What Happened to Durham County EMS (North Carolina)?

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
 
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.
 
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.
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.
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?
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.
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.
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,
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.
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?
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?
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?
 
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.
 
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.
 
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....
 
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?
 
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
 
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 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.
 
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.
 
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
 
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.
 
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.
 
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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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).
 
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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