EMS: A not-so-exclusive club

"I refuse to join any club that would have me as a member." - Groucho Marx

"Hey, Kelly, you got a minute?" He stood hesitantly outside my office door after class hours, looking around nervously as if he were afraid of being caught having a private conference with the instructor.

"Sure, man, what's up?" I answered agreeably, motioning him to a chair. Of my paramedic students in that class, he was one of the better ones.

"Well, it's about that missing paperwork from my files. The felony affidavit?"

"Look, if you forgot it, just bring it in on Monday. We've got a little time."

"No." he blushed. "I've got it right here. It's just that, if I turn it in... I'll have to mark yes on it or lie and say that I don't have a felony conviction."

"You're a convicted felon?" I blinked. I was flabbergasted.

"Yeah, a long time ago." He nodded. "I was 17. They tried me as an adult."

"Well, I don't want you to lie on your felony affidavit, but it's not the end of the world," I said, trying to put the best face on the situation. "There are felonies, and then there are felonies, if you know what I mean. What were you convicted of?"

"Armed robbery."

"Oh. Well." Apparently, my student had committed a felony.

"And drug possession."

"Um..."

"And resisting by flight, and five counts of grand theft auto..."

"Hold on a second," I interrupted. "How did you even get into a paramedic class with a record like that?"

"Well, I filled out my felony affidavit for my EMT class, but I suspect my instructor never sent it in. And my paramedic instructor before you never asked us for one."

"So you managed to become a NREMT-B with that record, and no one knew it until you told me?"

"Yeah, that's about it. So what do I do?"

"You send in the correct felony affidavit to the NREMT, along with as much supporting documentation as you can muster," I sighed, "and you keep your fingers crossed. Frankly, I wouldn't hold out much hope."

**********

That conversation happened nearly 15 years ago. My student, at age 17, had been a mixed-up kid with a drug habit and undiagnosed bipolar disorder when he committed his crimes.

As it turned out, the National Registry of Emergency Medical Technicians was sympathetic to his pleas for leniency, as impressed by how dramatically he had turned his life around as I was, and ruled that he had paid his debt to society and was free to continue his EMS career.

No doubt the glowing affidavits written by his probation officer, his psychiatrist, the presiding judge and the prosecuting attorney probably influenced the decision.

I often wonder today how different his life might have been – and the lives of the patients he treated over the years since – if even one of us had chosen to judge him by five days of misdeeds and ignored the life he had led in the 10 years after his conviction.

Recently, EMS forums have been abuzz with news of another couple of supposed miscreants who have somehow made it past the hallowed portals of EMS certification and joined our little fraternity. Many of the posters on those forums have expressed their outrage and indignation that such people were even allowed to enter our honored profession, convinced that the reputation of EMS will be forever besmirched by association.

Never mind that plenty of our colleagues manage to besmirch the reputation of EMS quite handily with clean arrest records.

Recently, it came to the attention of officials in Roanoke County, Va., that an EMT named Tracy Rolan, already several months into her probationary period with the Cave Springs Volunteer Rescue Squad, had acted in over 200 pornographic films under the stage name Harmony Rose.

The revelation disturbed Roanoke County Fire Chief Rick Burch so much that he sought legal advice on the matter from the county attorney. In his letter replying to Chief Burch, Roanoke County Attorney Paul Mahoney pointed out:

"It has been the practice of Roanoke County not to interfere in the internal membership decisions of volunteer rescue squads like Cave Spring. These decisions are left to the volunteers.

"... They must exhibit the highest degree of trustworthiness and public esteem since they will be dealing with citizens when they are most vulnerable, or entering citizens' homes and businesses under emergency circumstances. Anything that results in public ridicule of volunteer squads, departments, or the County must be avoided." 

That sounds reasonable enough, but Mahoney's letter ends with this sentence:

"It is my recommendation that you support the decision of the volunteer chief if she decides
to terminate the membership of this individual."

Translation: "Now, we're not going to tell you to get rid of her, but it sure would be swell if that's what happened."

Keep in mind that Tracy Rolan passed a criminal background check. She has never been convicted of a crime. There have been no reports of misconduct as an EMT.

Yet people are worried that the presence of a former adult film actress will be a bad influence on 16- and 17-year-old trainees or that she'll somehow ruin the marriages of the male volunteers, apparently because of some mystic porn star mojo that clouds the minds of otherwise morally upright and happily married men.

I ask you, which is more shameful: that the EMT performing chest compressions on your father used to have sex on camera for money, or the fact that the EMT only needed 1/10 the educational hours as the person that did her hair and makeup for those films?

The minimum EMT course in Virginia is 154 hours -- to administer EpiPens, metered dose inhalers, oral glucose, splinting, oxygen, defibrillation bleeding control -- while it takes ten times as long to do hair and nails, 1,500 hours to get a cosmetology license.

That is what is offensive.

Pornographic actress Nina Hartley was a registered nurse before her film career took off. She was a college graduate and healthcare provider, yet she made her fortune having sex on camera and shaking her moneymaker in strip clubs. Where was the brouhaha that her second career must surely have raised in the nursing profession?

Although, to be fair, I may have missed it. In 1984, I was a lot more interested in porn than nursing advocacy journals..

Four years ago, Robert Melia Jr. made international news after being indicted for sexually assaulting three young girls and engaging in sex acts with several cows. Yet when the former Moorestown, N.J., cop renewed his EMT certification later that year, he checked "no" in the box asking if he had ever been accused of a crime.

No one caught it for over two years.

That's two years Robert Melia could have been in contact with vulnerable girls or been distracted by the sight of comely cattle every time he went to a rural rescue scene.

And yet no one knows if he did, or even how many other men like Robert Melia might be out there, because the New Jersey State First Aid Council, in its quest to keep EMS in that state firmly rooted in the 1970s, managed to get Governor Christie to gut the EMS Redesign Bill via line-item veto earlier this year.

That bill, had it been left intact, would have standardized and streamlined EMS regulation in N.J. and enacted more stringent certification requirements of EMS personnel – including criminal background checks.

Every state should make criminal background checks mandatory, although the CBI isn't the panacea some would make it out to be. The ultimate decision to hire or fire should be left with the employer or squad membership, but they should at least have access to information upon which to base their decisions.

A criminal background check may turn up an armed robbery conviction, as it would have in the case of my former student, but the facts of the case could still be reviewed by prospective employers and credentialing organizations.

For example, in some states, a conviction for public nudity or indecent exposure can land you on the sex offender registry. Know what qualifies as indecent exposure in some states? Mooning.

Let he who hath never participated in a drunken fraternity initiation cast the first stone.

But the issue here isn't criminal background checks or the lack thereof. The real issue is EMS being held back by people and organizations with skewed priorities or more investment in protecting personal fiefdoms than advancing the profession.

In Roanoke, it's county officials worrying about what an EMT did in a former career while conveniently ignoring how shamefully easy it is to become an EMT in the first place. We set lofty moral standards yet cheat our patients with educational requirements less stringent than that required of journeyman plumbers.

In N.J., we have an organization dedicated to preserving the personal fiefdoms of a score of rescue squads who believe that volunteerism should trump professional standards, with the result that a convicted child molester and zoophile was still able to practice as an EMT for over two years.

There may be others, but Jersey's lack of mandatory criminal background checks makes it impossible to be sure.

Ask yourself which is the greater threat to our profession: practicing pedophiles and porn stars, or educational standards so low that EMT textbooks are written at the 8th-grade reading level?

I invite your comments...