that don't know that you shouldn't drink alcohol while taking anti-seizure medication. It's unfortunate, but we try to educate them of these things so they understand and can take their medication more safely.

 

Q: How do you manage that with patients who struggle with misunderstanding around their prescriptions or recovery?

EA: It's a fine line to walk, because some people are truly sick and need to go to the hospital, and you don't want to tell someone that they don't need to go to the hospital. Some only need to go to the hospital because they inadvertently did something that someone told them not to. You want to be able to educate people, but in a respectful way. I don't think anyone goes to the hospital for fun, but they definitely go to the hospital more than they need to because they often don't have any other option. 

With antibiotics, it's not uncommon to have an upset stomach. If you take it with milk or food, it doesn't irritate your stomach as much. They'll take it on empty stomach, get ill and want to go to the hospital. They stop taking the medication because they think they're having an allergic reaction, which is even worsening the situation. We tell them that they need to take it a certain way so they don't have stomach upset, in a caring manner so they understand. But unfortunately, there's a knowledge gap in some urban environments.

 

Emily working

Q: What else contributes to this misunderstanding?

EA: There are language barriers. It may be the way a physician may say something to someone with no medical understanding at all, or they just don't understand what is being said to them because of language differences. They'll nod their head because they don't want to be embarrassed and act like they understand, but they aren't getting the information the way they need to. It's important for us to give our patients the little extra pieces of information that they don't always get, or remember. We have a unique opportunity to do that. We just have to hope that they're able to file it away for next time.

 

Q: How do you manage through language barriers?

EA: I will often act stuff out. So, if I'm worried someone is having chest pains, I'll point at my chest. Or, we'll enlist a family member—I've had seven-year-olds translate for me for their grandparents or aunts/uncles. We do a full work-up and 12-lead IV and see what we find. When we get to the hospital, they can take what we found, get an interpreter and try to go from there. If someone does not speak any English at all and there's no one to translate, we'll do a full head to toe exam on them and see if anything abnormal presents itself. At least we're not missing anything if we do it that way.

Usually there's a family member or nurse at the doctor's office who will speak Creole or Spanish and the hospital has interpreters that can get us the rest of the way there. I speak a little Spanish, and I know enough to say the names of body parts and ask if anything hurts, but if you drop me off in Quincy, I'm useless. The languages most prevalent there are of Asian decent. We have a medic in Brockton who speaks Portuguese and it comes in handy.

 

Emily Snickers

Q: What is it about the EMS training you have access to at Brewster Ambulance that you really like?

EA: I have never had trouble getting information when we need it. When we switched over to the Philips monitors, they had in-service training in all of the towns getting those monitors, and anyone could go to that. South Shore Hospital has the sim lab, and I did a shift in Braintree and got to do that and it was really cool. They're great about giving us the information we need.

Regarding recertification, they offer everything—we don't have to pay a dime to re-certify except for the state fees, it's hugely convenient. It's one less thing to worry about to know that I can go online and send an email and be all set. I don't have to worry about going somewhere else to find what I need, Brewster offers everything. I try to participate in additional stuff outside of the company, but that's just who I am.

Every fall I go to Springfield for the Mass EMS Conference, and they have speakers come in and it's always good to get out of my little bubble. It's a whole different world in western Mass. I've gone the last three years in a row. It's good to get out of town and interact with new people. 

There is an exhibit hall, reps from different companies, new glide scopes, new ePCR software, textbook companies are there, and the fanciest new ambulances are there on display. A couple years ago there was someone from Shriners giving out info on burn treatment. They have guest speakers come in and there's always a lot of information to be had which is nice. 

This past year, a friend who works for Boston EMS went there with me. She used to work at Brewster and that's how we met. It was a good time. Over the summer I got certified as a flight-certified paramedic, that's the dream job I would love to have.

 

Emily Abraham

Q: Can you share a story about an experience you had working as a paramedic in Brockton?

EA: My partner, Tom Brennan, and I delivered a baby. The call included us, CA7, town BLS units, and Brockton FD Ladder 1. We got a call for an active labor, contractions two minutes apart. By the time we got to the house, the baby was almost all of the way out. As a group we got the baby and dried her off, and she was perfectly healthy. It all went smoothly. We let the father cut the umbilical cord and we bundled up the little peanut and went to South Shore Hospital. It could not have gone smoother.

One of the other EMTs later ran into the dad afterward and the dad said, "If you see the crew, tell them everyone's fine and the mom is good the baby is good." It sounded like everything went well. That's the first baby that I've actually delivered.

 

Q: What is it about Brewster Ambulance Service as a company that you really appreciate?

EA: It's the confidence of knowing that I'm working for a company that's ambitious. Everyone wants to get contracts and wants the work, or wants to say that they have the work, but I feel like the Brewsters really truly push to continue growing. There's a confidence knowing that my job is not going anywhere. Some other companies, people wake up and say, "Huh. Are we gonna have work today?" And there has never been that concern here with me. We never have to worry about them selling the company or losing work—it's a confidence thing. That's how I got into EMS. I graduated college during a terrible economy and there were no jobs. 

 

Q: What do you see for your future?

EA: I don't know where I'm gonna land, and I'm taking it one day at a time. Even if I did get a MedFlight job, I would hope that Mark and George would let me keep a shift one day a week, as I don't want to give it up.

 

Q: Lastly, what advice would you want to share with a new medic?

EA: Get comfortable boots and always bring a spare pare of socks.

ALS at the ER