By K. Richard Douglas
Last month, we told the story of outdoorsman Caleb Campbell in our Biomed Adventures feature. Campbell is a biomed who regularly traverses large distances in Alaska to do his job as a member of the Alaska Clinical Engineering Services (ACES) department.
The HTM professionals who make up the ACES team have a unique mission as they serve facilities scattered around the state of Alaska. Trips to clinics are often on dogsleds or ATVs instead of in a service van. A long day on the job can literally mean a long day; often 17 to even 24 hours of daylight.
“[The] Alaska Clinical Engineering Services Department is small for the large scope of service we offer,” says ACES Director Robert Axtell. “ACES has a total of seven personnel; of these personnel ACES has only five biomedical personnel.”
In addition to Axtell, there is Senior Office Specialist Kathleen Hillstrand, Lead Biomed Specialist Bill Noel, Biomed Specialist Jack Yerxa, Biomed Specialist Karen Ruth, Biomed Specialist Caleb Campbell and Biomed Technician Cody Mingo.
ACES is in a unique situation that calls for a different approach when compared to its counterparts in the lower 48.
“ACES is not your typical biomed; we act more like an independent service organization,” Axtell says about the Anchorage-based department.
The group supports a total of six sub-regional hospitals in Alaska, 20 sub-regional clinics and over 100 village clinics throughout Alaska.
“We provide biomed services to our Tribal Health Organizations/Indian Health Service (THO/IHS) clients all over the state of Alaska. ACES has contracts with 20 THO/IHS Alaska organizations. We provide preventative maintenance, corrective maintenance, equipment install, and equipment removal/destruction on everything that touches a patient,” he adds.
The group covers basic biomed, dental and dental X-ray, X-ray/imaging and even biomedical safety cabinets.
At one time, the department operated differently.
“ACES has been around for about 18 years, they were a federal program originally with all federal employees,” Axtell says. “Just prior to 1997, all the tribes came together and decided that all of the tribes, whether they were very small tribes or larger tribal health organizations, wanted the ability to have the same health care,” Axtell says.
Today, the group is a contract-based organization.
Because of the remoteness of their work environment, each team member is well trained to address the repair and maintenance needs of a variety of equipment.
“ACES biomeds complete ADEC dental training,” Axtell says. “Biomed specialists complete RSTI, Planmeca, safety cabinet training and various other vendor-specific training.”
“In order for us to work on some equipment, we require vendor-specific training, such as ventilators [and] X-ray,” Axtell says.
Also, there are times when the vendors themselves get involved and must sent an engineer to a site.
Projects and Problem Solving
For a biomed department, which is challenged to cover the largest state in the country the project list is bigger than life also.
“We have completed several projects all over the state of Alaska. Some of the big projects have been the opening of Samuel Simmonds Memorial Hospital in Barrow Alaska [and] Norton Sound Health Corporation Hospital in Nome Alaska,” Axtell says. “ACES is a project orientated group of technicians; [and] have installed a six-room dental clinic in Kodiak, Alaska, and X-ray systems, both dental and medical in various places throughout Alaska. Truly there are way too many projects to list them all.”
Not only is Alaska the largest state, but it is also the most sparsely populated. The sheer expanses the team at ACES has to cover, along with the modes of travel, make any workday challenging and unique.
“Every day is a challenge for ACES personnel, we travel all over the state of Alaska. ACES personnel travel three weeks each month and are in the office one week,” Axtell says. “An easy week for our technician looks kind of like this: 5 a.m., arrive at Anchorage International Airport – the weather may be 50 degrees.”
“Depart Anchorage to Barrow Alaska (723 air miles away). This flight has to stop in Fairbanks, Dead Horse Alaska, then to Barrow. Arrive in Barrow at 12-1 p.m.,” Axtell adds.
He points out that when the biomed arrives in Barrow, it could be 20 degrees below zero.
He says that all the travel on Monday would be followed up with four 10-hour days. Then, the biomed would depart Barrow at 11:30 a.m. and arrive in Anchorage around 3:30 p.m.
A crazy week for a technician would take this scenario a step further. The biomed might depart Anchorage at 6 a.m. on Monday on a small plane to Bethel, Alaska. They would arrive in Bethel at 10 a.m. The department member would then get on a bush plane and head to four to five small village clinics throughout the week.
“Technicians may travel on boats, float planes, snow machines, four-wheelers; we have even had technicians travel by dog sled to the clinic,” Axtell says.
Extreme HTM
If that overview of a typical day doesn’t sound over-the-top enough, consider this one.
“One of the craziest trips our technicians have ever had was a two-day trip to St. Paul Island, Alaska,” Axtell recalls.
“We chartered a flight to St. Paul to fix some medical equipment. After arriving at St. Paul, the fog, wind, and rain came in and the technician and the pilot were stuck for a total of 21 days. So, a two-day trip was now a 21-day trip,” he says.
Another time, one of the biomeds was visiting Adak Island and while there a tsunami warning was issued. The biomed had to make his way to the highest point of the island and wait it out.
When the team members are back in Anchorage for that one week each month, they are busy closing out all of their work orders and setting up all their trips for the next three weeks. They are at home on the weekends.
The four biomed technicians in the department were all hired from the lower 48. The lead tech is from Alaska. Axtell has lived there most of his life and the department’s office specialist is from Alaska as well.
For the biomeds, it’s a testament to the tradeoff of living in one the most beautiful places on earth, and facing the additional challenges of a biomed job that’s like no other. Axtell points out that for those living in Alaska, you go from your heated house to your heated car to heated stores and heated work places when the weather is extremely cold. He says that the summers are for fishing.
The team members of ACES love Alaska and everything the state has to offer – that is their reward for the occasional dogsled commute or a tsunami warning.