SANTA MONICA, Calif. — The Santa Monica Fire Department has begun deploying a two-person Advanced Provider Unit that pairs a nurse practitioner with a firefighter/paramedic to respond to non-life-threatening 911 medical calls, with the goal of treating more patients on scene and reducing unnecessary hospital transports.
The unit began responding in November and currently operates Monday through Thursday, the Santa Monica Mirror reported. It is part of the city’s two-year Realignment Plan approved by the City Council in October to strengthen public safety and emergency services.
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Fire Chief Matt Hallock said the program aims to keep ambulances available for critical calls, ease pressure on hospitals and connect frequent 911 callers with follow-up care. Officials said early responses have included minor medical treatment and behavioral health interventions.
The department plans to expand the unit to seven days a week in the coming months and is seeking part-time contract nurse practitioners with emergency or urgent care experience.
Should fire departments expand nurse–paramedic response units to handle low-acuity 911 calls, or does this shift risk stretching fire-based EMS too far from its core mission?
EMS1 readers respond
“Keep it going; it’s needed to reduce unnecessary ED runs and keep people at home.”
“Yes, fire-based EMS systems are at the initial point of contact for public health and public health emergencies. It only makes sense that EMS systems incorporate this into their dispatch algorithms. We can you longer function in a system where are only methods of delivering healthcare are transporting one to an emergency room. The status quo is not sustainable any longer for us or the hospitals. Advanced practitioner units, 911 nurse triage with redirection, a deep analysis on increasing response times for low, priority, calls and deploying specialized street crisis or mental healthcare teams are all levels of care that systems should consider based upon their particular needs.”
“Community paramedicine is a great idea. But I don’t think both the NP and paramedic are needed. Train the medic to treat primary care complaints or just send the NP/PA. Sending both a medic and an NP is redundant for non-emergency calls.”
“This is great news; it’s long overdue. As a former EMS coordinator and ambulance nurse doing critical care transport, I can tell you that every community with over 50K people in it needs this. But I had to laugh: when I read that the program was only Monday through Thursday, I thought to myself, ‘oh great, they need it to start at noon on Friday and go full bore until noon on Sunday.’ But the plans for schedule expansion to 7 days was good relief of my concern; in my opinion, they can’t get it going soon enough! I just hope the hospitals chip in for the costs because they’ll have indirect benefits and lowered costs from the pressure of primary care patient loads getting diverted to resources ither than ERs. Bravo!”
“Perfect ... great plan.”
“Absolutely! This is not only a service to the community, but the trickle-down effect frees up not only emergency service workers, but greatly needed emergency room beds for those critical patients.”
“Great initiative, lots of calls do not require transport to hospitals and a smaller car has better chances of getting through traffic easilly, in crowded cities the possibility of using a motorcycle EMT should be considered.”
“This is the best idea to be initiated, I am speaking from a personal experience point. I am a nurse in Kenya who is also a trained fire officer. I am currently attached at the fire and rescue unit at the airport, which has been implementing more of a nurse-fire team response for about 10 years. Although not a formal arrangement, the outcome of such calls speaks to themselves.”
“As a former FF/medic and now a APRN, this model is in my view an excellent way to treat minor injuries and illnesses! The problem is ‘corporate’ medicine, which charge exorbitant fees for obtaining care in the ER. The sad truth is the insurance companies pay them without question and these entities will find ways to explain why this model would fail or be risky? Literally a simple laceration or puncture wound could be managed for a fraction of ER charges. As an experienced ER nurse and 20 years plus as an urgent care NP, I would love to serve to implement this in my community and work in it as well. I have thought about this model for years!”
“Future NP with experience, coming at you in 2027!”
“As a PA-C who was a paramedic for 15 years in the fire service, I can’t think of anything that is more appropriate than a service like this. The ERs are overrun with patients of very low acuity and definitely NOT emergencies, so anything like this that alleviates that burden is a win-win! I’d love to do it, but not as a part-time contract PA, I’d want to be hired back into the fire service.”
