Clinical Practice
Bill Brown began his clinical EMS career as a USAF Pararescueman in 1969. Following military service he enrolled in Youngstown State University where he received degrees in Nursing and Law Enforcement Administration in 1977.
Early Years as an ED Nurse
Bill then moved to Martinsville, Indiana to attend Indiana University in Bloomington, IN. While attending Indiana University, Bill worked for a brief time as a nurse on an orthopedic floor at Morgan County Hospital. While taking an EMT-Basic course at Indiana Vocational Technical School, Bill became aware of the patient pathologies and emergency department volume experienced within the Wishard Hospital ER, and was so impressed that he sought employment.
Bill was employed full-time as an Emergency Department Nurse at Wishard from February 1978 to August 1979. Wishard was the “county” hospital, attached to the Medical School of Indiana, and the educational center for Paramedics who covered the City of Indianapolis in the late 70’s. The Paramedic program then contained well over 1,000 hours of education and employed many medics holding college degrees who were impressive clinicians. Indianapolis was covered at that time by three Paramedics working on three-person crews, and backed up by thirteen “district” EMT units; thus, the Paramedics were extremely busy, possessed high levels of skills and knowledge, and operated under broad-based standing orders. Because it was a teaching hospital, many physicians staffed the ED and covered the 150,000+ ED visits per year.
The Indianapolis EMS System, its leaders, and the medics formed an early but significant impression on Bill of what Paramedics are capable of completing, and remained a model for Bill regarding the future of Paramedicine.
Bill prospered in this educational environment, served as the lead nurse on many trauma and cardiac codes, interacted with psychiatric patients, and saw many patients with multiple pathologies.
Career Move to EMS
Bill eventually became the Program Director of Paramedic Education at Youngstown State University. During that time, he also worked part-time, on-call as an ED nurse at St. Elizabeth Hospital in Youngstown. During this period be became certified as an Emergency Department Nurse by the Board of Certification for Emergency Nursing (BCEN), and retained that certification for over twenty years. Bill remained a part-time, on-call ED nurse for six years while in Youngstown.
In 1981, Bill obtained a license in Ohio as a Paramedic after completing the necessary clinical skills he lacked as an ED nurse (endotracheal intubation, and field internship) and via teaching an entire Paramedic course. He then became employed as a Paramedic with Gold Cross Ambulance service in Youngstown. Bill arranged his teaching schedule at YSU to allow him to work every Friday on a 24-hour shift as a Paramedic. Bill believes the difference between working as an ED nurse and a Paramedic is that you are in a controlled environment in the ED, but as a Paramedic, you are working in the patient’s environment which is often uncontrolled. Patient symptoms and complaints are more evident in the ED, but are often masked in the field. As a result, Bill believes providing proper care in the EMS environment is a greater challenge