Volume 3, Number 29 - October 16, 2003
brought to you online by Pinedale Online
The Sublette County Rural Health Care District held a special meeting last Wednesday night to discuss problems with the Pinedale Emergency Medical Services. All board members, with the exception of Garry Eiden, were in attendance.
Chairman Walt Bousman called the session to order, immediately calling for an executive session between the board and Dr. Judy Boyle of the Pinedale Medical Clinic and the board's legal counsel, Ed Wood. Half an hour later, the board came back into open session, but Boyle left the meeting.
Board Member Mary Lynn Worl made a motion that the board terminate Pinedale emergency medical technicians Cori Laster and Sandy Anderson from the employment of the district, adding that after six weeks, the EMTs could re-apply for their positions, but only with the approval of the medical director and the board.
Board Member Jerry Jensen explained that state rules for EMTs require that a medical director oversee the ambulance service.
"What the medical director says is pretty much it," Jensen said, adding that if the medical director (Boyle) decides to withdraw her sponsorship of specific EMTS, "There is not anything we can do about it."
Jensen said the board was simply "playing the hand we was dealt."
Bousman said if the medical director pulls sponsorship, "We don't have the authority to override it," because state rules allow such action, "at any time, for any reason."
The board vote on firing Anderson and Laster was unanimous.
Worl then urged Anderson and Laster to contact Boyle "within 48 hours to arrange a consultation to clarify and understand what exactly is needed for your reinstatement."
This was the cumulation of a struggle in which Boyle had requested the EMTs be stationed at the ambulance barn during their full-time paid salary hours. The board had met with Boyle in executive session to hear her concerns, and then adopted the policy for the EMTs to stay at the barn, effective almost immediately. But shortly after the EMTs were notified, they voiced concern with the policy, so it was suspended after board members informally discussed the situation outside of a board meeting. When the board next met, the EMTs attended the session, and the board directed them to meet with Boyle to develop a proposal to resolve the situation.
Laster reported that the EMTs attempted to do so, but Boyle refused to meet with them. Boyle subsequently withdrew her sponsorship of the two full-time salaried EMTs, which led to last week's board decision to terminate their employment relationship.
The board discussed how communication problems were a significant issue and turned to Registered Nurse Pat Burroughs of Bondurant for a possible solution. Burroughs volunteered her services as a mediary between Boyle and the EMTs, to serve as a physician's advisor. She reported that Boyle had already agreed to the proposal, and at last week's meeting, the EMTs appeared to agree as well.
Burroughs said, "It is time that the board took the bull by the horns." She pointed out that the board consists of elected officials with no real expertise in the area they were addressing.
"You get ambushed every time you turn around," Burroughs said, advocating that EMT personnel rules should be put down on paper, as should the expectations and responsibilities of the medical director. Burroughs said she viewed some of the existing controversy as an ego problem and suggested methods to improve the professionalism of those involved.
Board Member Bill Barney asked if he was hearing an argument for a professional administrator, to which Burroughs replied, "Yes."
Pinedale EMT Aimee Binning said Boyle won't meet with the EMTs to discuss problems, and questioned whether a go-between would be effective.
"She won't even meet with us now," Binning said. "She won't even stay tonight to address the issue."
The board discussed how communication is a two-way street, with Burroughs offering a prime opportunity to improve the situation.
The EMTs also voiced concern about whether the ambulance service-call schedule can be filled with the loss of two full-time EMTs, but Bousman said that Boyle had agreed to fill the slots with her staff, "if worse came to worse."
Pinedale EMT Wil Gay pointed out that there are 20 six-hour paid EMT shifts in a week, so the two part-time EMTs can cover eight of those shifts, leaving 12 six-hour shifts to be covered either by the volunteer EMTs or Boyle's clinic staff.
Pinedale EMT Nick Schultz noted that he has been involved with the ambulance service for two years and has seen Boyle in the ambulance barn only once. He noted that the medical director "answers to no one. We sure get the short end of the stick a lot."
Barney said there is hope that the Pinedale service will move toward operating more like that of its counterpart in the Big Piney/Marbleton area, with a closer relationship to the clinic and medical director. He added that it appears that Dr. Alex Constantinides will become more involved in the ambulance service.
"I would advocate to take whatever steps are necessary ... to move that process forward," Barney said.
Pinedale EMT Kris Bacheller said the Pinedale EMS was unanimous in its support of Constantinides ... as a physician's advisor, but didn't want to give up the EMS supervisor position within its own organization either, which had apparently been discussed.
The RHCD board also agreed to increase the pay for any volunteer EMT who is willing to be stationed at the ambulance barn to $10 per hour during the workday, of $7.50 an hour to cover the workday hours but not be in the barn. This interim pay schedule will also be offered to the BECs and drivers. The board agreed to begin widely advertising for two full-time EMT intermediate applicants.
Worl once again pointed out that Anderson and Laster could re-apply for the jobs, provided they received approval from the medical director and the board. Barney added, "And I encourage them to do so."
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