COLONIE — You might get away with calling a paramedic an EMT, or an EMT a paramedic. But don’t call either one of them an ambulance driver. Ever.
When the Colonie Emergency Medical Services Department started 30 years ago this month, ambulance driver may have been a little closer to accurate, but the department has evolved into a cutting edge crisis care unit, and the situations where those skills are applied has grown exponentially.
“When I first started we took everyone to the hospital with red lights and sirens, didn’t matter if it was an ingrown toenail or a cardiac arrest. It was all about the size of the engine and how fast it could go,” said Peter Berry, the EMS chief who retired last week after 30 years with Colonie EMS and a 37-year paramedic. “Today, we rarely use red lights and sirens. It puts people at risk and the community at risk, and today we provide so much care in the field that there are only a few reasons for us to run hot to the hospital.
“Sure someone has to drive, but the worst thing you can call us is an ambulance driver. Many people just don’t have an understanding of what we do.”
The whole concept of EMS is a relative newcomer to public safety. There have been departments to police citizens’ activities since the Roman Empire, and Ben Franklin established the first U.S. fire department in 1736.
That fact of history has led to what some, like Berry, consider an inequity. A rookie in EMS makes substantially less than a rookie in the police department and whereas a police officer can retire after 25 years, a member of the EMS has to work into his or her 60s. If a police officer gets hurt on the job, he gets full pay until retirement but in EMS, it’s the same as everyone else.
“We are late to the table, and we have equity and it’s almost impossible to get them now,” he said. “We have similar exposure to risks and we don’t have nearly the same benefits and that is one of the biggest challenges we have from a recruitment and retention stand point going forward.”
A little history
EMS didn’t really get going in this country until after the Vietnam War, Berry said. It started in Colonie in around 1975 under the direction of Dr. Howard Westney, who taught the first EMS program and established the first medical patrol. Thanks to Westney’s tutelage, the town was one of the first in the state to provide advanced life support in the field.
The all-volunteer paramedics were assigned to police traffic patrols for a time, but the demands on both were not always congruous, and the paramedics were shifted to the fire departments. Prior to 1989, there were six all-volunteer ambulance companies stationed at six fire departments and while there was some oversight, called Colonie Medico, they were largely autonomous.
In 1986, the response times were heading to the realm of unacceptable and there was some negative press, Berry said, so the town commissioned Fitch & Associates to do a study and make recommendations about which direction EMS should go.
Three years later, the Town Board created the EMS Department and hired a director and 12 full time staffers for daytime shifts. Night and weekends were still covered by the nearly 100 volunteers.
At the time, the three ambulances handled 4,500 calls a year. In 2018, the department has more than 90 employees, seven ambulances and handles more than 12,000 calls a year.
While there are still some volunteers, demands on time and rigorous time-consuming training requirements make a good volunteer hard to find.
Society, too has changed.
“I don’t think people are volunteering as much as they used to because I don’t think they have that investment in community, in neighborhoods, like they did years ago,” Berry said. “And the demands of training have put a hurt on volunteer services across the state. You see it in fire services and EMS. As our call volumes have gone up, we had no choice but to hire more people.”
EMS has evolved from what some thought of as “a bunch of ambulance drivers” to bringing care to people in all sorts of situations, from car accidents, to confined space emergencies, rope rescues and HazMat situations. In 1993, the town’s EMS teamed up with the State Police to provide medical services on helicopter calls across the Capital District and in 2013, EMS was integrated into the town’s SWAT in the event of an active shooter or any other situation were special weapons and tactics are needed.
“The training never ends. Protocols change, technology changes and the science behind medicine is changing and all that requires training,” Berry said. “There is constant training and constant testing and that makes it difficult to recruit and retain volunteers and employees.”
Adding to the EMS demand is that Colonie’s population has steadily grown over the last three decades and its central location leads to huge volumes of traffic during the morning and afternoon rush hours. It has the largest number of senior citizens in Albany County and has a number of health care providers within its borders.
“All those medical facilities are demanding on us,” Berry said. “All those groups and offices draw people to the town and if someone goes to Capital Cardiology and has a stress test and has to go to the hospital they call us.”
Adding to that demand is fewer hospitals in the area. When an EMS squad takes a patient to the hospital, the paramedic has to wait until someone there can accept the patient and then they have to file a report. It can take 90 minutes or more and while that crew is waiting, others have to cover their territory.
It’s not an easy thing to coordinate given the department’s goal of getting to the scene of any call within nine minutes.
“Peter Berry has laid a tremendous foundation as EMS moves forward. He has been a right hand man for me and he’s been a partnered with our police and fire services. This is the greatest EMS Department in the nation,” said Supervisor Paula Mahan. “We are proud of what he has accomplished and we will miss him greatly but we wish him a great retirement with lots of happiness, good health and fun.”
Opting to not go into the families hotel business in Lake George, Berry found himself with two options: join the American Legion or the fire department. Not qualified to join the legion, he joined the fire department, and following the footsteps of a high school buddy, he got into the ambulance crew, which was separate from the fire department, and went to EMT school.
It was the beginning of a 37-year career that started in his home village and took him to private ambulance services, to being a paramedic in the rough and tumble streets of Newburgh, where he “cut his teeth as a paramedic,” and finally to Colonie.
“I consider Newburgh my first real job. They paid real money and bought us uniforms,” he said. “I grew up as a paramedic in Newburgh. I was on the critical care transport and it was an ‘interesting’ place to work. I handled my first shooting in Newburgh and that’s where I delivered my first baby. I learned an awful lot in the city of Newburgh.”
One of the biggest challenges of being in charge, he said, is providing the EMS coverage that is cost effective and responsible to the taxpayers and he foresees that continuing to be a challenge to the next chief, Chris Kostyun, a 28-year EMS veteran who the Town Board appointed chief at last week’s meeting (see following story.)
“Peter and I have been friends for a long time. He is a consummate professional and clearly one of the best paramedics I have ever met,” said Kostyun, who was briefly a volunteer, a full time paramedic, a flight paramedic and an assistant chief. “He was one of two guys I was deathly afraid of when I first started but one who I have learned the most from. We are on a very good road now. We have excellent equipment, excellent people and the programs we are involved in suits the town well.”
One example of the challenges to being cost effective, Berry said, is the department got a federal grant in 2010 to buy 17 heart monitor defibrillators. A nice thing except they had to buy the $30,000 pieces of equipment all at once and now, nine years later, they are all reaching the end of their usefulness at the same time and there is not another federal grant on the horizon.
“In order to get anything done you have to work together. You have to work with human resources, and public works and police and fire and the elected officials,” he said. “It’s a team effort in the town and you have to have good working relationships with all the players.”
He wrestled for an answer when asked about his most memorable call. One was when he was part of a team that answered a call of a bus that flipped down an embankment in Bolton Landing. There was only one fatality, but some 30 passengers were trapped under and in the bus and seriously injured. Any baby delivered stands out, he said, and anytime there are traumatic injuries too.
And, not all those have happy endings, which is part of the business.
“I don’t know if you ever get rid of it. But in this business you learn from what you do. You learn from experience and you apply it to the next call,” he said of seeing people die. “You try to compartmentalize it that way. In any public safety organization, you see death and tragedy but you have to be prepared to deal with it and cope with it and manage it and move on. Some people do it better than others.”
His two boys are now full-time members of the Colonie EMS and he is also going to pick up a couple paramedic shifts a month in Lake George.
“I’m a grunt paramedic at heart. I miss being in the field. I really do so I’m going to go back onto the street and maybe take care of some people,” he said. “It’s bittersweet leaving here. I love what I do but it’s time to pass the torch. I have had the pleasure of working with some really incredible people who do an incredible job and I do think I am going to miss that the most.”
In case you’re wondering, an EMT requires about 175 hours of training, a paramedic requires about 6,000 hours or training and an ambulance driver requires a clean driving record.