EMS Profile: Michael McKeage
Published: Sat July 11, 2009
EMS profile Michael McKeage
1. What’s your current position?
Director of Clinical Development and Disaster Planning for Emergency Health Services Nova Scotia.
2. When did your first job commence as an EMS professional?
In the spring of 1977 I was offered the position of emergency vehicle operator with the Ambulance Division of the City of Calgary Fire Department. After a taking a six-week course I graduated as an EMT—a new concept at that time—in Alberta. Prior to this I had volunteered in emergency rooms in both the Ottawa General Hospital (1971 to 1973) and Victoria General Hospital in Halifax (1974 to 1977) starting at age 16.
3. Why did you decide to pursue a career in EMS?
The emergency department of the Victoria General Hospital in Halifax in the early ‘70s was a truly unique and energized environment, consisting of emergency room physicians who had been to America (BTA), and emergency room nurses recruited from around the world. These personalities, combined with their passion for learning, as well as the hospital-based ambulance driver attendants, drew me to the field. The stark contrast between the competence and caring provided by this hospital-based ambulance service compared to that provided by many of their private contemporaries fueled my passion to see a better level of prehospital care come to Nova Scotia one day.
4. Who was the biggest inspiration to you when you were first starting in EMS?
Dr. Tony Williams, Dr. Margie Edwards, Dr. Ron Stewart, Paramedics Anne Slaunwhite, George Porter, Paul Morck, Bill McComb, Ron McManus, Nurses Nancy Lynch, Jan Foster, Nancy Kline, and Sister Marthe du Sauveur were all huge influences during the early years of my practice. While unknown to many now, all possessed three remarkable qualities. First, they all possessed a fierce commitment to patient care and advocacy. Second, all continually demonstrated a constant dedication to learning and a commitment to teaching others. Finally, none took joy in the behaviour known today as “dissing” associates. They build their greatness on their work, not the weaknesses of others or by putting down colleagues or associates.
5. Please provide a brief description of your career.
I graduated from the Southern Alberta Institute of Technology in 1979 with Honours and enjoyed two subsequent years of downtown practice with what was known then as the City of Calgary Fire Department Ambulance Division. During this time I developed a love of teaching, through my work with the Calgary Police Academy. This love would take me to the Northern Alberta Institute of Technology in 1981 where Lyle McKellar, Paul Ramer and I would develop NAIT’s first paramedic program. My two years at NAIT taught me how much more there was to learn about paramedicine, so I returned to practice in Grande Prairie, AB.
Grande Prairie would be my first experience in a rural practice and hospital-based system. Unlike the heavily resourced Calgary system, in Grande Prairie paramedics did it all—ground transportation, vehicle rescue, air medical rescue and transport. My curiosity about EMS management would be explored in 1986 as a natural evolution because of my predisposition to build things and systems. The creation of Project Outbound, teaching ACLS to non-traditional groups and working with the Registered Emergency Paramedic Association of Alberta, served me well as I began as assistant director for the Grand Prairie Ambulance Service.
My background in education and hospital accreditation experience acquired in Grande Prairie would allow me to accept a position with the Calgary EMS Department in 1988 overseeing their Clinical Quality, Continuing Medical Education, and PR and Safety program for that department. The City of Calgary’s staff development program would open doors to more teaching, as well as board positions with what was known then as the Alberta Ambulance Operators Association and the Alberta Prehospital Professions Association. In addition, I was able to finish my degree from Dalhousie and acquire a certificate in adult education from St. Francis Xavier University. These blessings would in turn lead to independent consulting contracts for several provinces and EHS organizations, as well as international speaking engagements.
The passion to return home to Halifax and assist with the long-awaited overhaul of the Nova Scotia Ambulance Service was realized in 1997 when I returned to Nova Scotia to consult and assist in the implementation of the Murphy Plan as the director of Ground Ambulance and First Responder Programming for the Nova Scotia Department of Health. Since 1999 I have worked for the ambulance contractor in Nova Scotia having the privilege of being the director of operations for that organization during the first nine years of its existence. I have been a board member of the Emergency Medical Services Chiefs of Canada, an advisor to Health Canada and a member of the Canadian Medical Association Committee on Conjoint Accreditation.
6. What is your most memorable situation while on the job?
Hurricane Juan—I lost one of my staff on my watch, that night. Paramedic John Rossiter, an excellent teacher, was killed by a falling tree. John’s death was one incident that taught us all how fast the end can come in our line of work. Equally memorable was the outpouring of support, kindness and love from the public and paramedics from all across Canada during our hour of need. We Nova Scotia paramedics will always be grateful for that caring.
7. What’s the biggest challenge facing EMS today?
As a profession, I truly believe we have to figure out what we want to be “when we grow up” very soon. Paramedics over the last 37 years have been trained in varied and sometimes controversial processes from technical institutes, to colleges, and now even stand alone schools. Paramedics have experienced many types of full-time, part-time, distance and online educational programming—most without ever darkening the doors of Medical School or the Health Science faculty. The end result has been that many paramedics today graduate only with technical skills without education on what the Canada Health Act is, how to define health, how to conduct research or how to analyze the changing needs of their communities. If we compare the evolution of our educational and formation processes in the last 20 years to other health care professionals, I see us severely lacking and stuck in the paradigm, described by a wise paramedic faculty member as “thinking only with our hands.”
8. If you could change one thing in EMS, what would it be?
Change the title of EMS to EHS (Emergency Health Services), and embrace and celebrate the significance of that one letter change. It was not until I arrived in Nova Scotia that I saw what could truly be done when paramedics were engaged not as a public safety service but as members of the health care team. In my opinion, it is only when we have successfully infiltrated and have become full partners in our area/district/regional health care team that we will be able to evolve to the next level of professional activities and innovation.
9. What’s your favorite tool/technology available to EMS professionals and why?
With apologies to my communication colleagues for classifying them as a “tool/ technology” I truly believe that medical communication centres have been underutilized for too long. I see a future where the communications officer truly becomes the third partner on each call. Communication officers could provide things that far exceed what is currently being done in many areas, including call response planning, pre-arrival clinical coaching and health resource gatekeeper services. The enhanced use of CAD technology as a syndromic and injury surveillance tool is another example of how the resources and expertise of these centres could be further engaged.
10. What does the future of EMS look like?
As I look back over the last 32 years of my Canadian ALS experience I do not see the academic development of practitioners, field innovations or research in my profession that I see in sister professions such as diagnostic imaging, respiratory therapy, or the nursing profession. As of this date we still do not have a national definition of what a paramedic is. Despite this, the development of a national registration exam will soon be driven by external influences as the need for international registration becomes increasingly apparent, and as Canada’s paramedic human resources dwindle.
The increased demand for service performance, better ROI equations for monies provided to EHS systems and the generational needs of paramedics will eventually cause EMS to develop more non-traditional services, which in turn will see credential bridging programs into other health professions as we now see in Australia. We will see increasing international sharing of solutions and cooperation in EHS as we begin to realize how easily accessible sources of wisdom and experience are for the price of a phone call. Lastly, we will increasingly have to think for ourselves as we fall under self-regulating legislation. In the near future, all Canadian paramedics will have to set our own codes of conduct, criteria for our college’s membership and ensure we protect patients from practitioners ill-prepared to care for them. No longer will we be able to be dependent on medical directors for this type of judgment.
11. Paramedics see a lot of strange things in their work. What’s the funniest thing you’ve witnessed in EMS?
The look face on my preceptor’s face when his bare feet hit the lobster I had placed in the bottom of his bed, on my last night of practicum, still ranks as a very memorable moment that I thought was funny.
12. What do you do when you’re not working?
My Creator has blessed me with my wife Lynne and our three very special children Christina, Matthew and Micah. In my time off I try to repay the debt I have incurred to them, over the years of countless hours away, on call, etc.
|