In case you missed it: Part 1, Rural Dispatch: When The System Has Gaps, and Part 2, Every Minute a System Can't Save Lands on a Dispatcher or a Responder
I still pick up a shift in Carlisle County here and there through the month. When we stop for lunch at the local cafe, I can look around a room of 40 people and know we've transported close to half of them.
They recognize us. At the grocery store, someone will stop me and ask if I remember picking up their wife, or their child. We do the same in return and ask how everything turned out at the hospital. In a county like ours, knowing who your patients are is just part of the job.
The job is heavy before anybody touches a keyboard
I knew the weight of the dispatcher's chair early. When I was in it for eight hours, the whole county was in my hands. That's true in any center. In a small one, you also know the names on the other end of the call.
People ask whether that makes the job harder. I think the connection is a good thing. But during the call, you can't carry it. When I'm with a patient, it's almost like an equation. Here's the problem: chest pain. Here's my standard of care. Here's what I need to do to reverse it. I don't look at it as my neighbor, or my dad. It's a problem to solve, and your training kicks in.
After the call is when it sinks in. These are my neighbors. I go to church with these folks. I grew up with them. It might be my best friend's kid.
The person is the redundancy
For years, the way this job handled that weight was to push through it. Something critical happens, you compartmentalize, and you go from that call to the very next one.
That's the same pattern this series has been about. In the first part, it was dispatchers and ambulance crews mapping the county on their days off because no system did it for us. In the second, it was the minutes spent on the phone and the radio when a system can't share what it knows. When the system doesn't do something, a person does. In smaller communities, that person isn't just using the system. They're the redundancy for it, and they're usually still carrying the last call when the next one comes in.
Bigger centers know this too. Every center has a thin overnight shift. But in a rural county, nobody is sitting at the station waiting for the tone to drop. Volunteers are getting up and leaving their homes. The slack has to come from somewhere, and it usually comes from the people already on.
What time back actually means
When money is tight, departments go for the shiny stuff, the things they can hold and see. Yes, you need new trucks and new ambulances. But the technology that runs all of it in the background is just as important.
At one center I worked in, calling an entire shift of firefighters and explaining the call details to each person could take up to 30 minutes. With paging in 10-8 Systems, that became about 15 seconds for the dispatcher to type a message and send it.
That isn't a convenience. It's half an hour a dispatcher used to spend working down a phone list while every other call kept coming in. Time a system hands back is capacity that didn't exist before.
"It's okay to not be okay. What's not okay is to stay in that."
Where the hour should go
If a system gave a dispatcher or a medic an hour back in a shift, I know where I'd want it to go. Not to more calls. To the time after a hard one, so the stress can come down before the next call comes in.
First and foremost, you have to take care of your people. That takes leaders who care about their people, not just the statistics of the calls. It means time to debrief with your partner after a bad call, or to seek professional help, or to find some healthy outlet, whatever that is for you.
Because if you don't have healthy people running the trucks and sitting behind the console, the system is going to fail. Eventually, it will crash.
What is your system still asking your people to absorb? And if that system gave your people an hour back in their shifts, where could that hour go?