When it comes to preventative health in the Fairbanks community, the city’s newly hired community paramedic brings a passionate approach to her job.
Fairbanksan Melody Smith was recently recruited to fill a role the Fairbanks Fire Department hopes will fill a service gap and reroute critical services to other areas.
“I am always trying to educate patients how they can prevent themselves returning to the emergency room,” Smith said during an interview on Friday. “I try to help people with what they’re dealing with, find them resources, or talk to my nurses and my doctors over there who are receptive to what I’m seeing.”
Smith’s background includes training as an emergency medical technician, caregiver and medical assistant. She did her paramedic school training with Mercy Flights in Medford, Oregon in 2019 and at the start of the Covid-19 pandemic in 2020.
Smith is based out of the city’s Crisis Now office at Fairbanks City Hall.
The community paramedic role is still very new and will eventually evolve as she builds additional roles, makes connections in the community and develops resources.
One big goal: wound management for people who have wounds that could become infected.
“Once they get infected, if a lot of these people don’t get it treated, they get sick and they become septic,” she said. “That’s a possible ICU admission and that’s a very long process.”
Helping those who are injured or instructing them on how to treat cuts and injuries could help reduce a hospital or clinic’s admission rate.
“It saves the hospital money, it saves the patient money and gives the patient a better quality of life,” she said.
She approaches it with an enthusiastic, patient demeanor that the mayor’s office and Fairbanks Fire Chief Andrew Coccaro hope will reduce stress on the emergency services and improve the lives of city residents with chronic needs.
Some of her duties have involved transporting some people to pick up their medication, and offering follow-up resources for people faced with substance abuse challenges.
“I really want to find a way to help these people like they’re falling through these cracks, and we’re seeing them,” Smith said.
Smith didn’t always see herself going into a caregiver or emergency services role.
“When I was younger, I wasn’t quite sure,” Smith said. “I had a myriad of dreams, all different. I’ve always wanted to work with people, but I thought, ‘I’ll learn all these languages and find how to translate for people so they can better communicate.’”
Her interest soon evolved into preventative medicine after she became a caregiver.
“I realized I liked helping taking care of people,” she said. She trained as an EMT as a prerequisite for the University of Alaska Fairbanks nursing program when it sparked her passion for emergency care.
“I’m getting a different side of how I’m working with the patient and I’m getting a different kind of interaction with them,” Smith said.
While in paramedic school in Oregon, she noticed a gap that medics and nurses are hard-pressed to fill when they receive patients who could otherwise have avoided the emergency room.
“When I saw this position and read about what it was, I became elated because I’ve heard about mobile integrated healthcare before,” Smith said. “The fact that it’s being able to be implemented into Fairbanks is so exciting.”
When the Fairbanks City Council first funded the position for its 2024 budget cycle, the intent was to bridge gaps in services currently provided by the city’s mobile crisis teams, the city’s homeless/housing coordinator and the re-entry coordinator.
The concept involved integrating community partners such as Tanana Chiefs Conference, Refine, Foundation Health Partners and others for a mid-term/long-term care plan to help citizens in need. The position isn’t assigned to a fire engine or fire department ambulance.
Smith uses an SUV which is equipped with basic medical treatment gear and essentials, such as naloxone overdose kits. But her primary duty is helping people and making connections.
“I’m meeting people that I generally see in the emergency department and I’m getting a different side of them out here, talking to them and trying to see how I can help them,” she said. “I think that is going to be very beneficial once people get used to me.”
She’s also spoken with care providers and businesses around town, whose goal is to reduce patient counts who might become chronically ill and admitted to the hospital.
Smith’s duties also involve helping with transport and follow-up care, especially those with chronic mobility challenges who find it difficult to make essential doctor appointments.
“I can go to their homes, do their blood work, send information to their providers, do EKGs,” Smith said.
Smith also said the position may require some adaptability, a concept common to any emergency medicine position. During the pandemic, she learned how to be especially resourceful.
“You gotta be ready for a change, and you gotta just kind of find a way to roll with it,” Smith said. “We had to find different ways of patient contact, different ways of working with patients and different ways of managing airway issues. “Smith said another goal includes reminding the community to detach stigma from people who might suffer from substance abuse or from chronic conditions.
“People are not a condition,” she said. “We don’t look at people with diabetes, with COPD or any of these diseases, like we do with people with chronic addictions.”
Smith said she’s seen people from different walks of life and backgrounds deal with addiction problems in different ways. Those include people who might have been sober for a year but relapsed due to a rough patch or other issues.
“It’s generally a coping mechanism to something and it doesn’t define them, and they can find ways out of it,” Smith said.
However, she noted if society treats people with a substance abuse problem or relapse issue negatively, it can take a toll on a person.
“If you are someone who’s trying to elevate yourself from an addiction, and you are in a really bad spot, and you’re starting to lift up, but then everyone around you tells you that is who you are, that is how could anyone battle that?” Smith said.
Sometimes breaking that trend might involve ending toxic relationships.
“I feel that if you are constantly around people with the positive and current like and like positive motivation and continuous positive reinforcement eventually that can help some people break out of that fall back cycle, and then they eventually start moving forward and helping themselves,” she said.
Smith noted the community paramedic program is still young, but she hopes it will grow.
“I would love to see this grow into many units working with patient caseloads,” she said. “There’s a lot of people that need help.”