Andre V. Jones

“KSU SR42, 18J, Lot D, looking for a white Honda Civic, 1805 hours KNHD245” was the start of my career in public safety telecommunications (at Kennesaw State University [KSU], Department of Public Safety & University Police, Kennesaw, Georgia, USA). It was not, however, the career I initially chose. I started off wanting to be a doctor. More specifically, an OB/GYN. My logic was that people would always have babies (job security).

While at Kennesaw State University, I would listen to the city and county radio and dream about being as awesome and professional as those I observed. I would go home, and I would pretend I was 911 dispatcher, handling and dispatching the WORST events. Make no mistake, this was not child’s play. I had maps, manuals, everything! This was very detail-oriented and well-organized role-playing.

As it were, I would go down another path of “job security” related to emergency services and emergency management, on-boarding with Marietta E-9-1-1 (Marietta, Georgia) and later consolidating with Cobb Department of Public Safety 9-1-1/Communications Bureau (Marietta, Georgia). When I got behind the console, tragedy did not faze me because I had already dispatched every emergency there was. I had accepted that the caller’s crisis was not my crisis, and I was there to help them, not become part of their experience.

These abilities I attribute to my dream, one that manifested itself with the act of “pretending,” which I was quite good at. In doing so, I learned dedication, reliability, integrity, and objectivity as well as empathy, kindness, and discipline. For me, I learned how to see the world as it should be and to treat people within the world as they would want to be treated. I saw, I felt, I dreamt, and I appreciated and valued my version of the “land of make believe” where I could create the experiences. It was then that I committed to the profession with a vision to become the best communication center manager I could be. Part of my professional development plan included goals in higher education where I earned several degrees as well as aspirations of presenting at conferences.

The one thing I did not consider in this venture when I stepped up to be a supervisor is that I had to be people-oriented. Though I may have become a charismatic person, I realized that I couldn’t make anyone do anything no matter how much I tried to persuade them for the sake of progress. I may have been the “best dispatcher,” but that was not the job description of “supervisor.” Many times I had to step back and learn how to follow regardless of who was leading. THAT was tough.

I learned that you can only control what you can control. In leadership, you must engage, cultivate, and inspire people to get results. You develop a culture that does what needs to be done because there’s a shared sense of purpose and duty to do the right thing right, and not just waiting for someone to give orders. It’s called empowerment: making something organized seem improvised.

So I dreamed. Not whimsical and magical dreams, but optimistic dreams. Then I designed and developed the framework to make these dreams—the visions—become reality. After all, I will still be a doctor, just a Ph.D. instead of an M.D. It is about to be a new year. What do you dream of? Can it be reality?

Heidi DiGennaro

There are times when the protocol does not fill the gaps on a call. Every call is different; that is the nature of our business and no protocol can cover every situation. One of the best pieces of advice I received when I started was, “If you think you know everything, quit. You don’t.” So what do you do when the protocol isn’t enough? Below are scenarios the protocols do not cover and you, the emergency dispatcher, must think fast to handle them.

Caller pretending not to have you on the phone

People will call and pretend like they aren’t talking to an emergency dispatcher. You need to be at your best because most likely they are in danger, someone else is in danger, or something wicked your way comes. Many have heard about the woman who called to order a pizza while in a domestic violence situation, and the dispatcher caught on and helped her. What if that dispatcher had missed the cues?

What to do?

Listen. Callers need you to listen to what they are not saying. What’s the caller’s tone of voice? What’s happening in the background? Are they aware they have misdialed? Did they whisper in the phone that they couldn’t let the other person with them know that they are calling for help?

Stay quiet and use a soft tone of voice. Many emergency dispatchers crank up the volume on their phones loud enough where people around the caller can hear conversations. If you are loud, you might put the caller in danger. A soft tone shows your caller that you understand there is a problem. Callers will try to give you what they can. Have you heard calls where the telecommunicator is saying in a strident or bored tone, “This is 911. Do you have an emergency?” Do you want this to be you in the media playback?

Caller drops off and leaves an open line

Occasionally, the caller says one thing and the line stays open; she does not answer you thereafter. Increasing your volume means the louder you are, the more you are not listening to what’s happening in the background. You could miss shots fired or cover over them with your fourth, fifth, or sixth “answer me” request.

I handled a call from a female who told me the address and about the domestic situation before she stopped answering, and I had an open line. Months later I was told my silence allowed the recording to capture the rape in progress. By my not talking and only listening, the recording captured the entire crime, and it was used against the suspect in court to secure a conviction.

You, the emergency dispatcher, can help yourself when the protocol does not fill the gap. Identify the gaps. If you have a suggestion, forward it. The Academy has a process in place to request changes; make suggestions and benefit all of us. Review the protocols frequently and find the gaps; discovering there is a gap during a call isn’t the right time. Play the “what-if” or “what would I do” game by yourself or with others in your center to go over the protocols and where they stop.

If the situation has never happened before, protocol cannot cover it. Think of major events in your jurisdiction that happened once and never again. Now you probably have a plan for this odd event that occurred once. How many oddball, screwy, kick-you-in-the-teeth situations do you think are out there that you haven’t seen yet? The only thing you can do is to accept there is a gap and suggest change. No protocol can cover every eventuality, and understanding that not all calls will fit on the protocol reduces stress and anxiety.

You’re the one that people call in a crisis and part of you managing the chaos of a 911 call is knowing the strengths and weaknesses of the tools in your toolbox.

Kate Dernocoeur, NREMT

There are by now several generations of emergency care providers who have perhaps missed one important EMS book: “Streetsense: Communication, Safety, and Control.” The book’s first edition was published way back in 1986, and the third edition was released in 1996. But many industry leaders today will tell you it had a huge impact on their street careers.

I wrote the first edition in the early 1980s out of desperation. Although my paramedic school instructors back in the 1970s were magnificent at teaching about bodies, what could go wrong, and what I could do about it in the prehospital setting, they were nurses and doctors. They had no direct experience with the streets.

As I started my years of service (at the Denver (Colorado, USA) Paramedic Division, 1979–1986, and for a private service for a year before that), I realized there was much—oh, so very much—still to learn about the craft of EMS. It was quickly evident that capable and efficient field providers incorporated abundant non-medical skills on every call. How not to knock on a door. When to dig in at a scene, and when to cut and run. Why I should learn how to hold a patient’s hand sometimes.

I learned these and many other tips and tricks of effective delivery of emergency care from watching both gifted mentors and others showing me what not to do. Over time, I wondered why no one had written a book about these things. Finally, I decided to write that book myself.

I mulled over the possibilities for a couple of years, keeping idea lists while awaiting calls at the corner of 17^th and Federal or somewhere up on Denver’s Capitol Hill. I noticed, when running our average of 10 calls in a 10-hour shift, many various elements that would need to be included in such a book as the one I was proposing. Over time, I decided there were three main pillars of street sense: effective interpersonal communication, a variety of aspects of safety, and control of everything from crowds and weaponized situations to ways of handling stress and death and dying. When I pitched the idea to the Brady Communications Co. at a conference, I was told they’d mail a contract to me within a week. The book’s time had come.

So much has changed since the 1970s! Believe it or not, when I started, my instructors pounded into us that our very first priority on a call was the patient’s ABCs (Airway, Breathing, and Circulation). It took years (and I do credit “Streetsense” for having a hand in this) to alter that message; these days, everyone knows that the first priority is personal safety. It’s been fun to revise and build a better book with each new edition (second edition in 1990, third in 1996). Infection control came into the collective conversation for the second edition. Gangs and a new chapter on customer service and the nature of routine debuted in the third edition.

This book is being updated yet again. The fourth edition retains its usual triad of communication, safety, and control while reflecting the evolution of the EMS industry since the arrival of the millennium: computers and cellphones, social media, active shooters, and so much more. Scheduled for release in February 2019 by PennWell, the fourth edition of “Streetsense” will offer the same lodestone of tips and tricks to help EMS providers—both new and street-savvy—do the job even better. Watch for it!