# What Happened to Durham County EMS (North Carolina)?



## MMiz (Jun 13, 2017)

I was reading an article that said:



> About 44 percent of employees in 2016 and 39 percent in 2015 rated staff morale as low, according to EMS staff surveys, and 28 percent in 2016 and 21 percent in 2015 rated it very low.





> Only 34 percent of employees said EMS was successful in 2016 in meeting the county’s EMS needs, down from 60 percent in 2015.



What happened?


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## NomadicMedic (Jun 14, 2017)

Skip Kirkwood was placed on admin leave and had since retired.

I'm sure @DrParasite knows more.


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## RocketMedic (Jun 14, 2017)

The timeline seems more like issues started on his watch. And administrative leave seems more ominous than benign.


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## DrParasite (Jun 14, 2017)

I know a little bit, but not what happened with Director Kirkwood (no one seems to be talking about that, and I have asked).....

Skip (who I have met personally, but haven't spoken to in almost two years) is an agent of change; he was brought in to fix a system that was experiencing numerous issues.  DCoEMS has been involved in some legal action prior to his arrival, many of their paramedics weren't permitted to intubate as per their medical director, one of their larger contracted EMS agencies was under investigation and in the process of folding due to financial irregularities, and their system had suffered from years of financial neglect (stations were falling apart, not enough units for the call volume, etc).  So he inherited a **** show, and was tasked with making things better. 

1) Durham County EMS pays less than many of the surrounding counties, at both the EMT and paramedic level.  And they run more calls than anyone else in the region (the exception being Wake).  So they did experience a seasoned paramedic exodus to other agencies.  This has been an uphill battle, and the county FINALLY has approved payrates for all DCoEMS employees.

2) DCoEMS used to have a "hell week" in their schedule system, where you worked three day shifts and then 4 night shifts (at 12 hour shifts, with the flip being on saturday night so it wouldn't be OT), followed by 7 days off.  He got rid of the rotating schedule, and set everyone on day or nights, with set 12 hour shifts.  And he asked people what they wanted, instead of telling them (which apparently didn't go over well with some people).

3) Their medical director quit, and a new one was hired in 2015, and we all know how much people like change.  And I heard through the rumor mill that she kinda sucks as a person, and isn't letting them do anything super progressive.

4) There have been several people that have been terminated (and some that rightfully deserved it), and others that have been disciplined.  I got the impression that having a strong leadership presence has been lacking in recent years, so once someone started cleaning house, people got nervous.  And I did hear that some of his supervisors fired people who probably didn't deserve a full termination, but I did only hear one side of the story second hand.

5) They purchase a bunch of brand new sprinter ambulances.  They were different than what previous administrations purchased, and some liked them, while others didn't

6) They obtained all new uniforms, and redesigned their patch and badges. Some liked it, others not so much.  Some asked why they were spending money on this while other items didn't have the funding for.

So I do think in many ways, the deck was stacked against the new administrator, who still had all of the old administrative staff, and now he was telling the county administration that he needed a lot more money to handle the call volume (50% increase in staff), something the department had never asked for previously.  And he was enacting changes, cleaning out dead wood, and I do think he was trying to make improvements to a system that had been sorely neglected for years.  And besides, agents of change typically only have a 3 to 5 year career span in director roles, compared to those that go with the flow that last 10+ years.

Many of the causes of the low morale (low pay, poor equipment, crappy stations) are improving, and morale will increase, but many of these things do take time and approval above the director level.  Give it two years, with the agency getting the funding it needs and deserves, and I bet you will see the numbers increasing, regardless of who is at the helm.

By the way, if "About 33 percent said EMS provided outstanding customer service (down from 60 percent in 2015)", that would reflect more on the field staff than the actual administration. 

I will also say that I know of at least one person who worked for DCoEMS, left for a neighboring county EMS agency to be a whiteshirt, and went back to DCoEMS to be a field staffer.  So even though it might be bad now, it is still better than other places.

As for the investigation and suspension for the director, I find it interesting that they publicize in the news the announcement of the accusation and that an investigation is underway, but I haven't read anything about the outcome of the investigation, or what he was even investigated for.


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## NomadicMedic (Jun 14, 2017)

This story has been pretty quiet, but if you read Skip's posts on FB and LinkedIn, it's pretty obvious he got railroaded.

He posted a great article about having the right staff to back you if you're making change, and while it didn't mention anything specific... the message was loud and clear.


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## agregularguy (Jun 14, 2017)

DrParasite said:


> I know a little bit, but not what happened with Director Kirkwood (no one seems to be talking about that, and I have asked).....
> 
> Skip (who I have met personally, but haven't spoken to in almost two years) is an agent of change; he was brought in to fix a system that was experiencing numerous issues.  DCoEMS has been involved in some legal action prior to his arrival, many of their paramedics weren't permitted to intubate as per their medical director, one of their larger contracted EMS agencies was under investigation and in the process of folding due to financial irregularities, and their system had suffered from years of financial neglect (stations were falling apart, not enough units for the call volume, etc).  So he inherited a **** show, and was tasked with making things better.
> 
> ...



I interviewed here just right before they announced Skip was leaving. From the people I talked to at least, Skip was really good (and part of the reason why I even started to look at them!) The pay issue was a known problem, that they seemed to have been working on for a while, and I'm glad they finally got a bump. From what I heard, the new medical director wants to go back to intubating, but with much more practice for the medics to improve success rates. She apparently worked as a medic for Austin-Travis county for a while before being a doc, and seemed to be looking into some progressive things, from what I heard.  I came out of the few days I spent there being really impressed with what I saw, so I was surprised to see this post. But you bring up a lot of good points, especially 
"So I do think in many ways, the deck was stacked against the new administrator, who still had all of the old administrative staff, and now he was telling the county administration that he needed a lot more money to handle the call volume (50% increase in staff), something the department had never asked for previously. And he was enacting changes, cleaning out dead wood, and I do think he was trying to make improvements to a system that had been sorely neglected for years."
People don't like change, and especially changes that affect them (scheduling, getting rid of certain employees) I hope they continue to fix things there, from the glimpses I saw, I really liked Durham County.


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## DrParasite (Jun 14, 2017)

agregularguy said:


> From what I heard, the new medical director wants to go back to intubating, but with much more practice for the medics to improve success rates. She apparently worked as a medic for Austin-Travis county for a while before being a doc, and seemed to be looking into some progressive things, from what I heard.


My information was mostly second hand from people who worked there; I don't know the woman, never met her, but I hear her personality clashes with people.  She might be a good medical director, but I was told she has clashed with people.

I think some people liked Skip, but a lot didn't, because they didn't like change, or they disagreed with the changes that he wanted to implement.  I know he wanted to bring in good people from the outside, and get rid of people who should have been gotten rid of years ago.  If you were friends with someone he pushed out, it jaded your opinion of him.

I still think that Durham has a lot of potential, but is still under funded and understaffed.  Changes are coming, and they will be positive to both the county and the system as a whole, and 5 years from now, things that were initiated during his tenure will benefit the agency in the long term.

I did speak to a few people at Wake EMS after Skip left; they said they were glad to see him go.  These were also the same people with a HS diploma, and a paramedic cert (no degree), who think they don't need any fancy education, and we have always done it this way, and we don't need no yankee coming here and telling us how to do things, when we have done it this way for decades.  but again, when you bring in an agent of change, you are going to upset people who are content accepting the status quo.

No system is perfect, and no good and effective leader will make everyone happy. I still think if I was looking to relocate to NC (again), and had my paramedic cert, Durham would be on the list of places I wanted to work.


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## VentMonkey (Jun 15, 2017)

I know next to nothing about Durham County EMS and its political woes, but when the name _Skip Kirkwood_ comes across even the more proactive providers in my region, and is seen as an "issue", well, that there has some major red flags even all the way on the Left Coast.

That man has, and deserves the respect of many-a EMS providers nationally. He was synonymous with Wake EMS when I was contemplating an uprooting. You don't get many like him anymore, Jarvis either.


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## RocketMedic (Jun 15, 2017)

The question is what sort of "issue", and whether the managers in place see it as a threat.


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## DTownMedic (May 11, 2018)

Durham EMS is now going to be a part of Emergency Management, so the EM director will be in charge.  There are plenty of vacancies and lots of money to be made working overtime.  Getting released is difficult.  The clinical clearance test is really intense, and you have to pass a protocol test every year to maintain your credentials.  The protocol test is tough too.  Some of the captains had trouble with it.  If you don’t pass after a couple of attempts, then you get terminated.  Still, if you don’t mind the hard work, there’s plenty of overtime.


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## DrParasite (May 11, 2018)

DTownMedic said:


> Durham EMS is now going to be a part of Emergency Management, so the EM director will be in charge.


So the former director of Orange County Emergency Services, who was never a paramedic, and left Orange County to be the Durham County Emergency management director, is going to increase the size of his department by like 500% (or more), all while never having actually worked as a paramedic on the ambulance.  Yet he is going to be in charge of EMS  I don't see this as a good thing for Durham County EMS





DTownMedic said:


> There are plenty of vacancies and lots of money to be made working overtime.


not really a good selling point, I'm just saying.....





DTownMedic said:


> Getting released is difficult.  The clinical clearance test is really intense, and you have to pass a protocol test every year to maintain your credentials.  The protocol test is tough too.  Some of the captains had trouble with it.  If you don’t pass after a couple of attempts, then you get terminated.


This tells me one of three things: 1) the previous credentialing process was a joke, and many people working there who passed shouldn't have passed and someone is trying to clean house 2) it's unreasonable to expect field staff to pass an exam that even the experienced field supervisors are having trouble passing or 3) your FTOs suck and haven't been preparing their new orientees well enough so they would be ready for the final exams.  Not sure which, all the people i knew from DCoEMS have since moved on to other opportunities (most of them voluntarily and they are in a much better position as a result of it).


DTownMedic said:


> Still, if you don’t mind the hard work, there’s plenty of overtime.


I don't have any objections to hard work, but your post really doesn't make me want to go out and apply for Durham o EMS........


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## RocketMedic (May 12, 2018)

Sounds like a distressed system. Putting in a non-EMS manager tells me the county commissoners don't really get it- they want someone who toes the line and shuts up running the show, not someone who wants to change things or even someone who thinks EMS first.

EM isn't even EMS. It is a niche. EMS is literally a daily demand. Might as well put the sheriffs under EM too...


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## DrParasite (May 12, 2018)

RocketMedic said:


> Sounds like a distressed system. Putting in a non-EMS manager tells me the county commissoners don't really get it- they want someone who toes the line and shuts up running the show, not someone who wants to change things or even someone who thinks EMS first


Not always...  In NC, since EMS is a county responsibility, it's actually quite common for Emergency Services to be the department  to be in change of the Fire Marshal's office, 911 communications, Emergency Management & EMS; however, its usually those smaller counties, where you have less than 6 EMS units for the entire system, with the ES director typically having a strong EM background....

However, in this case, I think your right. Durham's system is large enough to warrant it's own director, who has a seat at the table alongside the EM director, not reporting to him.


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## DTownMedic (May 25, 2018)

RocketMedic said:


> Sounds like a distressed system. Putting in a non-EMS manager tells me the county commissoners don't really get it- they want someone who toes the line and shuts up running the show, not someone who wants to change things or even someone who thinks EMS first.
> 
> EM isn't even EMS. It is a niche. EMS is literally a daily demand. Might as well put the sheriffs under EM too...




It is distressed.  Three captains and a major have resigned in the last 3 weeks.  The medical director is leaving at the end of August and no one knows who will take her place.   I am planning on leaving too.   I love my co-workers and my partner, but I need job security.


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## RocketMedic (May 25, 2018)

I make 25.75 an hour in houston


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## cruiseforever (May 28, 2018)

RocketMedic said:


> I make 25.75 an hour in houston



How many years of experience?


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## RocketMedic (May 28, 2018)

9, 1.6 years here


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## FiremanMike (May 29, 2018)

Didn’t I read a thread on this forum not too long ago that said folks interested in Wake County EMS should look to Durham instead because it was a much better working environment?


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## DrParasite (May 29, 2018)

FiremanMike said:


> Didn’t I read a thread on this forum not too long ago that said folks interested in Wake County EMS should look to Durham instead because it was a much better working environment?


Not likely.  What you probably heard (and I was one who said it) was if you are looking at Wake County EMS, look at Durham, Orange, Johnston, and Nash (which are the counties surrounding Wake), because Wake does have some issues (like every system), and if you don't like it at Wake, you have other options, and your pension time and PTO time can come with you.  So don't look at others _instead _of Wake, while you are in the area, look at others in _addition _to Wake.

4 years ago, Durham EMS was expanding (one of the county franchise agencies had recently crashed and burned), they had just hired a new director, and it looked like things were getting better.  Since then, that director has retired, their medical director is leaving, many of their senior personnel are leaving for other positions, and they are changing from a stand alone county department to one under a non-paramedic EM director.



DTownMedic said:


> I am planning on leaving too.   I love my co-workers and my partner, but I need job security.


If you are a medic, there are plenty of places to hire experienced and competent NC medics .  It all depends on how far of a commute you want.   

And for the record, It is my personal opinion that no one at Durham EMS will be laid off, but the good people will leave for better options, and conditions will deteriorate further until a strong leader is able to take over running Durham Co EMS.


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## Medic4Lyfe (Jun 1, 2018)

It is not a coincidence that people with great jobs and 29 years of experience are leaving. The environment is quickly becoming toxic. Favoritism abounds and it gets harder to care. One operations captain and one lieutenant get private offices while the other 2 captains and 8 lieutenants have to share.


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## Sylvestermedic (Jun 1, 2018)

The fall of Durham County EMS started when Skip Kirkwood was hired. He had no idea how Durham worked . He wanted all the old gaurd as he put it out. He took away a work schedule that most of us liked because he did not like it. He bashed the former management in open forums. He belittled the employees. He was arrogant and the service had done nothing right before he came there. Which not true at all DCEMS was a respected agency until his arrival. The call volume jump was his play on the numbers they were cooked. If he is so great why has not stayed anywhere long? A lot of very good paramedics and EMTs were lost while he was there pushed out or terminated under questionable circumstances. Which resulted in payouts I might add after lawyers were involved. So for everyone who thinks Skip Kirkwood is so great the truth is he sucks and is not worth a s..t and was there way to long glad he is gone never to return . I am happy I am out of there


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## DTownMedic (Jun 3, 2018)

I'm not worried about layoffs.  I'm worried that the system will get taken over somehow.  If it wasn't for a small group of people working lots of overtime we wouldn't be able to stay running.


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## DrParasite (Jun 4, 2018)

Disclaimer: I know Skip Kirkwood, and I think he's a very smart guy from NJ, who is both educated and is well known nationwide for always advocating for the betterment of EMS.


Sylvestermedic said:


> The fall of Durham County EMS started when Skip Kirkwood was hired. He had no idea how Durham worked .


Ahh yes, because Durham EMS operates completely differently than any other EMS agency.





Sylvestermedic said:


> He wanted all the old gaurd as he put it out.


Your county management hired an outsider because they lost confidence in the existing management.  That sounds like the powers that be realized there was an issue, and brought in an object outsiders to clean house.  I'm guessing you are one of the "old guard" who he wanted to replace with better people?





Sylvestermedic said:


> He took away a work schedule that most of us liked because he did not like it.


are you referring to hell week?  three days on day shift, followed immediately  by three nights on?  you are aware of all the studies involving circadian rhythm disruption, and how it is detrimental to your health right?  It's also one of the reasons I decided against applying to Durham in the first place, and I am glad they finally got rid of it.





Sylvestermedic said:


> He bashed the former management in open forums.


multiple people from outside of the agency saw there were issues, which is why an outsider was brought in to change things.  Maybe you disagree with what he said, but admitting there is a problem and setting forth steps to rectify them is generally viewed as a good thing.





Sylvestermedic said:


> He was arrogant and the service had done nothing right before he came there.


Can't really argue that statement, but when you have been a paramedic since 1984, and have a doctorate, I'm likely to give a little extra slack.  But you might be right that he can be a little arogant, 





Sylvestermedic said:


> Which not true at all DCEMS was a respected agency until his arrival.


ehh, it was an EMS agency that served a county that had one major city in it.  I have not heard that it was all that respected, or well known, at least not compared to some of it's neighbors.  

I have heard that he didn't help with the relationships between DFD and EMS, but that was because he felt that EMS should handle EMS, and the FD should do first response and then hand off to EMS, not knowing that in the past, DFD was actually quite competent as EMS providers.  But outside of the county of Durham, I haven't heard that DCoEMS was anything special before he got there, and heard several not so great things from former employees about the system before he accepted the position.





Sylvestermedic said:


> The call volume jump was his play on the numbers they were cooked.


The call volume jump was because parkwood VFD was shut down by the county due to financial irregularities, and the county EMS had to pick up their slack and put on additional trucks.  how do you cook the numbers on call volume?





Sylvestermedic said:


> If he is so great why has not stayed anywhere long?


8 years at Wake EMS as Chief, 4 at Durham EMS as a director, 15 years at Fitch and Associates, 5 years as an EMS Battalion Chief in Oregon, almost 5 years as the State EMS director in Oregon, 5 years as an EMT in Hawaii, and 6 years in the Navy.  And he has a Bachelors, Masters, and Doctorate.  All this information is on his LinkedIn Page btw.   It's not like he changes jobs every year, but even he will admit that he likes accepting new challenges, so why stay stagnant if a better opportunity exists elsewhere?





Sylvestermedic said:


> A lot of very good paramedics and EMTs were lost while he was there pushed out or terminated under questionable circumstances. Which resulted in payouts I might add after lawyers were involved. So for everyone who thinks Skip Kirkwood is so great the truth is he sucks and is not worth a s..t and was there way to long glad he is gone never to return . I am happy I am out of there


You know, I throw the BS flag that payouts were given to terminated employees.  If that were the case, the news would have been all over it.  I'm sure some terminated employees filed complaints with HR, even retained attorneys.  But If there were there major payouts, someone would have leaked it to the local media, and it would have been front page news on WRAL. 

I'm sure some great paramedics and EMTs left, and others were terminated.  Maybe you were on of the terminated ones, who felt you were treated unfairly.  Don't know, don't really care.  I heard some of the stories, from people within DCoEMS, and there was some super questionable stuff going on, and medics who should have been fired years ago.  A coworker of mine was fired form DCoEMS (albeit under somewhat questionable circumstances, meaning the punishment didn't fit the crime, but he definitely committed the crime), and while it stung at first, he's much happier where he is now.  And I suspect that is how it is for the majority of the "good EMTs and Paramedics" who were let go, they found better jobs elsewhere.  And those who weren't as good as they thought they were, well......

I do know that there are people at Wake who were glad to see him gone.  There are the providers who a HS diploma and a medic cert who didn't think they needed any fancy college learning, who didn't like the fact that a yankee was leading their organization, one who had several degrees to his name.  Maybe you are one of them?


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## PrincessMedic38 (Jun 4, 2018)

Sylvestermedic said:


> The fall of Durham County EMS started when Skip Kirkwood was hired. He had no idea how Durham worked . He wanted all the old gaurd as he put it out. He took away a work schedule that most of us liked because he did not like it. He bashed the former management in open forums. He belittled the employees. He was arrogant and the service had done nothing right before he came there. Which not true at all DCEMS was a respected agency until his arrival. The call volume jump was his play on the numbers they were cooked. If he is so great why has not stayed anywhere long? A lot of very good paramedics and EMTs were lost while he was there pushed out or terminated under questionable circumstances. Which resulted in payouts I might add after lawyers were involved. So for everyone who thinks Skip Kirkwood is so great the truth is he sucks and is not worth a s..t and was there way to long glad he is gone never to return . I am happy I am out of there



The fall of Durham began after Skip left.  Sure, not everyone agreed with Skip or his tactics, but under it all he did a lot of great things for Durham.  Since he left we have seen a sharp decline in staffing, morale is in the toilet, and we are now being taken over by another department.  

Let's talk about the current "leadership".  Since Skip left, Kevin Underhill has single handedly destroyed any sense of leadership durham had.  The leadership team was broken apart and only a few certain people are let into the inner circle.  The failure is to blame on the upper management of Durham County.  Nobody in their right mind would assign someone to be in charge of a moderate sized agency with 150+ employee positions and a 15+ million dollar budget with nothing but a glorified high school education and a cracker jack box associates degree from a discredited community college... but to our surprise, Durham has.  Kevin Underhill is woefully unqualified for the position.  He's not even qualified to be a captain in the department, let alone the director.  When we thought things couldn't get worse, they went ahead and assigned Rodney Medlin to Operations Chief.  To my knowledge, he has only a high school education.  Now I'm not saying education is everything, but you do learn a lot about business, management, finance, etc. in higher education, which is why it is required for these positions.  

We just saw the beginning of the end for Durham EMS.  A VERY well educated, smart, dedicated assistant chief walked out the door for a department that values his skills and abilities.  We are watching a captain walk out the door after 28+ years of service, loads of experience and education to pursue other career options at the same time a second administrative captain, also well educated and experience, walk out the door for a neighboring agency for the same job he's been doing for Durham EMS.  This is not a coincidence... happy people don't get up and leave for other jobs. Our open positions are at their highest ever with the worse response times we've had in recent history.  I have been working for Durham for many years now and I too, am looking for other jobs.  I did not work this hard to get this far in life to let some uneducated, sociopathic, pathological liar, drunk destroy my workplace.  Kevin has had many complaints against him, including an EEOC complaint, the media has investigated his questionable spending, his HR practices for hiring are probably illegal for age discrimination, etc... something a leader with education would know how to do.  

All in all, Kevin is an absolute failure of a leader and should be immediately fired in order to save whatever Durham EMS has left to save.  Rodney Medlin has no business being in a position of power in the organization and will continue to destroy the department with his micromanaging, lack of trust, and power trip he has been on since he was given his position as part of the "good old boys club" leadership we currently have.  I hate to say all of this because it truly makes me sad to see what our department has become so rapidly.  I, like many, miss the way Durham EMS used to be.  Unfortunately we are never going to be the same we were before... and if this continues, we will never be a respected agency again.


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## PrincessMedic38 (Jun 4, 2018)

Also, in regards to the call numbers being "cooked"... you are horribly informed.  The numbers jumped due to the increase from Parkwood as well as natural call volume increase.  Many thought that we were/are issuing additional call numbers for each call that resulted in additional ambulance response... for example, structure fires that had 2 units dispatched, MVC with entrapment that dispatch more than 1 medic truck, CPR response, etc... These calls, while require more than one medic unit, never, nor does it now, issue additional call numbers.  No matter how many units respond to the call/dispatch, only one call number is issued.  Call volume is based off of the amount of call numbers, not how many ambulances respond.


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## DrParasite (Jun 5, 2018)

And apparently Interim Director Underhill has caused other issues with other public safety agencies in Durham http://www.heraldsun.com/news/local/counties/durham-county/article188089324.html


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## PrincessMedic38 (Jun 5, 2018)

Ah yes, forgot about that fine example of his “help” to Durham EMS. Staffing is worse than ever, call volume higher than ever, response times worse than ever... let’s close down a first responder agency with amazing response times because they can’t operate 24/7/365. Last I checked, the school doesn’t operate 24/7/365....


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## PrincessMedic38 (Jun 5, 2018)

Lets not forget the time he took an employee out to dinner after this employee quit to try to make a deal with him to stay. Favoritism?


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## PrincessMedic38 (Jun 5, 2018)

Or the time Kevin sent out an email and memo in regards to the protocol test stating that it was not to be punitive and would only be used to guide our education program... then later fires part time employees that couldn’t pass the exam that wasn’t punitive?   Sounds trustworthy to me


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## PrincessMedic38 (Jun 5, 2018)

https://www.google.com/amp/amp.health.com/mind-body/sociopath-traits

Kevin defined


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## Bullets (Jun 5, 2018)

DrParasite said:


> And apparently Interim Director Underhill has caused other issues with other public safety agencies in Durham http://www.heraldsun.com/news/local/counties/durham-county/article188089324.html


What?


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## PrincessMedic38 (Jun 5, 2018)

He shut down Duke EMS after he put impractical requirements on them. They’re a university EMS System that ran during school sessions. Kevin wanted them to be available 24/7/365... even when school was not in session. So instead they’re no longer assisting


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## ThatPrivate (Jun 11, 2018)

I work for a transport company and I often run into Durham EMS crew in the bay. They always have a lot of nice things to say about working for Durham. I am a little embarrassed to admit I hadn't heard about the "mass exodus of brass and the MD" or the merger until a few days ago. I feel like there is a lot of change going on within the agency all at once and hopefully Durham with be able to come out on the other side a much better and stronger. It may take some time and more good people may leave during that time. As long as the crews keep the same positive attitude I see in the bay of hospitals then I believe they'll be fine when everything settles down.


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## Sylvestermedic (Jun 12, 2018)

I think this will be a good thing . However the damage done in the recent past is there and it will take time for that to go away.


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## Bullets (Jun 13, 2018)

PrincessMedic38 said:


> He shut down Duke EMS after he put impractical requirements on them. They’re a university EMS System that ran during school sessions. Kevin wanted them to be available 24/7/365... even when school was not in session. So instead they’re no longer assisting


I guess i dont understand how they can tell a school that they cant respond to calls on their own property


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## DrParasite (Jun 13, 2018)

Bullets said:


> I guess i dont understand how they can tell a school that they cant respond to calls on their own property


In NC (more than other places I have seen), all EMS agencies, or agencies that respond to 911 calls within the EMS system, must do so with the blessing of the county medical director.  This includes fire departments and anyone else who is acting as a medical provider.

If you don't have this blessing, you can be accused of practicing medicine without a license.  

So can Durham County EMS prevent Duke EMS from responding to calls?  probably not.  Nothing is stopping Duke PD from calling for Duke EMS, and having EMS drive the truck to the scene. Can they prevent them from performing any medical intervention from EMR to paramedic?  apparently so.


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## jsmithems619 (Jun 14, 2018)

Having been one of the members of the department that received 2 emails from the department. The first stating that this "testing" was to assess where the educational needs of the department were. And then the second stating that because I missed the "cut off" by 1 point, I would have to retest or be unable to serve the department. Now I am all for a process. But when it is given under one pretense, then turned. That shows the lack of integrity of the leadership and medical direction. That was the tipping point for me to seek elsewhere. ( The test was also not a standardized test, it was made up by the training department and medical director. Using non-standardized questions. Some of which have multiple answers that were correct, not your standard which one is best or first)

In the few years I personally was there, We as a department hired approx the same number of individuals that the department has an authorized strength of, 166 or so. This is a combination of Skip's and Underhill's leadership. When I was hired they told us it cost in the neighborhood of $40k per person to hire and completely train. I don't know all the numbers, but I would safely put that number at least at $20k if not higher. That is a lot of money to burn through. 

There was also the number of questionable firings and a few that were not surprising. The punishments did not fit the crimes on a lot of them. With at least one of them involving supervisors that were more in the wrong than the subordinate, and no obvious repercussions other than the subordinate being terminated.

Add in the nepotism/conflict of interest of the Medical Directors wife working in the department as a Medic and "training" staff.

LOTS of problems, YEARS to straighten the department out it will take. I for one am not surprised that it is getting shoehorned under another department. They will be lucky if the powers that be don't just put the system out for bid to AMR or the likes.

The Duke EMS nightmare is a product of the medical director and leadership. Again what was a good working relationship, ruined. The students that responded had an interest and potentially (as Duke is a medical school) could have been aspiring EMS MD's. Good sour taste in the mouths.

My suggestions for future management. Clean up the department. Stop the good ole boy's mentality. Stop the secret squirrel meetings behind closed doors. Be open with your employees. Trust is a 2-way street. I don't think the current management can earn it back. Step out of the way and let the system breath.

And for gods sake. GET REAL AMBULANCES! 911 is different than pre-planned transports. The room is needed for work by multiple providers at times. Skip was very quick to point out that x% of calls were BLS. But it's not those calls we as Medics train for or need the room to work in. At one point they were talking about some guy that stopped on the side of the road and pulled the pt out and worked him on the side of the road under a tree where he had lots of room. Umm, not a very professional move in the age of youtube. There is also a safety factor with the size of the ambulance being utilized. 

I'll save the stretcher argument for another time.


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## TraumasaurusRex (Jun 15, 2018)

I've known about this site for some time and never had reason to join until now... but since recently getting back into transport from a long break from using my cert, and following questionable termination from DCo, I came across an old coworker just now from DCo at DUMCs ER bay...

Then I wondered what happened to Skip and the "investigation" which, at the time came to a huge surprise for me, since Underhill terminated me, Skip's signature was on my termination letter... and Skip lost his job less than 24 hours after I lost mine. And I came across this thread in my Google search

I was asked to resign during my time as a student in Academy 14 because I had asked for the page reference for the specifics of a protocol (that we would be tested on later), which was apparently skewed as "undermining the expertise of the academy senior instructor and asking for written proof"... which was incredibly petty, in my opinion and the opinion of my squadmates in the academy. I challenged Underhill and they told me "as a member of the Academy, I am not allowed to appeal or present my side, and that they have heard all they need to hear."

After that, which comes to 7 paid years (overall) in EMS/Transport, and 2 years volunteer, I finally said screw it, removed myself from the EMS community entirely, reviewed career options/education options and now I'm back mostly because I LOATHE 9-5 jobs and love medicine.

I liked Skip for the short time I knew him, and spoke to him on a few occasions outside the academy and could appreciate his devotion to the department, and saw he was trying to improve things. Its disheartening to see nothing came of the "investigation" and that they got rid of the progressive minded leader. Durham Co's way of doing things was the straw that broke the camel's back for me and strongly made me consider leaving EMS altogether... And now, as someone who's seen a number of agencies with "problems" (political and otherwise), I'm sick of it. At the end of the day, I can never return to DCo and have no intention to do so... but I am determined to change things like he did, and so I'll be studying for my degrees in EM to hopefully change the way agencies run their people into the ground one day. Underhill, thanks for giving me that motivation.


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## DrParasite (Jun 15, 2018)

TraumasaurusRex said:


> I was asked to resign during my time as a student in Academy 14 because I had asked for the page reference for the specifics of a protocol (that we would be tested on later), which was apparently skewed as "undermining the expertise of the academy senior instructor and asking for written proof"... which was incredibly petty, in my opinion and the opinion of my squadmates in the academy. I challenged Underhill and they told me "as a member of the Academy, I am not allowed to appeal or present my side, and that they have heard all they need to hear."


Since moving to NC, I have seen some EMS systems where the FTOs are always right, never wrong, and even suggesting otherwise can result in a negative effect on your employment.  Which is pretty scary, because some of those FTOs are FTOs because they have been with the agency for X number of years, not because they have any levels of competence....  Def not all, but there are a few who shouldn't be in that position.  

If I had been in your position, I would have stopped what I was doing and have gotten the protocol book, and looked up exactly what they were talking about.  this way you aren't challenging them, you are making sure you understand the protocol exactly as written (because many of those FTOs love showing off how smart they are, and how you don't know anything and need to go to them for assistance).

Since your career was done in Durham, I would have told him to fire you so you could collect unemployment, and then went to the county HR department and filed a formal complaint.  Worst case scenario, nothing happens.  Best case, they investigate, find the termination was unfair, and fix it for future recruits (because you wouldn't want to work there anyway).

If you are living in Durham, you are less than an hours drive from Orange, Person, Wake, Cary, and Granville Co EMS (maybe even chattam, franklin and vance if that if you like those places better).


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## TraumasaurusRex (Jun 15, 2018)

I appreciate it, but I left FHC (FirstHealth of the Carolinas) at Chatham Co for the opportunity at DCo. I'm not necessarily burned out of the career, just burned out of the ... well... BS. I am on leadership at a volly squad in Wilson now and making leaps and bounds in recovering that agency from the ashes I found it in, and thats kind of where it dawned on me... "Hey, I'm getting pretty good at fixing the system" haha. And I believe that's the route I'll take.

My room mate works JoCo at Smithfield and I work transport while in school (starting this fall). I'll probably keep Stantonsburg EMS (volly) going but other than that, I'm done with paid public services for now. I appreciate you looking out though.


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## cruiseforever (Jun 25, 2018)

RocketMedic said:


> 9, 1.6 years here



Did they start you at the 9 year level?


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## Medic4Lyfe (Jun 27, 2018)

While on the topic of Duke EMS, t


DrParasite said:


> In NC (more than other places I have seen), all EMS agencies, or agencies that respond to 911 calls within the EMS system, must do so with the blessing of the county medical director.  This includes fire departments and anyone else who is acting as a medical provider.
> 
> If you don't have this blessing, you can be accused of practicing medicine without a license.
> 
> So can Durham County EMS prevent Duke EMS from responding to calls?  probably not.  Nothing is stopping Duke PD from calling for Duke EMS, and having EMS drive the truck to the scene. Can they prevent them from performing any medical intervention from EMR to paramedic?  apparently so.



So Duke EMS was picked up by Duke Life Flight who has apparently agreed to do their training and support them as an agency! Way to go Life Flight! At least some agency believes "the children are our future" or at least our future medical directors.


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## Medic4Lyfe (Jun 27, 2018)

I also heard from one of the captains that left that there was an EEOC complaint for sexism that was "founded" and now they are in discussion for a settlement. If this is the case I believe or hope that Underhill will be fired for a major policy violation. I have heard from some previous employees who were fired that they "were not allowed to discuss any details concerning their separation from DCEMS" if that doesn't sound like a confidentiality agreement/gag order, I don't know what does.


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## RocketMedic (Jun 28, 2018)

cruiseforever said:


> Did they start you at the 9 year level?



I don't think so? I started at the "P2" level


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## NCknitting (Jul 25, 2018)

I have been at DCoEMS for over 20 years, and now I am being forced out. I have no recourse.


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## DrParasite (Jul 25, 2018)

Plenty of other agencies around durham that would love to hire a competent 20 year veteran.  And as long as you get hired by a county agency, your pension time, sick and vacation time should all carry over. 

So while it might suck now, it's not like you don't have other options.


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## NCknitting (Jul 25, 2018)

DrParasite said:


> Plenty of other agencies around durham that would love to hire a competent 20 year veteran.  And as long as you get hired by a county agency, your pension time, sick and vacation time should all carry over.
> 
> So while it might suck now, it's not like you don't have other options.



Thats the problem though. I have been told that all of the administrators talk to each other if you are from a neighboring county.


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## luke_31 (Jul 25, 2018)

NCknitting said:


> Thats the problem though. I have been told that all of the administrators talk to each other if you are from a neighboring county.


If you're a competent paramedic and it wasn't anything too egregious I don't see any reason why you couldn't be hired by one of the other counties.


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## DrParasite (Jul 25, 2018)

NCknitting said:


> Thats the problem though. I have been told that all of the administrators talk to each other if you are from a neighboring county.


I'm sure that's true to a point; EMS is a small world, and everyone knows everyone.  But plenty of people have been fired from Durham and ended up at Person, or orange, or franklin, or wake, as well as been fired from Wake and ended up elsewhere.

It also depends on why you were let go.  Some reasons are more forgiving that others.  To be honest, they would be negligent in their position if they didn't reach out, either by official or unofficial channels, to see what happened.  But if you have good references at durham, especially a supervisor who will say, unofficially, that you got a raw deal, and would be an asset to another agency, than often they will have no problems giving you a shot.

But if you don't fill out the application, and jump through the hoops like everyone else has to, your chances of getting hired are exactly 0


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## Bullets (Jul 26, 2018)

While its true that i talk to all the agency heads around me, i also know which agencys are well run and which are dumpster fires. If an employee is leaving one of those agencies and coming to mine, im pretty lenient about why they left or under what circumstances. I dont blame anyone for jumping off a sinking ship


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## The truth hurts (Aug 4, 2018)

Sylvestermedic said:


> The fall of Durham County EMS started when Skip Kirkwood was hired. He had no idea how Durham worked . He wanted all the old gaurd as he put it out. He took away a work schedule that most of us liked because he did not like it. He bashed the former management in open forums. He belittled the employees. He was arrogant and the service had done nothing right before he came there. Which not true at all DCEMS was a respected agency until his arrival. The call volume jump was his play on the numbers they were cooked. If he is so great why has not stayed anywhere long? A lot of very good paramedics and EMTs were lost while he was there pushed out or terminated under questionable circumstances. Which resulted in payouts I might add after lawyers were involved. So for everyone who thinks Skip Kirkwood is so great the truth is he sucks and is not worth a s..t and was there way to long glad he is gone never to return . I am happy I am out of there


As a former employee who lied on by a medic that had terrible skills. Even after I expressed intergrity a proved I was wrong and they lied Underhill and Kirkwood who lied openly were aloud to keep there job. I’ve been in this county for years what was built over years took Underhill, Kirkwood months to destroy. So for anyone who thought they were great please wake up. Durham County EMS isn’t respected by anyone there joke of all counties.


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## DrParasite (Aug 6, 2018)

The truth hurts said:


> As a former employee who lied on by a medic that had terrible skills. Even after I expressed intergrity a proved I was wrong and they lied Underhill and Kirkwood who lied openly were aloud to keep there job. I’ve been in this county for years what was built over years took Underhill, Kirkwood months to destroy. So for anyone who thought they were great please wake up. Durham County EMS isn’t respected by anyone there joke of all counties.


I tried to read this, but there were too many spelling (incorrectly spelled words that were corrected to the wrong word) and grammar issues to make it make sense.  But I am going to try to translate.

What I think you are saying is you had a medic who had terrible skills.  you expressed integrity and was proven wrong (which makes me think that you weren't as right as you thought you were).  Someone lied and they were able to keep their jobs.  You had been with the county for years (as an EMT), and were let go.

Durham County EMS is not a great place to work; it's a joke that isn't respected by any of the neighboring counties.

Did I get that right?


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