Steve Beckman replaces supplies in a jump kit after an ambulance run.  (Photo by Lisa Aciukewicz)

The Press recently spoke with Harvard resident Steve Beckman to find out what it’s like to be an adult volunteer on Harvard’s ambulance squad.

Press: What does your job involve?

SB: As director, my general responsibility is for management of the Harvard Ambulance Service, in accordance with guidelines established by the Massachusetts Department of Public Health, the Harvard Board of Selectmen, and the squad’s medical director, Dr. George Stedman. In essence, I must ensure that human resources, ambulance operation, training and development, technical infrastructure, and finance concerns are in order. As an Emergency Medical Technician (EMT), I am responsible for providing acute pre-hospital medical care. I participate in EMT runs but also have other member responsibilities—continuing education, participation in monthly business meetings and duties, as well as training and mentoring less-experienced and cadet members.

Press: How did you receive your training?

SB: To become an EMT, you must complete training in an Office of Emergency Management Systems-approved certification class. There are three levels of EMTs in Massachusetts: basic, intermediate, and paramedic. Most service members are trained to, and Harvard ambulance is currently approved to operate at, the basic level. EMT-basic (EMT-B) certification requires roughly 140 hours of didactic and practical training and successful completion of both state exams (practical and written). To achieve intermediate and paramedic status, the training programs are roughly 400 and 1,100 hours, respectively.

Press: How much time is required of volunteers on the squad?

SB: We’re proud of our all-volunteer status. No member has ever been paid. Again, this is a fairly unique status for services in the state. En masse, squad members have been volunteering at unprecedented annual rates—6,000 hours “on-call” time, 1,800 hours “run” time, and over 1,000 hours of participation in meetings and continuing education.

For an individual member, the decision regarding level of volunteering is a personal one. There are certain base requirements for ongoing state certification: 28 hours of continuing education and a 24-hour EMT-B refresher course every two years. In addition, to be a Harvard Ambulance Service member, the requirement is for a minimum of 10 ambulance calls per year and monthly meeting attendance.

Press: How many calls on average in one year does the service go on?

SB: On average, we respond to a little over 300 calls each year. Call distribution by time is consistently skewed toward heavy daytime demand. About 48 percent of calls occur between 8 a.m. and 4 p.m., while 37 percent occur between 4 p.m. and 12 a.m. The smallest percentage, about 15 percent, occurs between 12 and 8 a.m.

Press: How many members are on the squad?

SB: Harvard ambulance personnel are varied and diverse. Ages range from 16 to 50+ years. There is a near equal mix of men and women. There are 25 full-members, 11 provisional members, and 10 students. The 11 provisional members are state-certified EMTs who are refining their skills and learning operations en-route to promotion to full-member status. The cadet class of 2010 recently completed its certification class and is in the process of taking state exams toward promotion and provisional membership on the squad. In addition, we are now in the process of recruiting adults and Bromfield students for this fall’s in-town EMT certification class.

Press: How do you become a member of the squad?

SB: For the past 13 years each fall we have offered a state-certified EMT-B training course. This 140-hour course is available to all adult Harvard residents free of charge. Classes are held one or two nights per week, plus an occasional Saturday, and run from mid-September through January. The EMT-B program includes EMT safety and responsibilities, airway management, patient assessment, medical emergencies, trauma, infants and children, geriatric care, ambulance operations, poisons, allergies, cardiac emergencies, rescue operations, childbirth.

In this course you must sit for the two state exams, join the squad as a provisional member, and work actively toward promotion to full-member status. After certification, volunteers are equipped with a pager, two-way radio, uniform, and jump kit.

We are one of only two towns that have a state-approved waiver that allows a select number of high school students to train and run with us after completing the normal set of certification requirements. This has become known as the Cadet Program because the students graduating from the program are specially designated as EMT-cadet until they reach 18 years of age. This has been a terrifically successful program over the years in helping to address the chronic shortage of available daytime adult volunteers.

Each year’s ambulance-sponsored EMT-B certification class is a hybrid mix of adult Harvard residents and Bromfield trainees. This course is conveniently run out of the Public Safety Building.

For adults interested in helping, without committing to EMT certification, we have opportunities as ambulance drivers and first responders. Volunteers interested at this level enroll and complete a first responder and CPR certification course (total 43 hours) and then receive driver training for the ambulance. These volunteers are especially helpful in satisfying crew staffing requirements during daytime hours when EMT resources are most limited. I would suggest anyone who may be interested in volunteering should check out our website at www.HarvardEMS.org. Our website lists contact information for all Harvard ambulance officers, and any of us would welcome the opportunity to meet or discuss the opportunities to contribute to the service. Also, people can e-mail me at Director@HarvardEMS.org or call me at public safety building at 978-456-4110.

Press: What is your biggest challenge as a volunteer?

SB: Few volunteer positions have as steep a “price of admission” as does that of an EMT. In addition to the up-front training, EMT skill sets are most practically and effectively developed on actual runs. There is no substitute for “street” experience. Given that there are about 300 calls each year in Harvard, accumulating this run experience can occur quickly or may take an extended period of time, depending on a member’s particular availability to respond to calls. Remember, our calls are never scheduled; we must respond to 9-1-1 calls for assistance at anytime, 24 hours a day, 365 days a year. Each run generally takes two hours—from initial tone, assembly and response of crew, patient care and/or transport, to documentation, return, and restocking of the ambulance. Given that this is not scheduled time, some volunteers may find this element of unpredictability difficult to manage, especially in the context of other family and work commitments.

Press: What is your greatest reward?

SB: It is an extreme privilege to have the opportunity to respond to neighbors or visitors in our town in their time of greatest need. Every response starts with a desperate call to 9-1-1 for emergency medical assistance. We never know exactly what we’ll find when we arrive. But, that uncertainty is also part of the allure. Being equipped with the requisite medical knowledge and support infrastructure, we are able to effect highly-focused care as part of an effective emergency medical response. We are confident in our ability to make the right “life or limb” decisions.

Press: Why do you volunteer?

SB: Harvard is a wonderful community to live in and to raise children in. Part of its uniqueness is the rich fabric of volunteerism that runs across many of the town functions. I felt that I owed something back to the community. I have always had an interest in medicine and health care, and was surprised and pleased to learn that after a moderate investment in time to train as an EMT-B, I could have a big impact by participation with the Harvard Ambulance Service. Running as an EMT in this town affords the opportunity to contribute to this town’s safety and security.

Press: What would you say to someone who might be thinking about starting volunteer service?

SB: The personal rewards are great. The skills you acquire may just help to save the life of a friend, family member, neighbor, or even a perfect stranger. However, I would convey the pragmatic issues associated with certification—the state required training and exams. I would suggest that the work does not end with certification. That’s really the launching pad for practical skills development that will be honed in real-world acute care scenarios right here on the streets and in the homes of your neighborhood. It takes about one year of front-end work to reach the competency to assume full independent patient care.

Press: Why is the ambulance service so important to Harvard?

SB: For more than 35 years, the citizens of Harvard have trusted and relied upon the town’s ambulance service to render excellent, standard-of-care basic life support emergency medical services. We are staffed by an all-volunteer group of residents whose primary focus is patient care and well-being. EMTs triage all emergency care needs and decide when to escalate or de-escalate responding medical care responses as appropriate. We ensure that the “chain of survival” is maintained: early response, patient stabilization, intervention, and transport to the most appropriate definitive care facility. We are dedicated to providing our members with continuing education opportunities and up-to-date training to ensure adequate preparation for whatever emergency needs may arise. We are an integral part of the town’s emergency management services team, along with our partners at police, fire, and dispatch.