As a rerun of Law & Order plays on the TV, emergency personnel at Ryan Brothers Ambulance in Sun Prairie are half-engrossed. It’s about 11 in the morning, and at any moment, the landline phone may ring, requiring an immediate call to action.
But during this visit, no call comes.
It’s unusual, to be sure. On one of the first rainy days after a seven-week drought, the phones fall silent. “This is really odd,” says Jimmy Lindsley, an EMT/intermediate technician and one of the four staff members on hand this day.
“I’ve been on the job five hours already and haven’t been out on one call,” another EMT comments. “Two weeks ago, we had six calls in eight hours!”
A third nods in agreement while playing a video game.
It’s clear this is life in the emergency transport business – feast, it may seem, or famine. One never knows where or when the next call will come, so time drags on. Two ambulances parked in the garage have already been washed and disinfected, a daily ritual.
Kurt Opgenorth, 37, a critical care nurse and member of the Ryan Brothers management team, clocked in for a 24-hour shift at 8 this morning and waits patiently with the other crew members. As a manager, he is also in charge of supply and inventory, and oversees crew chiefs. “It used to be that peak flu season was our ramp up, in the winter months, but that’s not the case so much anymore. Now, we’re pretty busy at all times.” Except, ironically, this morning.
Opgenorth has worked for Ryan Brothers Ambulance for over eight years and enjoys the variety the job affords. “There’s always something different,” he says. “But you have to know what you’re doing, and keep on your toes with education and training.”
Originally, he graduated from UW-Platteville with a degree in biology and a minor in biotechnology, but after working for a couple of years as an EMT in Milwaukee, he went back to school to earn a nursing degree from UW-Madison. He has been a nurse for 11 years, including two years as an emergency room manager.
For as long as he can remember, he’s been drawn to the high-stress occupation. “For me, it’s not about the rush. It’s about helping someone in need,” he says. “I can make people more comfortable, and I also have the unique opportunity to use my nursing degree in the field.”
A family man, Opgenorth says the job’s perks – in particular, being able to be home in Platteville four to five days a week – are particularly nice. He and his wife own eight acres of land and recently started a tree farm on four of them. “It’s something I’ve always wanted to do as a hobby,” he says.
The youngest of three siblings, Opgenorth says he and his brothers earned their educations. “We worked for everything we got. I worked construction jobs in the summer and saved money to pay for tuition, room, and board.” Now he hopes the responsibilities of the family’s tree farm will teach a similar responsibility to his children, ages 9, 4, and 2 (a fourth child is due in March).
Continuing care
Opgenorth’s typical 48-hour week includes two 24-hour shifts. Other rotations might include three 16-hour shifts, or other combinations totaling 48 hours. Ryan Brothers’ emergency staff is non-union and paid hourly, with overtime. Beds are provided, but getting a good night’s sleep while on the 24-hour clock is rare, he admits, as they anticipate or handle middle-of-the-night calls.
“The emergency setting has always been my passion,” he said. “I don’t get too stressed because I know my skill set.” A strong Christian faith also runs through his core. “There is finality to life, and you can only do so much. You do everything you can with your abilities and your training, and the rest is in God’s hands.”
Ryan Brothers Ambulance has about 95 employees and 19 ambulances distributed across seven locations. The company is on track to handle 16,750 calls this year, and most of those (85%) are non-emergency “interfacility” transports – taking patients to and from hospitals, clinics, nursing homes, or assisted living facilities. “It is crucial that we provide the same level of care [from point A to point B] that was given at the hospital, clinic, or ER,” Opgenorth explains.
While the privately owned, 50-year-old family business is not a part of the broader 911 emergency network, it is the exclusive provider of 911 service to the village of Maple Bluff and the city of Fort Atkinson, providing advanced life support and basic life support services in addition to transport. “We have training every month, one in the classroom and a second that relates to policies and protocols,” Opgenorth says.
Patients using the service are charged based on the level of care rather than whether or not it is deemed an emergency, so basic life support can cost around $500 to $600 per transport, while advanced life support can average around $750 to $1,000. There is also a per-mile charge, making longer-distance runs more costly, and the company bills insurance companies on the patient’s behalf.
Tools of life
On this day, Opgenorth is partnering with Jimmy, who’s worked for Ryan Brothers for two and a half years but has been an EMS for 26 years. During the morning’s downtime, Jimmy helps a new trainee learn the intricacies inside the ambulance.
Opgenorth gives a brief tour of the inside: Cabinets with Plexiglass doors allow staff to see items used for “ABC,” or airway, breathing, circulation. There are breathing tube kits, portable suction apparatus, and life-saving and pain-relieving drugs.
One bag includes an IV pump. Another is strictly for pediatric emergencies. “When we have a pediatric patient, we can quickly unfold an informative piece of tape that measures the child from head to foot and is color-coded based on height.” The color corresponds to a pouch of the same color, which includes everything staff would need to treat the victim, including proper drug dosages for someone of that size. “Everything is smaller,” Opgenorth notes. It’s not foolproof, and sometimes staff needs to use their own judgment based on the situation, but Opgenorth admits it’s a handy and effective tool for quick treatment.
Pediatric calls are the most distressing. “I don’t know any nurse, medic, EMT, or doctor that doesn’t get a little anxious about pediatric emergencies,” Opgenorth says. “It’s such a different mindset. You’ve got a child that is very young and hasn’t lived life yet, so innocent, and they can’t always tell you, or control their surroundings. They’re scared, and you’re anxious.”
Sadly, two years ago, Opgenorth lost a 5-year-old niece – his goddaughter – to a virus. “I know the EMTs did everything they could. It just couldn’t be changed. That was tough,” he sighs, remembering.
“We prefer that parents don’t ride along in an emergency situation, but we certainly understand.”
A basic ambulance costs about $110,000 new, but fully stocked it can be worth $175,000. It’s not unusual for a Ryan Brothers vehicle to rack up as many as 275,000 miles before it might be either retired or refurbished by an Iowa company – saving about 25% in cost compared to a new vehicle. Refurbishing typically means the ambulance’s “box” is put on a brand new chassis, extending the vehicle’s overall life.
All emergency staff undergoes driver training, and Opgenorth says one of the biggest frustrations, as an ambulance driver, is traffic that does not yield to the emergency vehicle. Even at a crowded intersection, he says, the ambulance crew expects drivers to pull to the right, and the driver will always slow down and look both ways before proceeding through an intersection, even in a critical situation. “I’d rather have my partner driving safely and more slowly than going quickly,” he says, admitting that the ride is often the most nerve-wracking part.
The Ryan Brothers’ Sun Prairie station includes three bedrooms, a shared bathroom, and a small kitchen and lounge area. Staff is responsible for their own meals.
TV or not TV?
As noon approaches and rain continues to fall, interesting conversations ensue. The most popular shows watched, besides Law & Order? CSI, NCIS, and Burn Notice, they respond. Do any television dramas portray a true-to-life experience, where emergency calls are concerned? “No,” they all respond. “You can’t script what we do and see,” one says.
“We get hit with body fluids every day,” Jimmy adds. “We have to assume all patients are sick and contagious until we prove otherwise.
“Now, if it were smell-o-vision …” he says, and the others nod in agreement. Smells are apparently a difficult and often unshakable part of the job.
It’s no secret that emergency personnel of all stripes encounter life and death situations every day, and at Ryan Brothers, for the most part, staff keeps things close to the vest. “Certain conversations never leave these four walls,” one EMT says. “It’s an unwritten rule. We can laugh or cry with each other inside, to cope, but you don’t talk about it on the outside. That’s just the way it is.”
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