This adventure started off with the 30 minute hike in negative degree weather to the firestation...that I had only ever seen in passing. I just jammed to the Frozen soundtrack on my phone (I can really relate you know? Especially that line "the cold never bothered me anyways." It's like repeating that line will actually make me believe it haha :) ) Actually, when I'm bundled up in my ski pants, hat, mittens, and fat scarf, it isn't too bad!
So here is the gist of what I learned. The firefighters and paramedics operate under one jurisdiction. The government supports both with about 1% of taxes. The government organizes the country into regions, and these regions are responsible for the cities and firestations in their area. So Savonlinna is part of a district that covers Mikkeli, Savonranta, and a few others, and the firefighters can float among those areas. Because the federal government regulates the firestations, everything is structured so similarly. The branch president told me that if he had to go to Helsinki to work for example, he would be ok because the order of things, the layout of the trucks, and the system is so precise. There are no volunteer firefighters, it is their career. He said that that is how it should be, because the people are paying for their service, so they expect quality.
I had to admit that I didn't really know much about how our system works. All those elementary trips to the firestation haven't seemed to pay off much. After researching it, I relearned that ours are regulated by the city or local government, and we have about 70% (according to the website I found) volunteer firefighters.
I was very impressed with the Savonlinna station. The firestation has a dive team, a water boat (because of all the lakes), several fire trucks, their own mechanic shop. And every member of the team is cross-trained for every job. They have hydraulics for opening cars, so many electric tools, generators that can maintain electricity for entire buildings, saws for dealing with storms and fallen trees. They deal with water rescue, animal rescue wildfire, car accidents, fires, medical emergencies, you name it. Within one minute of receiving the call, they are ready to leave for the run. Basically, I've decided that a firefighter would make a good boyfriend because he would be handy to have around.
I mentioned that the paramedics fall under this jurisdiction as well. In the old days, firefighters were crosstrained as paramedics and they did both. Now it has become so specialized that this isn't practical. All the paramedics now are specially trained nurses. They went to nursing school and then furthered their education with a 4 year specialty training. They can give about 55 different medications on route, and have full authority to treat the patient in the ambulance. Our branch president actually trained as a nurse too and then moved to the firefighter side.
As a nurse, I really like this idea of nurse run paramedic teams. I don't claim to be an expert though, so please don't quote me on any of this. In our system, paramedics are only able to give a small handful of medicines: nitroglycerin, saline, morphine, epinephrine, some basic medications. They can do resusitation, and some can intubate. Because the paramedics are trained nurses, they can treat on the spot much better than in our system. We have to take the time to deliver the patient into the care of doctors and nurses, but here, the nurses and sometimes doctors too come directly to the patient. By the time they have arrived at the ER, many patients are stabilized. This provides for continuity of care. Also, since this is part of the federal government, it is structured very exactly. Everything is the same anywhere you go. In the US, training and certification of EMTs and paramedics also is very variable and differs in different cities, or states. I think that sometimes our system is very fragmented by shifting patients from different hands. This continuity of care is one plus for their healthcare system.
Overall I was impressed with the emergency care provided by the government here in Finland. I was thinking about this through, and realized how difficult that would be to implement in our country. Think about it. We have to train more specialized nurses...but what would that do for the livlihood of all our paramedics? And we are already short on nurses. The ambulances would need to be affiliated with an organization....is it problematic that our private ones have limits to which hospital they go to? With as many people in our country, could we pass a law requiring 1% of taxes to go to this service? The sheer number of private hospitals and lack of nurses would make this a very difficult project. I can't help but see, though, this system provides continuity of care in a way that improves outcomes for patients. In an emergency setting, the structure of this system is what patients need to be stabilized.
The whole time I was there I kept wanting to take pictures of everything. But I decided to be polite and wait til the end so I could get a picture with the branch president. Too bad they got a call and he to leave. Literally, we were talking and one minute later he drove the firetruck away. Talk about an exciting end to it all. So all I have is this selfie after I was left alone :)
Comments or questions? Anything I left out? I'd love to answer any or find out the answers if there are any :)
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