Portrait of a Responder: James Foshie

Ask first responders around Greene County about James Foshie, and you will get words like hard-working, driven, and mentor.   At 37 years old, James is the Chief of Town of Mosheim Fire Department, a Lieutenant with the Greeneville Fire Department, and a successful co-owner of Fireman on Call. 

The modest, ever-grinning firefighter started his career like many others, the recommendation of friends from school to join the Town of Mosheim Fire Department back in 2001.  Since joining the Town of Mosheim, Department James has been Safety Lieutenant, Training Lieutenant, Training Captain, Assistant Chief, and now Chief.

Like his volunteer career, James started with the Greeneville Fire Department in 2005 as an auxiliary member after some friends reached out to him about the opportunity.  He became a full-time firefighter in 2006 and has been a Lieutenant since 2016.  He is also a member of the Origin and Cause Team for fire investigation, whose members assist the Fire Marshall, David Weems.   

If you ask James what role he likes best on a fire scene, his ever-present grin gets bigger, "aerial truck!" The position high up in the air on the end of the top ladder would be terrifying to most people, but James loves it.

"I believe the best explanation I can give is that it provides another perspective, another dimension of the fireground that you don't see that often."

As reflected in his volunteer career positions, training and mentoring are especially important to James.  Training is a key aspect of the fire service; you must do it regardless of whether it is full-time or volunteer.  He also feels you should take something away from each call, each an opportunity to pass along to fellow firefighters.   

While James enjoys the excitement of the job, he enjoys helping others and serving the community he grew up in.

"Knowing someone needs help and having the ability to help someone who is having the worse day of their life" is what keeps him responding.

The responding, training, and station management take a lot of time, but without it, the Town of Mosheim department would not be where they are now with membership growth, upgrades of equipment, acquisition of trucks, and an effective community fire prevention program.  James was quick to point out this is all thanks to the department's members and officers and is reflected in their improved ISO rating of 3 obtained in 2018. 

Being a firefighter taught him many things: being a leader, responsibility, teamwork, essential communications, and having the extended fire family called the "brotherhood" in the fire service.  He also takes these lessons to the landscaping business, Firemen on Call, a co-owner with fellow Greeneville firefighter Miles Kilday.

All the volunteering, working two jobs, and responding to calls would not be possible without the support of his wife Kimberly, who has been with him the whole way.  His mention of his daughter, Taylor, makes his grin flash again, "she asks every day if we are going to stop by the fire hall."

Portrait of a Veteran: Robert "Bob" Kaltenmark

This my 82-year-old father, Robert “Bob” Kaltenmark, he is my veteran.  

I grew up hearing the stories of his time in the service.  How much he loves the planes. His time overseas.  Getting to meet some of his buddies when visiting the occasional base open house at the 122nd at Bare Field in Fort Wayne, Indiana.

Truth be told, I really did not hear his stories. I probably was not listening because I was busy doing other things or letting my mind wander as I often do.   I had a chance to do some research, and to hear his full story again.  Like many veterans, there is more to the man (or woman) wearing a hat with their service branch or unit than meets the eye.

Kaltenmark joined the Air National Guard in 1955, he was 17 years old, during his junior year of high school.  Given his age, his mother, Pauline, also had to sign his enlistment papers for a 6-year obligation. 

His early enlistment was the result of watching the news and studying what was happening with the French in Vietnam.  Family members suggested he decide where he wanted to go versus waiting to get drafted as had happened with the previous two wars. 

His guard experience was normal for that period, “basic” was held there on base and weekend drills were regularly scheduled.  He married Marilyn Cayot on April 23, 1960, shortly before the Gary Powers U-2 incident increasing tensions between the Soviets and the “Western Powers.”

Unit mobilization rumors started going around.  Even though Kaltenmark was due to be discharged in 1961 he was called to active duty in August of 1961 for deployment to France.  Operation Tack Hammer, the United States response to the Berlin Crisis of 1961, was about to happen.

In November, 1961, the Indiana Air National Guard 122nd Tactical Fighter Wing was deployed to Chambley France from Baer Field, Fort Wayne, Indiana. When activated, the 122nd consisted of three tactical fighter squadrons, the 112th at Toledo Express Airport, Ohio, the 113th at Hulman Field, Terre Haute, and the 163rd at Baer Field.

The deployment of the support units was a hopscotch path from Fort Wayne to Charleston on to Bermuda, the Azores, and finally Chambley.  Each stop provided an opportunity to deplane, stretch their legs, and grab a meal.

The Chambley Air Base was in Northeast France near the German border having a history dating back to 1940 when it was used for a short period by the French Air Force.  Located near the French city of Metz, the base went through several upgrades for use by the United States in response to the Cold War threat of the Soviet Union. 

Kaltenmark’s Military Occupational Specialty was Air Police.  He was 1 of 55 security personnel divided into 4 flights to cover base security.  A tall order given their small numbers and only being armed with M1 carbines, 38 caliber revolvers, and 45 semi-automatic pistols. 

Each shift started with a briefing providing standing orders for the day and updates on security threats.  Their primary mission stayed the same, should the alarm sound they were there to protect the aircraft until they could get into the air.  After that, they were on their own.  “This meant nuclear war,” Kaltenmark said.  “No orders were given to regroup with other units; we were on our own.”

If the threat of war with the Soviets was not enough, they had a constant fear of subversive activity.  While the Cold War was going on, Charles de Gaulle was dealing with the French withdrawal from Algeria, causing problems within France.  The Chambley Air Police had problems with Algerian sympathizers trying to get on base to steal guns and ammunition.  One night the rear gate was put on high alert expecting a cargo truck to ram through to get to the ammo dump.

Base life was about routines with guard duty, patrols, and color guard activities for Kaltenmark.  Winter months were miserable on the flight lines with the blowing cold winds and few places for shelter.  Color guard duties were for visiting officers, politicians, and ceremonies.

All the soldiers lived on base in dorms, responsible for keeping their quarters clean and orderly.  Kaltenmark described the meals, “were taken at the enlisted club, that is where I had my first egg and cheese omelet!”  I also suspect this is where he had S-O-S, short for shit-on-a-shingle that I heard so much about growing up.

His favorite part of the tour was his time off base.  Visits across the border to Saarbrücken, Germany were common.  All were surprised how quickly Germany was rebuilt after World War II.  While the older Germans were more accepting of them, the younger was more hostile to the American visitors often spitting on them or creating a scene in local restaurants if Americans were served before local Germans. 

On one lucky occasion, a group of Airmen was treated to a tour of Vatican City, a private tour of the Sistine Chapel, and an audience with Pope John Paul the 23rd.  This was always one of my favorite stories. 

As the Berlin Crisis turned into the Berlin Wall, it came time for the 122nd personnel to rotate home.  This time the hopscotch had fewer steps starting in Chambley to Glasgow, a stopover in Newfoundland, and then finally back at Bare Field.  Kaltenmark had the 23rd seat on the plane coming back home.

Needless to say, a large party was thrown to celebrate their safe deployment and returned home.  Shortly after were the 1-on-1 meetings behind closed doors with reenlistment offers. 

“You could go anywhere you wanted; you just had to sign on the line,” Kaltenmark said.  “We all knew that would be Vietnam.” 

Kaltenmark passed on the offer getting his DD214 discharge papers and exiting the Guard as an Airman 2nd Class. 

We would go to airshows and base open houses as I was growing up.  Sometimes he would see others he deployed with; one time I was lucky enough to meet his Sergeant. 

He has since stopped looking at the obituaries as there are fewer and fewer of his comrades left from that deployment 60 years ago.  That does not keep him from wearing his hat when he goes for his daily walk.  That is how veterans recognize each other. 

Portrait of a Responder: Ryan Holt

Some people are called to be a firefighter, a teacher, or even a volunteer, Ryan Holt is all 3 wrapped into one.  At 47 years old Ryan seems to be a perpetual motion machine between time with his family, working as a firefighter with Greeneville Fire Department, as Chief of the Caney Branch Volunteer Fire Department, and in multiple instructor positions throughout the state.   

Ryan hung out with his parents at the Caney Branch department back when it was a two-bay building with a wood stove for heat. It was not until he turned 18 that he showed interest in firefighting, joining the department to get training to become a firefighter, and starting a 29-year career.  As a volunteer, he worked his way up to Lieutenant for 2 years, Assistant Chief for 2 years, and became Chief in 1997 which is also the same year he was hired into the Greeneville Fire Department.  Continuing his training he obtained his A-EMT rating and became a Lieutenant with Greeneville Fire Department 1-1/2 years ago moving him to the coveted “shotgun” position on the fire engine.   

To say Ryan is a people person is an understatement.  He is a man with a constant smile, a quick handshake, and a willingness to help anyone in need. He wants to be there when a firefighter is called to help others, which is often during their worst day, to help recover what they worked so hard for.  That desire to help pushed him to become an instructor for the Tennessee Fire and Codes Academy and the Volunteer Fire Insurance Services, as well as become a Task Force Strike Team Leader and to be on the state mutual aid fire representative for Greene County. 

When not teaching Ryan is working to improve his Caney Branch department by obtaining grants and funding for equipment and upgrades and overseeing the building of their current station.  He was also instrumental in Caney Branch having the first medical response program for Greene County, a service critically needed with a community so far from town.  In support of the Greene County Fire Association, which he was President for 8 years, he helped get the grant for the fire safety trailer and the Sparky costume, both of which are used for teaching fire safety to the kids in our communities.   

Ryan would not be able to do all the work he does without the support of his family.  His wife of 22 years, Malinda, and two kids, Susanna and Simon can be found at many Caney Branch activities.  They also provide stability after calls and the support for the countless hours away responding to pages or teaching the many classes each year.   

He is also very thankful for the department membership; they are there for him, so he always wants to be there for them.  This is especially important in a time when volunteerism is low.  The commitment for firefighting is high, it is hard for people to take the time away from family and harder yet to get groups of people to come together for training.  The Caney Branch station is also different in the number of medical calls, which do not always have a good outcome.  This is when a strong station family is critical, they come together to talk and work through it together.  A common theme when talking with Ryan, teamwork.     

Ryan did not get to where he is today by waiting for an opportunity, he is clearly a person who is driven to make things happen.  He suggests to, “set your goals high and strive for them” and to, “strive to do better tomorrow than you did today”.  While being an instructor he wants to help others overcome weakness, he is also humble to remember to always be open to learn from others as well.    

Portrait of a Responder: Jeremiah and Misty Taylor

If you sit at the kitchen table in the firehouse long enough the conversation will eventually become about family.  Stories of bravery or amusing pranks will be interlaced with the relationships to the subject of the stories.  In the past, it was always someone’s father, uncle, or brother; today it is quite common to hear about someone’s mother, aunt, or sister in the fire service.  In the Sunnyside Volunteer Fire Department, it is husband and wife with Chief Jeremiah and Treasurer Misty Taylor. 

At 41 years Jeremiah is a 3rd generation firefighter with the family tradition going back to his grandfather being part of the original Tusculum fire brigade while working maintenance at Tusculum College.  His father was also a firefighter and a member of the Greeneville Emergency and Rescue Squad.  Jeremiah “always being around it” made it a logical step when he turned 18 and joined the Newmansville Volunteer Fire Department where he served as a firefighter and a Lieutenant.  He went on to serve with Nolichucky, and Tusculum Volunteer Fire Departments before joining Sunnyside Volunteer Fire Department where he served as Secretary, Lieutenant, Training Captain, and Chief.  While serving in the fire service Jeremiah also was a member of the Greeneville Emergency and Rescue Squad where he was a full-time member for 8 years and has been a lifetime member for 2 years.

Misty, also 41, had a different path in emergency services.  The events of 9/11 motivated her to serve but in more of a “behind the scenes” position versus frontline like the fire service.  That desire to serve lead to a career as an emergency dispatcher at Greene County 911 for the past 17 years. Misty’s transition to the “frontline” came about with her relationship with Jeremiah and joining the Sunnyside department 5 years ago where she has gone on to become a certified exterior firefighter and has served as treasurer for the past 3 years. 

The experience as a firefighter gives Misty better situational awareness when working at 911.  Understanding what command at the fire is dealing can help with the smoother flow of communications with the scene and 911 making her a better dispatcher.  “What if it is Jeremiah on the other end of the radio, does that make it more personal?”   Both Jeremiah and Misty were quick to respond, “hearing each other on the radio does provide reassurance that each other are ok.” 

That reassurance only goes so far.  The worry is there every time for Misty as the hardest part of her job is not knowing if Jeremiah, her husband of 5 years, is coming home after a call or not.  When asked how they handle this as a couple Jeremiah says it is not something he thinks about when leaving for a call, “because the fear could keep him from performing the way he should.”  While Jeremiah is keeping his head in the game on the call Misty gains comfort hearing other experienced firefighters radio in responding as well as neighboring departments in mutual aid.

The difficult times are not just over the radio but after the calls as well.  There are the bad calls that come with the territory but here is the time away from home and the kids because of calls, training, station management, and Misty’s rotating schedule at 911.  Many weeks the only time Misty and Jeremiah get to see each other is a few hours to sit down at the station to go over the budget or station activities. 

The positive reasons to serve however outweigh the stresses.  For Misty, being a role model is very satisfying like the time a “little girl recognized that girls can be firefighters too” or her kids being proud of her for earning her position as a firefighter.  But she is also proud of the work at the station.  She is a person that likes to set goals and seeing them accomplished like making sure the department has the funding.  Seeing the department member’s “faces light up when she tells them they have the money needed to buy equipment” makes it worthwhile.

For Jeremiah, there is the rush of fighting a fire but the older he gets “it’s the sense of duty and service.”  He was not able to serve in the military, so this is his service.  “It’s hard to do working two jobs but he takes pride in doing this and giving back” to the community. 

That sense of duty and service provided the drive to the position of Chief which is what he is most proud of.  The fact “the membership is putting their trust in him to lead them and carry them into the future” is humbling but it is also not easy.  Being Chief is hard work, it is not always fun and when something goes wrong, you are the guy everyone looks for.  But it is a role he accepted and as such he will be there for his members or any other responder. 

While they have their individual goals for their positions, Jeremiah and Misty’s joint goal as department officers are the family environment for the Sunnyside Department.  Misty wants to see more women involved as, “they can be the glue to the departments”.  “If the wives are not comfortable the members are not going to be here”.  She wants them to be family-oriented, for the kids to play together and husbands to talk and work with each other. 

Under Jeremiah’s leadership the department equipped their brushfire truck with a new skid unit, obtained new air packs, and recently upgraded their tanker truck.  While Jeremiah is thankful for the foundation the past members and Chiefs put in place he now sees his job as how he can best train, equip and motivate the department family into the future to be of service to the Sunnyside community. 

Portrait of a Responder: Daniel Chandler

Daniel Chandler is a man who absolutely loves his job.  At 36 years old Daniel has been a firefighter for 13 years with his volunteer career staring like many others, a suggestion from a friend at work to stop by the station and “take a look”.  That first stop at the Newmansville Volunteer Fire Department is all it took; he has been there ever since which helped set the foundation for his current position with the Greeneville Fire Department as a Firefighter / EMT.   

Daniel has been a Training Officer, a Lieutenant and a Captain with Newmansville and has been with the city for 9 years.  He also served with the Greeneville Emergency and Rescue Squad for 1-1/2 years and is now a Vehicle Extrication Instructor with the Tennessee Association of Rescue Squad’s (TARS) Rescue College.   

Some people want their free time to resemble anything but their nine to five jobs however emergency responders often continue their service by volunteering, and Daniel is no different.  Continuing to volunteer is a way he can give back to the department that started his fire career and to provide his training experience he receives from the full-time position to those in the county who wish to continue their education.  As he pointed out, “it’s not about the me, it’s about the we” which is why he continues to expand in training by becoming a Vehicle Extrication Instructor with the TARS Rescue College about a year ago.   

Daniel points out the hard work of training pays off and “training will never fail you, regardless how long it’s been”.  He learned and continues to teach, “you have to have a backup plans” for every situation you go into.  These are the same lessons he passes along to local students and those he meets across the southeast teaching with the TARS Rescue College.    

What makes him most proud are incidents such as the Profile fire earlier this year, how everyone came together in the taskforce.  It’s how people are willing to sacrifice their time, even when so far away, to come help a department or a community in need that provide fond memories as he continues his career in the fire service.    

Portrait of a Responder: Danny Ricker

Danny Ricker is the spiritual responder for the first responders.  As such Danny has spent 13 of his 55 years as a chaplain with the Tennessee Highway Patrol which eventually lead to expending his services to Greeneville Police Department, Greeneville Fire Department, Greene County EMS, Greene County Sheriff Department, Greene County 911, Emergency Management Agency and support to the Greene County Volunteer Fire Departments. 

This volunteer career path started with a request from the THP asking for assistance with death notifications.  His early work with THP set him on a path of providing spiritual and emotional support to the officers which eventually turned the notification position into an officer support program and statewide training program for THP Chaplains. 

Feeling the desire to do more, Danny started the Emergency Chaplains in 2014 which is comprised of a group of chaplains able to respond 24 hours a day in support of emergency responders as well as victims of any emergency.  Danny is quick to point out how proud and humbled he is of the men and women who make up the Emergency Chaplains program.

When asked why he does all of this in addition to his full-time job Danny simply states, “It’s what the Lord called him to do”.  He points out that Jesus was the first, First Responder and he is blessed to be of service to what he calls “his first responders”.

To serve “his” responders, Danny is paged out to all structure fires and is often on the scene of large motor vehicle accidents and search and rescue operations.  His goal is to provide moral and spiritual support to the responders before, during and after the incidents.  As he pointed out there were more suicides in 2016, 17 and 18 than the line of duty deaths which he and other chaplains work to reduce with Mental Health Strike Teams who are specially trained in debriefing techniques to combat PTSD. 

The past 13 years has taken a lot of work, which at times Danny wishes he would have started earlier and yet slowed down more to talk with more people along the way.  Forming credible relationships is critical in his work as “you can’t touch anyone for Jesus unless you are real”.  At the end of the day, he just wants to be able to put his arm around a responder, tell them he loves them, and that they know that is real. 

Portrait of a Responder: Tanner Barkley

Tanner Barkley, 22 years old and he already has 3-1/2 years of service as a volunteer firefighter with the Tusculum Volunteer Fire Department.  His interest in volunteering started while talking with friends from United VFD.  When he showed interest in doing something in fire or rescue services, they suggested he look into Tusculum VFD since he lived so close.   The first visit was all it took; he immediately fell in love with firefighting.

During his short period of service, Tanner completed basic fire school becoming rated for interior firefighting.  He has since responded to numerous fires, both small and large, as well as motor vehicle accidents.  Not every call is flashing lights and a rush of excitement, especially when responding to an accident with people you know or dealing with a difficult fire call. This is when Tanner said he is thankful for his, “station family” who pull together as their own support group as well as the support from his fiancée, Molly.

There is a saying, “The funny thing about firemen is, night and day, they are always firemen.”  The problem is there are fewer of them every year with volunteering hitting an all-time low and having volunteers available during the day is even more of a problem.  While Tanner said one of the things he is most proud of is responding to the 3:00 AM calls, the understated value maybe with the calls he can respond to during the day.  Being able to get the truck rolling for a daytime call during the workweek can be invaluable when other responders are still at work or en route to the call.

Each volunteer has different motivations for their service.  For some it’s the rush of the call, others might have a family tradition of service.  For Tanner, it’s knowing, “when the pager goes off you are going to help someone, even if it’s as simple as a fire alarm.”  As a volunteer there is no pay, however Tanner said a handshake and a “thank you” makes up for that

Portrait of a Responder: Marty Shelton

Marty Shelton is a man known in the fire and rescue community as a dedicated firefighter and educator.  At 50 years old Marty has spent more than 60% of his life in emergency services through his volunteer and professional fire career.   

Like many responders, his call to service started when he was young growing up in the Orebank community with many friends in the Orebank Volunteer Fire Department.  The TV show Emergency certainly inspired him but a personal tragedy in the passing of his father from a heart attack when he was 10 years old created a drive to have the skills to respond when a person is in need.   

Marty’s professional career started with the Greeneville Fire Department when he was 19 and continues to this day. His volunteer career includes 4 years at Orebank VFD, 10 years at Mosheim VFD where he was Assistant Chief, 15 years at the Rescue Squad with 5-1/2 of those as Captain. He also had 8 months at Camp Creek VFD, 5 years as the County Fire Association President and 11 years with Tusculum VFD where he has been Chief since 2014.   

It does not take long talking to Marty to figure out his love of the fire and rescue service.  As his wife, Bridget said, “it’s in his blood, it’s who he is”.  His love of training and drills reflects his desire, “to be the best at what he does”.  That goes for the fireground as well as the administrative side of the service.  His ability to bring the knowledge from his experience to other departments inside and outside of the community is something he is very proud of.   

The volunteer service is something also very close to his heart, but it can also be very difficult. This is a high demanding job with standards and requirements that you are asking volunteers to do for free.   As a volunteer you are not getting paid for your service or getting a pension for retirement, “but you are getting paid by the satisfaction by the work you perform”.  People also don’t have as much time to help; volunteers are down by half and you are competing with sports and other activities, so “you have to make it worth their time if they are willing to serve”.   

With having than such a long professional and volunteer career Marty has several accomplishments to be proud of such as being instrumental in the implementation of the station backfill system when the home station is on call.  He regularly instructs classes on siphoning and drop tank drills, so departments are not running out of water on scene.  The goal with all of this is to perform to national standards, proven guidelines for firefighting.   

Reflecting on his career no one item stands out.  The calls have characteristics that are good and bad but there is nothing else he would ever want to do.  It’s the fire family that makes it worthwhile, you are with them at work 1/3 of your day or nights and weekends in life and death situations.  It’s all about the family. 

Portrait of a Responder:Kevin “Bucky” Ayers

At 56 years of age Kevin “Bucky” Ayers has dedicated over half his life volunteering as an emergency responder in both the fire and rescue services.  His first exposure to the fire service was as a 13-year boy with a house fire next door to his home.  Seeing the response of the firefighters inspired him to join the Saint James Volunteer Fire Department in 1984 where he went on to become a Lieutenant, Captain and eventually Chief for 11 years. 

Captain Kevin “Bucky” Ayers

While serving with Saint James, Bucky gained exposure to the Greeneville Emergency and Rescue Squad which he joined in 1999.  Over the years he served in the First and Second Lieutenant positions as well as multiple years in his current position of Captain.  In addition to his responsibilities with the Greeneville Squad, Bucky served as Tennessee Association of Rescue Squad’s (TARS) Region 1 Vice President, TARS Vice President and finally President, which he considers the highlight of his volunteer career.

Having a background in farming, working long hours and a desire to continue learning was a perfect fit for his volunteer career.  Much like farming, the job is not over until the fire is out or the rescue or recovery is complete.  

Volunteering in emergency services can be stressful as Bucky pointed out, “there are memories you do not want to remember”.  But Bucky pointed out that serving can also provide positive contributions such as the people you meet, the friends made over the years and the learning experiences provided in the fire and rescue services. 

Having spent 35 years as a first responder, Bucky missed multiple Christmases, birthday parties and grandkids’ school functions, all in the service of others. But when asked, he said he wouldn’t change a thing.  He’s given his all from day one in order to help victims or provide families with closure.  The years spent training and responding created a reputation of a firefighter and squad member who is there when the pager sounds. 

A Day With Wings Air Rescue

Here, in East Tennessee, you normally see them coming to a car accident.  Actually, you hear them coming before you see them.  It’s a faster, higher pitch vibration buzz versus the thump, thump, thump of the larger military helicopters that occasionally come overhead.  As they near the accident, you hear the flight crew talking to the medical crews over the loud truck radio speakers.  Before you know it, they are on the ground.

Wings II Bell 407GX after takeoff.

The flight nurse and paramedic exit the helicopter to meet with the ambulance crew, which already stabilized and prepped the patient for transport.  The nurse checks the patient, while the paramedic works with the ambulance crew for the patient transfer.  Together, with the support of a rescue personnel, the stretcher is taken to the waiting helicopter.   The patient is loaded, and the chopper is gone as fast as it arrived.

 En route to the trauma center the pilot is flying the aircraft, communicating on the radio and keeping an eye out for other traffic.  In the back of the helicopter, the medical crew work one to keep the patient stabilized, performing additional procedures, if needed, and prep for the landing.

 Upon arrival the opposite actions take place. The hospital crew help unload the patient with the assistance of the paramedic, while the fight nurse provides the patient transfer to the receiving medical staff.  The debrief complete, the flight crew loads back onto the helicopter for the trip back to base to refuel and restock.

Wings II takeoff from the Greeneville base the day of my visit.

The truth is, it’s not always swoop in and soar out.  There is bad weather that keeps them on the ground.  Sometimes there are delays finding a suitable LZ in our hilly part of the country.  Or, the flight and ambulance crews must take additional actions to stabilize the patient before they are safe to fly.

There is so much that can go wrong, yet they make it all look so smooth.

 I was able to spend a day with the Wings II crew in Greeneville, TN last year and concluded that it’s one word that makes this go smoothly despite everything that can go wrong.  That word is - purpose.  Everything they do, is done with purpose.

 The crew

 The crew consists of the pilot, flight nurse and flight paramedic, all of which have equal share in responsibility of the success of the mission.  Their shift starts with purpose.  A daily briefing in which the status of the aircraft, flight crews, weather and daily schedules are reviewed on a conference call with all four Wings bases.

Preflight startup.

While all members of the crew are involved in the preflight of the aircraft, it’s the pilot’s primary responsibility to check airworthiness, weather and flight restrictions.  The question I had was why the combination of a nurse and a paramedic?  Why not two paramedics or two nurses?

Using an example of a motor vehicle accident, the ambulance crew assesses, stabilizes and preps the patient for transport.  When the patient is transferred to the air transport crew, the flight paramedic, having the background in EMS operations, is the “lead” in that transition.  Just as the flight nurse, having a background in hospital care, is the “lead” in the transition over to the emergency room.  A small detail in the larger scope of patient care, but one that underlies that every detail of the process is reviewed and mapped for effectiveness, efficiency and, of course, purpose.

 Small details, biner clips and cloth tape

 Each crewmember seemed to have their own custom loadout, if you will, of personal equipment.  While their equipment/survival vests vary in design, the smaller details I noticed were a carabiner on a nurse’s flight suit epaulette and the cloth tape on the paramedic’s leg.

A carabiner on the flight nurse’s epaulette or a medical device?

A carabiner, that could have been purchased for 99 cents, can easily become a medical device by holding an IV bag in an elevated position.  A simple keyholding device, repurposed.

The tape on the paramedic’s flight suit leg becomes the log sheet for the patient’s vitals in an environment that can quickly become too cluttered with equipment.  Upon arrival the information on the tape can be transferred over to the patient report.

 The non-glamorous work

 There are unseen parts of the job that are critical to mission performance.  To maintain the highest uptime performance standard maintenance is purposely performed during the statistically lowest call time period.  This provides for the highest available flight transport hours, but not a lot of fun if you are the dedicated mechanic getting up in the middle of the night.

 The helicopter is not the only item with regular QA checks.  Complete review of missions, reports and flights are completed, filed and peer reviewed before being closed.   The purpose being to achieve high-quality patient care.

Behind the scenes

 It was awesome to have the look behind the scenes, to see the interaction when they were not in the spotlight.  Based on working with them in rescue and training capacities, I knew I would see professionalism.  What I found was manufacturing and quality processes but with good bedside manner.

 For example, the standup meeting at the start of the shift - common in many industries and a good practice all the way around.  However, it was the explanation of the medical crew setup that left me with the lasting impression.  The skill overlaps and specializations were to be assumed.  How the interactions with the different medical crews, in the field and at the hospital, are mapped and developed show how all the smallest details are purpose driven. 

 No doubt about it, they have a cool ride.  It’s the purpose they put into all of their actions, large and small, that was impressive. 

Wings II N631MT (Med-Trans) returning to the Greeneville Base after a medical transport.

I would like to thank the Wings II crew for allowing me to spend a day with them: Nurse Mary Ketron, Pilot Jennifer Brannon, Paramedic Allen Dale Davis and Base Manager John Smith.  I would also like to thank Paramedic Adam Williams who provided additional educational insights along the way.