By Laura L. Otto
Kendria Donaldson thought the career she wanted was traditional nursing. Then, when her boyfriend’s brother joined the Milwaukee Fire Department, she considered a different option.
Becoming a firefighter would still allow her to help people with their health, but in a way that would build long-term wellness rather than just provide spot care. A University of Wisconsin-Milwaukee program helped her do just that.
Donaldson discovered that running into burning buildings is a relatively small part of the job. Far more common are health-related 911 calls, including many that aren’t true emergencies. Many of these frequent calls are from people unequipped to manage chronic diseases like asthma, diabetes and heart conditions.
“A lot of times, when we get there, the person tells us they just don’t feel good. That’s where the conversation starts,” Donaldson said. “We have to find out why they are not finding the right care. With those patients, we are forming a long-term relationship. When you spend two hours with a patient, you can have an impact.”
In 2015, the Milwaukee Fire Department partnered with the UWM College of Nursing and Milwaukee County Emergency Medical Services to train firefighters who are already paramedics as “community paramedics.” Their role is educating, fact-finding and building relationships with patients whose emergency calls are not urgent.
The goal was two-fold: improve people’s health habits while reducing the number of non-emergency calls coming in. And the strategy worked.
Under the program, which the fire department calls Mobile Integrated Healthcare (MIH), 911 use across all demographics for Milwaukee County dropped significantly from 2014 levels. According to Michael Wright, MIH care coordinator for the Milwaukee Fire Department, the calls were down 56 percent in 2016 and 62 percent in 2017.
UWM has trained more than 70 community paramedics at fire departments all over Wisconsin, and nearly half of them work in Milwaukee. Another class will be offered this fall.
Community paramedics try to learn what barriers prevent patients from managing their own health, whether it’s finding transportation to clinics or understanding the correct use of their medications.
Community paramedics also check for safety hazards around homes and give patients information on other programs that can help them.
That’s different from traditional firefighter paramedics, who perform triage in order to quickly transport a patient to a hospital for treatment.
“The community paramedics program capitalizes on the strengths of all participants,” said Kim Litwack, dean of UWM’s College of Nursing. “Our expertise in health promotion and health education paired with the knowledge of fire department paramedics in neighborhood-centered care can lead to improved health outcomes for the citizens of the state.”
UWM’s nurse-trainers expose the firefighter paramedics to different parts of the medical field, including pregnancy issues and chronic conditions like asthma. They also learn how to help navigate the challenges faced by many people who live in poverty, such as how to get around on a bus with children, where to go when you are homeless, or how to obtain and use food stamps.
“It was very eye-opening,” Donaldson said. “Sometimes, people are stuck between paying their energy bill or buying their medications. By telling them about various other programs available, we may give them some more options.”
For Donaldson, the most valuable aspect of the training was learning how to interact with people who may be struggling with untreated mental health needs. She also takes pride in being able to directly help her community.
“I like the idea of treating our own frequent callers,” she said. “We’re a brotherhood and sisterhood. And if we’re helping our own, it will ultimately lead to fewer calls.”