In St. George, community paramedicine fits well with ‘being aware and doing something about it’

When Candy Davis first started working as an EMT in St. George nearly 25 years ago, the town’s ambulance service was an all-volunteer organization. Today she is one of the town’s paid paramedics providing 24/7 coverage for 911 calls and is in charge of a “community paramedicine” pilot project—one of 12 in Maine—that is now in its fourth year of implementation. Her long years of service to this community where she grew up has put her in a particularly good position to understand how a paramedicine program could be a real benefit to people here.

“I started with the service in about 1992,” she recounts, “I started as a basic volunteer EMT providing basic life support. Then I went back to school and obtained my intermediate license which allowed me to start IVs, give a limited amount of medications and use a cardiac monitor. So I worked at that level for a while. And then I obtained my paramedic certification—that was a few years prior to starting my paid position in July of 2011. So you can imagine if I’ve been with the service since 1992, I’ve had the opportunity to watch people age, to witness the services we have and to see areas where there could be improvement. So when I looked at community paramedicine programs that were happening in rural areas across the country I could see it was a footprint that really fit us well. With our call volume in the 200-300 range, we certainly had enough down time that we could provide those community paramedicine services—medication reconciliation to see that a medicine is being taken correctly, blood pressure monitoring,
glucose level monitoring.”

Davis and other ambulance service members who have had the requisite training can provide those services to community members only if their primary care physician has ordered them. They can also assist care providers like Kno-Wal-Lin, nurse practitioners, and hospice.

“Our community paramedicine care in St. George is not meant to replace any existing services,” Davis notes. “We identify our program as an opportunity to augment other services. So let’s say Kno-Wal-Lin has a client who has been discharged from the hospital and who lives alone here in St. George. They might come in once a week on Monday. We would try to come in later in the week to check in on that client so both ends of the week are covered. In addition to that, when the Kno-Wal-Lin services stop, we can continue to provide those services if the primary care physician has asked us to do that. We can also provide wound care if asked. For example, a Kno-Wal-Lin nurse might have someone who needs wound care in St. George, but she’s in Union during a blizzard. She can ask the patient’s doctor to give us an order to make that visit.”

The needs assessment Davis conducted while setting up the pilot community paramedicine program in St. George—each pilot program in Maine is community specific—identified serving the town’s aging population as a particular priority. “We have an aging population and as a result of that our community needs assessment identified elderly folks who really want to stay and age in place in their homes,” Davis explains. “So think of an individual in their 80s driving up the peninsula in winter to their doctor’s office and they have blood drawn for testing. The round trip drive is about 42 miles. Then let’s say they get home and there’s a call from the doctor’s office saying we need you to come back for another blood draw. That is a lot for that individual. It gets dark early in the winter and the weather conditions just aren’t always feasible for driving the peninsula for an individual of that age. So that’s an area where, if the physician orders it, we can help by taking a blood draw or take a urine sample or whatever the case may be and drive that to the lab and keep that person from having to leave the peninsula again.”

Sometimes, Davis says, a paramedicine visit also has an added benefit. She cites the case of a 90-year-old woman whose blood pressure and glucose levels she was monitoring per a physician order. “She did not drive—she relied on her neighbors to take her to church and different social events and she went grocery shopping once a week with one of her neighbors. I called her on my way to visit her and I asked do you need anything?  I’m going by Harborside Market. She said she needed milk, didn’t know what had happened to the milk she bought two days ago but it had gone bad. When I arrived at her house I opened the refrigerator to put the milk in and noticed the light didn’t go on. The refrigerator didn’t work. And there was lots of other spoiled food. She had lost her sense of taste and had no idea she was eating bad food. So I got on the phone with her family who lived out of state and they got the ball rolling on getting the refrigerator cleaned out and repaired. That visit made it possible to circumvent a horrible event.”

There is a lot of record keeping involved with the pilot community paramedicine program, Davis admits. But the hope is that between all the pilot programs in Maine and across the country there will eventually be enough data to show that the services being provided represent a real cost savings. “Medicare needs to recognize the benefit,” she says. “The program is preventing hospital re-admissions and reducing emergency room visits. Sometimes just having the human interaction of a regular visit prevents someone from feeling isolated and getting depressed, which can then lead them to become non-compliant with their medications.”

Davis often refers to herself as a “community paramedic,” which is perhaps a big reason that the pilot paramedicine program seems so well suited to the St. George ambulance service’s overall philosophy. “Everything for us circulates around attention, prevention, action. We just try to be aware of what’s going on. If we notice that someone has developed swollen ankles or has labored breathing we’ll suggest, ‘Let’s call your primary care physician and let them know.’ That’s not a community paramedicine service because the physician didn’t ask us to check on that person, that’s just being aware and doing something about it.”

Reflecting further on her approach to her work, Davis adds, “You have paramedics who like high-volume 911 calls and these are the people who live in cities where they run hundreds of calls in a month and thousands a year. It takes a certain type of individual to be a community paramedic. If you don’t have the empathy, the compassion, the understanding—that bedside manner—if you don’t have it you’re not a community paramedic.” —JW

PHOTO: Julie Wortman

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Enjoying the fun—and artistry—of making all the pieces go together

OLYMPUS DIGITAL CAMERA“When people think of plumbers they think of plunging toilets,” admits Gary Minery, who with his wife, Shasta, has been running GC Minery Plumbing & Heating for the past 10 years. “But the only toilets I plunge­—rarely—are in my own house,” he adds with a laugh.

In the plumbing business, jobs that might involve toilet plunging fall under the heading of “service calls,” and those account for only a very small percentage of the work Minery does. His specialty is, instead, designing and installing the plumbing and heating systems for new construction and renovation projects. Thanks to several loyal contractors such as Harbor Builders in St. George and Lorraine Construction out of Rockport, he has had plenty of opportunities to hone the skills necessary for such work.

“I enjoy the new stuff the most,” Minery says. “A lot of it is like a big puzzle—I like to do puzzles, so it’s putting all of the pieces together. I like doing the boiler piping. I guess it’s artwork in a way—running everything in straight lines and there are so many pieces that have to go together. You can do it a quick fast way and just get done or you can make it look like something.”

A job Minery did for a client who was a nuclear engineer on a submarine, he says, is a case in point. “He said he shuts himself in the mechanical room of the house and he feels like he’s on the boat. He says he just loves it. Hearing stuff like that makes me smile. It’s about good craftsmanship.”

Calculating how all the pieces of the plumbing and heating systems should go together can be a big challenge, Minery points out, because different types of buildings are framed differently, use different types of building materials and are laid out differently.

“Every house has its own sort of problems that need to be figured out—how you are going to run things depends on so many factors. We had a house in Rockland that had a lot of steel in it. That took quite a lot of thinking to get the bathrooms from the second floor connected all the way down to the basement—going through or around the steel.”

Log cabins, Minery adds, are “horrible.” “I’ve only done a couple of them. You really have to think outside the box to figure out how to run stuff with all that solid wood—how to get from A to B to C. And post-and-beam structures pose their own problems because there is no place to hide anything.”

But even when a project poses difficulties, Minery likes to take an upbeat view. “All projects can be fun if you let them be,” he says. “You have to be positive. Luckily my wife helps me with part of it. I definitely couldn’t have done all this without her.” Minery’s wife, Shasta, keeps the books for the couple’s business. Three children ages 6, 9 and 14 also keep them busy.

Minery says that although he is proud of the business he and his wife have built, as a young man—he is now 43—it wasn’t his aim to become a plumber. For six-and-a-half years he lobstered with Doug Anderson out of Port Clyde, but when Anderson began going to Florida for the winter that left Minery without a job. “I went to Maritime Energy for a year and found I didn’t like cleaning boilers every single day and found I wanted to do more. I ended up working for AM Plumbing and Heating in Rockland for six years and got all my licenses through all the hands-on learning I did there. Then we started our own business in 2006. But if I could do anything I’d be lobstering again. I love being on the water, not surrounded by people all the time.”

But Minery’s craving for the solitude he experienced while lobstering, he says, does sometimes still get satisfied when he comes up against a project deadline. “That often requires a lot of 4 am starts, which suits me fine. From 4 am to 7am is the best part of the day—it’s when there’s no one else around.”—JW

PHOTO: Julie Wortman

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New lighthouse museum trail a community-minded Eagle Scout project

Diana Bolton, chair of the Marshall Point Lighthouse Museum Committee, and Museum Director Nat Lyon look on as Eagle Scout Jacob Knowlton cuts the ribbon to open the new trail at the museum’s property on July 13.

Diana Bolton, chair of the Marshall Point Lighthouse Museum Committee, and Museum Director Nat Lyon look on as Eagle Scout Jacob Knowlton cuts the ribbon to open the new trail at the museum’s property on July 13.

When Jacob Knowlton was searching for a community service project that would allow him to complete the requirements for the rank of Eagle Scout, a conversation with Mark Bartholomew convinced him that building a trail on the property of the Marshall Point Lighthouse Museum would be a perfect fit.

“I used to be in the troop down here in St. George and one of the boys in that troup, Kyle Waters, had built a path from the library to the school. So I thought it would be kinda cool to build a path, something that somebody had already done but that would still be different,” Knowlton says. “I love the lighthouse, it’s a really nice place and I like looking out to the ocean. And building the path was a way I could learn some leadership skills because I needed to organize a work day because I needed volunteers from my troop to come help me. So I could learn some leadership skills along with learning a bit because I needed to figure out some information I could put on the signs we put out along the path.”

Knowlton says the only difficulty with planning and executing the project was finding a day everyone could do the work. Once that was figured out, laying out the trail and erecting the eight signs that mark it went quickly.

“It only took us a couple of hours working with four of us boys and two adults. We were all strong, able-bodied boys so the work went fast. We were able to mix the cement and set the signs and spread the wood-chip mulch rather well. The adults ran the power tools so everything was safety-oriented.”

The signs were designed to work as four pairs, the first posing a question, the next giving the answer. “Nat Lyon, the museum’s director, wrote up the first two questions,” Knowlton explains. “Then I did some research and wrote up several of my own questions that I thought would be cool.” One of those questions had to do with Charles Clement Skinner, the longest serving lighthouse keeper at Marshall Point, a person Knowlton says he’d like to learn more about.

At age 14, Knowlton is unusually young to achieve the rank of Eagle Scout. Although he plans to continue with the Boy Scouts, he recently also joined the Sea Scouts, which has a “ship” (a synonym for “troop”) in Bath. His goal is to achieve that organization’s highest rank, Quarter Master, before he is 21.

Thinking about what he liked the best about the Marshall Point Lighthouse Museum project, which was unveiled on July 13, he says, “I led that project and knowing that I personally added something to the community is a good feeling.”—JW

PHOTO: Julie Wortman

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Land Trust offers pollinator walk and talk on Appleton Ridge

Blueberry SMOn Friday, July 29 at 4pm Georges River Land Trust invites the public to take a walk through a productive blueberry barren on top of Appleton Ridge with Francis Drummond, Professor of Insect Ecology and Insect Pest Management, to explore the link between pollinators and Maine blueberry production.  Drummond’s research topics have included:  wild blueberry production, blueberry plant reproductive ecology, agricultural production practices that affect pollination and vegetative growth, and evolutionary tradeoffs in flowering.

Maine blueberry producers depend on bees to pollinate this cash crop.  Blueberries fail to produce large quantities of berries without pollination. This means blueberry producers must bring in hives of bees to pollinate these fields. In recent years Colony Collapse Disorder has led to declines in bee numbers and an increase in pollination costs to Maine producers.   Drummond will discuss the challenges facing pollinators like honey bees and the effect on Maine blueberries.

Bring your cameras for the beautiful view and park at the gravel lot near Perry’s Pond on Appleton Ridge Road in Appleton.  From the South:  Drive North on Rt. 131 from Rt. 17 for 5.4 miles and take a left on Town Hill Road.  Drive .8 miles and take a right on Appleton Ridge Road.  The gravel parking area will be .4 miles on the left.

This walk is organized in cooperation with the University of Maine and is free and open to the public. For more information please visit www.georgesriver.org or call (207) 594-5166.

PHOTO: Courtesy Georges River Land Trust

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St. George VANITZ

July28Vanitz SMWhose plate will you have plenty of time to memorize if you are ever driving behind them on Rt. 131? —Susan Bates

Who’s behind the wheel? Email your answer. The first reader to respond correctly wins a free business-size ad in the print edition of The Dragon. Terry Parker knew Kristin O’Neal’s plate K-OTIC in the June 30 issue.

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For 13 years determined to shoot a ‘first-rate’ fireworks show for St. George

FireworksB#3 smIt wasn’t until June 25 that the fireworks scheduled for the Saturday night of St. George Days were a sure thing. The barge used for shooting the show in past years had become unavailable and, until then, Mark Pierson, the lead shooter, didn’t have a substitute shooting site lined up.

“I had begun working with Dave Schmanska [St. George’s Harbor Master] to find a place,” Pierson says. “Finally Dave said, ‘How about the beach at Blueberry Cove Camp?’ So we went and looked and found the perfect place at the bottom of their field. So I’m going to be within 500 feet of where we’ve shot the fireworks before from the barge. Without Blueberry Cove we would have been toast!”

Pierson, whose family on both sides has deep roots in St. George, has been shooting the fireworks for St. George Days since the town’s bicentennial in 2003. It is one of his three favorite shows to shoot. The other two are the Fourth of July show in Portland that is choreographed with the Portland Symphony Orchestra, and the July 3rd show at Funtown in Saco. “I only shoot six-inch shells for two places—Portland, which is the biggest show in the state, and Tenants Harbor,” he notes. “The Tenants Harbor show is a first-rate show.”

Pierson began doing fireworks in college at UMass Lowell. “It was old-school stuff. We worked for a guy who sat in a lawn chair next to a 55 gallon drum filled with sand with three tubes in it. He had a cigar and would light the shells with that and drop them in the tubes.”

Pierson says he didn’t do fireworks for a long time after that until Fred Stimson, who lived across Mosquito Harbor from the house where Pierson’s grandfather was born and where the Pierson family spent summers, threw a big party and had some professionals shoot fireworks. “We rowed out into the harbor under the display and I thought, ‘Oh gee, I should do some fireworks again.’ So we began shooting stuff off at the end of the dock for the Fourth of July. Over a period of time it got bigger and bigger and then I thought, ‘Well, if I got my license somebody would pay me to do this.’”

FireworksA#2 smThat was in 1999. By this time fireworks were being shot electrically, a method that is much safer than the “old school” technique of Pierson’s college days. So with license in hand [actually, Pierson says, four different licenses are required],  Pierson began doing some shooting for Blue Hill Pyrotechnics. Early on he did such shows as the Rockland Lobster Festival and the Union Fair. His day job being electrical engineering work at Idex Laboratories in Westbrook, he soon began itching to get more involved with the artistry of designing the shows he would shoot.

“So I went to the largest fireworks company in the northeast, Atlas—they shoot New York and Boston and on the Fourth of July they will have 700 people on the payroll—and I said, ‘I’d like to shoot fireworks for you, I’d like to be a lead shooter.’”

The advantage of working for Atlas would be that they would handle all the necessary permitting, the insurance and any other paperwork needed. And, if Pierson had his own equipment and his own magazine for storing the shells, Atlas would let him do whatever shows he wanted to do, providing him with whatever shells he wanted. Then, as Pierson was considering the possibility of working for Atlas, in August of 2000, the Piersons’ son, Weston, was hit and killed by a car. And not much longer after that Pierson’s wife, Chrissy became pregnant.

OLYMPUS DIGITAL CAMERA“After Weston’s death and over the period of time Chrissy was pregnant I needed to keep my mind occupied,” Pierson recalls. “So I said, ‘Alright! I’m going to build a fireworks company.’ So over that winter I built all the equipment and built the firing systems.” He also was able to build a magazine on the edge of his brother Dale’s large nursery in Biddeford.

“When I finished I called up Atlas and said, ‘Well, I have the equipment and I’ve built a magazine.’ They came to have a look and said, ‘Gosh, we guess you have!’ From that day forward I started doing some significant shows. That was 15 years ago.”

Some of Pierson’s fellow engineers at Idex became interested in his fireworks enterprise so he invited them to be on his crew if they’d be willing to get some training. Some eventually got licenses of their own and crews of their own, renting Pierson’s equipment for shows.

Designing a fireworks show like the one he will shoot for St. George Days this year can be a complicated, time-consuming endeavor. “The biggest contributor to designing a show is the size of the shells you can use,” Pierson explains. “And that’s determined by the setback. You have to have 70 feet setback per inch of the diameter of the shell—that’s 70 feet from any people, houses, or cars. We don’t want debris falling on them. Then, once I know the maximum size of the shells, I can determine how many shells of what size I want. If I’m shooting in a grove of trees I have to use big shells to get beyond the trees and if I’m shooting on water on a float I can use more smaller shells to fill in things.”

Each shell contains a sphere and that contains the effect that people see in the sky. A charge on the bottom launches it into the air. Most shells are made in China, Pierson says, adding, “But  very high-end shells, where you need precise timing and amazing effects, are typically made in the U.S. or Japan. The shells that provide the reports for the 1812 overture in Portland on July 4th are U.S. shells—I won’t use anything else because the timing has to be precise.”
loading#4 sm
Loading up for a show, then setting it up and then repacking the equipment after the show (taking care to check for duds) can take a couple of days from start to finish. Every shell is put into a separate cylinder and wired, although the wires of some shells are linked together so they fire in quick succession—as for a finale—with the press of just one button (each shell is fired from consoles that contain dozens of buttons, one for each firing).

Pierson’s crew has shot fireworks in the rain and even in the fog, something he hates to do. One year the night of the St. George Days show was very foggy, so Pierson went to the town manager and fire chief and said  the show should be postponed. “‘Can we do that?’ they asked. And I said, ‘Sure, if I sleep on the barge!’ You see I couldn’t leave the shells once they were wired.”

Some of Pierson’s determination to make sure the St. George Days show is the best he can make it, he admits, is because of his family’s longtime connection to the town, but also because of his son Weston. “He’s  buried in Seaside Cemetery. If you go down to the water’s edge you’ll see a bench with his name on it and it’s the best place to watch the fireworks in St. George.” —JW

PHOTOS: Fireworks images courtesy Chrissy Pierson; portrait by Julie Wortman

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St. George VANITZ

VANITZ July 14 CHWhose license plate describes a normal day with four children and an Old English Sheepdog, while working as a fitness instructor and customer service rep for her family’s local business? —Susan Bates

Who’s behind the wheel? Email your answer. The first reader to respond correctly wins a free business-size ad in the print edition of The Dragon. Nobody recognized Bill Zierden’s plate SS-396 in the June 30 issue.

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