Chief of Operations Stueben County EMS. Andy Grote

In this episode of Frontline Voices, we sit down with Andy Grote, Chief of Operations for Steuben County EMS—a leader at the center of emergency medical response, system coordination, and frontline decision-making.
Chief Grote brings a unique perspective on what it takes to manage not just patients, but an entire EMS system. From overseeing daily operations to navigating high-acuity calls, staffing challenges, and evolving demands in prehospital care, he shares what leadership truly looks like behind the scenes.
In this conversation, we cover:
The realities of leading EMS operations in a busy and diverse county
How critical decisions are made in fast-moving, high-stakes situations
Building and maintaining a strong EMS culture under pressure
The importance of training, consistency, and accountability across crews
Lessons learned from years in emergency services—and how they shape leadership today
We also dive into the human side of the job—balancing operational demands with the well-being of providers, and why strong leadership matters now more than ever in EMS.
This episode offers a candid, inside look at the challenges and responsibilities of keeping a community’s EMS system running at a high level.
If you want to understand what it takes to lead from the front in emergency medical services, this is a conversation you don’t want to miss.

Transcript

SPEAKER_01 0:04

This is Frontline Voices. Conversations with our local people. Here's your host.

SPEAKER_00 0:12

Hello, Andy. Welcome to the show, Frontline Voices. Thank you. I appreciate your time. Uh it's nice to get people out from the community that that a lot of people aren't aren't aware of that that exists. We do know that you have a class coming up for the actual Hudson Fire Department, for the public, for uh the Stop the Bleed. So we'll cover some of that, but we just want to talk about you and your different programs and stuff like that.

SPEAKER_01 0:37

Sounds good. Appreciate your time today.

SPEAKER_00 0:40

So Andy, for listeners that may not know you, can you introduce yourself and give us a quick overview of the role of your role in Stuben County EMS and med training and consulting?

SPEAKER_01 0:51

Yep. So for some of you guys who know me, uh my name is Andy Gretti. Uh I've been a paramedic for the last 16 years. I've worked through many different agencies throughout Northeast Indiana. Parkview, uh West Central in uh Allen County, uh Whitley County, and then currently up here at first Tuban County, where I'm chief of operations. So my main area is day-to-day operations of the department, managing those, managing the crews, um, and just making sure that service functions as it should. Um in the in my spare time, I own Med Training Consulting, kind of a first responder-based civilian company that we do free training and then also classes for more of the civilian and first responder side to get more education.

SPEAKER_00 1:36

That sounds really cool, Andy. Uh why don't you take me back to the beginning? What what got you into initially into the spark the interest in the uh emergency medical services?

SPEAKER_01 1:46

So it kind of started back when I was five or six. Um, my great uncle was fire chief of Fort Wayne. So kind of grew up in the firehouse. Um my aunt was a nurse, so I spent a lot of my younger days either in firehouse or at the hospital. So kind of just grew from there and just kind of progressed further. Initially, I started kind of going down the fire science career path and being a firefighter, but then um that quickly changed over to emergency medicine and kind of gone that route from here.

SPEAKER_00 2:17

So you came came from a pretty distinct line of first responders and and such like that. So that that was the big um inspiration, I assume.

SPEAKER_01 2:27

It was, it was, yeah.

SPEAKER_00 2:28

So you graduated with your paramedic science degree in 2011. Walk us through that journey. What was the most challenging part of paramedic school and how did it prepare you for the real world?

SPEAKER_01 2:39

So paramedic school uh for me was challenging, but at the same time, it was kind of came natural to me too. Um, I was one of those few people who just and it just kind of clicked for me. Um I think the most challenging part was a lot of the self-study. Um in high school, I struggled a lot um with a bunch of different things like breeding and all that. Um growing up, I have I had dyslexia growing up. So through college, um working through all of that, um, just gave me a lot more self-confidence to get me to where I am today. Um, those challenges have made me grow as an individual and as a leader.

SPEAKER_00 3:18

That's really awesome. Early in your career, you were recognized as a hometown hero with the Cal BMS around 2018 and again in 2020. What does that recognition mean to you personally and how has that motivated you over the years?

SPEAKER_01 3:32

I mean, it's it's always nice to be recognized by other other organizations outside of EMS. Um, but for me, I don't pride myself on I'm more I'm more humble, I guess you could say. So for me, it was recognition not for only myself, but also from a department. Um I always put department first. Um I'm just one individual of a much bigger team. So I felt for me that was just bringing a good recognition to my whole department.

SPEAKER_00 4:02

You've worn many hats with Stewang County EMS, from paramedic to assistant director, and even interim roles. How has the department evolved during your time there, especially in a rural area like Northeast Indiana?

SPEAKER_01 4:14

I think over the last few years, um, kind of EMS as a whole, we've progressed um to a leadership role and to a lead role of our area of being more patient-driven. I would also say bring in the new the newer equipment, we're more progressive, and we're always building every day. I think uh EMS in our area always needs to progress. I think we're starting to become on the forefront of that through some new equipment like our trauma gel we just inserted into our team, um, and also our new monitors equipment. So we're always trying to get the best equipment and the newest technology from our crews so that we can provide our our our citizens with the best care we can. Always trying to drive and be better for everybody.

SPEAKER_00 5:03

Push forward.

unknown 5:04

Yep.

SPEAKER_00 5:05

So for a typical shift, how do you juggle administrative responsibility with still running calls as a paramedic?

SPEAKER_01 5:12

It's challenging. Um right now, current with the current role, I'm more administrative than I am actual on the streets. I try to I try to do 50-50 mix of both, um, but there's times where it's definitely more administrative heavy than it is actual street side. Um but the more higher acuity calls, um, I do go on those when I'm available just just to help lend assistance to my crews. I'm not there to direct them, I'm not there to do that. It's just meaning they're to help assist them because those higher acuity calls, as you know, can be very challenging at times and need multiple sets of hands, and that's where I'm kind of falling that role of.

SPEAKER_00 5:50

Now, going into that, with EMS having its own set of unique challenges, longer response times for rural areas, buried terrain, fewer resources, what is the biggest hurdles you've faced in Stewang County, and how does your team overcome them?

SPEAKER_01 6:07

The biggest challenge we've had, you know, post-COVID, I would say, for a while was the staffing. You know, that was a huge hindrance, and that just not for Sustain County, but that was for the area as a whole. Staffing for a long time was very, very challenging. We were understaffed. So over time we have developed a plan to go with that, to move forward with that. And our staffing right now is 100% good. We're almost fully staffed, we're short from one person right now. But I think that was one of our biggest hurdles. Um, if we look at an operational standpoint, um, through specifically Steven County, with 101 lakes, that poses a huge challenge for us at times. Um, not only navigation, but figuring out you know, where that individual is access to those individuals. So something would happen on the water. And that's something that we work really closely with our departments and also our EMA department to help kind of narrow those areas down. And we're always looking for areas of improvement.

SPEAKER_00 7:08

Now you touched on that with staffing. Um as far as recruitment, you said that you're doing very well with that, you're almost at 100%. How does your department handle retention? Because that is something that that a lot of the emergency services are dealing with, not only staffing for recruitment, but the retention aspect.

SPEAKER_01 7:29

Retention's always hard. Um, but for us, not only are we trying to make it like more like a home atmosphere in a big family, but we also try to, I try to really instill in my crews their opinion matters. So letting them have a voice, letting them help make some of the decisions on the day-to-day operations, giving suggestions, and I take those suggestions and then develop a more fine-tuned formal plan. Um, but I think giving that giving them a voice and having them put input into it helps keep with that retention thing so that they feel they feel are so they feel wanted at the end of the day.

SPEAKER_00 8:07

Keep them involved as part of the team. Okay. In 2024, you and several colleagues received a life-saving award for responding to a medical emergency with the community corrections officer without sharing protected details. What made the call stand out and what does teamwork look like in those intense moments?

SPEAKER_01 8:25

So that that was a very, very unusual day. Um, myself and multiple others of my leadership team at that point were in a um NIMS 300 class. So we're all in class, and all of a sudden pagers went off. Um we were with a couple other fire chiefs from the Angola area, all hell broke. So we knew something big was going on. So we figured out the incident was right across the street from us. So we ran um with even without even thinking, we just jumped into our roles um and had multiple agencies just doing what we do. It ran seriously. Um we were able to get the individual back. Um I see them every day, check on them every day. And that that's a that's a great feeling of in seeing that we are able to save someone. Because a lot of times throughout our careers, we have these type we have had these type of events um situations, but we never really truly know the outcome. Um being able being able to see that outcome every day and talk with that individual every day, you know, it drives home that we do have a great responsibility and it gives us it just keeps giving me a drive. Um and for the members of my team who are on that call with us, I think we kind of feel the same. Um and it just gives us a new outlook.

unknown 9:40

I see.

SPEAKER_00 9:41

With that, situations similar to that, situations all over the place. EMS can be very emotionally taxing. How do you and your team handle the mental health side of this profession?

SPEAKER_01 9:54

So mental health is something that when I started my career, um, was always pushed the back side. It was never really talked about, it was more like you just suck it up and go on. Um throughout my career, I've realized it's a lot more important. Um I've had some very challenging calls, very challenging situations throughout my life, even the last couple years. It's drove home the fact that I'm not able to always take care of everyone in the show. Um needing individual, I'm a fixer. I like to fix things for myself. Well, there's some situations where fixers in that we get to the first time. We need other professionals. So I'm a very big component and supporter of health care training, uh and then also being able to put individuals in contact with the professionals. I really instilled my crews. If they have a bad call, you call at the same time, I'll be able to talk to you. Um we also work with Remedy Live to kind of help offer on the call assistance. If a bad call were to happen, I can call them a one-hander number, get some presentation with them right there, help with that. Um just continually grow. I'm gonna bring it in the forefront. So just being on the cusp of that and providing our crews with the best resources possible to like I want to do that. A lot of my supervisors and other department members have to do as well.

SPEAKER_00 11:31

Very good, very good. Um on a lighter side, you're currently enrolled in the Ball State Certified Public Manager program and are set to complete it in September of this year. What motivated you to pursue the CPM program at this stage of your career? And how is the program shaping the way you think about leadership, public service, and EMS operations right now?

SPEAKER_01 11:53

It was kind of something that was brought to my attention through Stephen County HR Department. Um, but it was a way for me to grow as a leader. I'm always looking at ways to grow not only in my skill set, but also the way I think through situations. Um this course has really helped fine-tune some of that stuff so far. Um it's really giving me some insight of the business world, um, public safety versus private's completely different. So, how can we take some of the best of the private sector and bring it into the public sector of EMS and the policies, procedures, and kind of stuff like that?

SPEAKER_00 12:34

I see. Now, continuing with education, you founded Med Training Consulting in 2018 with the mission to inspire, train, and equip people for emergencies. What gap did you see in the medical training that motivated you to start this company?

SPEAKER_01 12:48

So back then there wasn't a lot of frontline, easily accessible training for civilians. There was some CPR courses out then, but there was no stop of bleed, um, and there was just not a lot of easy access for civilians. So being throughout my career, I've loved educ I love educating not only first responders, but the public as well. And that's what kind of drew me to starting Med Training Consulting was that need for civilians wanting to learn more and not having an avenue to do that. Uh and I feel like with our with my company, we are able to kind of bridge that gap, not only for the first responder side, but also for the civilian side as well.

SPEAKER_00 13:33

Med training offers a range of courses from stop the bleed to pre-hospital trauma life support and more. Why is ongoing education so critical for both professionals and civilians?

SPEAKER_01 13:43

I think people like to learn. Um, with today's climate politically and just the way the world is right now, things are always changing. For good and bad, I'm sure you know. Civilians want to be prepared. A lot of people in Northeast India want to be prepared for that situation. And if somebody were to go on, they're gonna be self-reliant. Um, I'm big about teaching self-reliance through medical site. Um and I think that just gives them an avenue to be more self-reliant and to just grow as what I call civilian responsibility. So as you know, EMS fire response times in rural Indiana is about 10 to 15 minutes for an accident of any sort. Civilians having training like stop the bleed or CPR can very easily save alive and be a very positive uh thing in our communities, and that's what I'm just trying to do is promote community growth within all self-producing.

SPEAKER_00 14:44

One of your flagship programs, the pre-hospital hemorrhage control for civilian responders, often called stop the bleed style training, what makes uncontrollable bleeding such a priority and why empower everyday people with these skills?

SPEAKER_01 14:58

So depending on where the injury is, someone could potentially bleed out between three and seven minutes. Um, from just a normal motor vehicle accident to an industrial accident to a mass casualty school shooting or something like that. Giving these civilians the ability to be trained with tourniquets, woof packing, and press regressing stuff that gives the first responders community a a little bit of a stopgap. It gives us the ability to have the ability to respond as we should, but that individual could potentially be saved through that civilian's training. Um so that kind of just empowers that civilian to get trained, but then have the ability to save a life and just um be community-driven, community-based. It gives them a sense of pride.

SPEAKER_00 15:52

With the most recent flyer, it highlights a strong collaboration with the Ashley Hudson Volunteer Fire Department with their trucks featured and the joining forces theme. How did this partnership begin?

SPEAKER_01 16:02

So this partnership started a few years back when the chief and I uh worked closely when I was at Parkview uh DeCal. Um, we've kind of over the years just developed a partnership of working closely hand in hand. Um we do a lot of trainings professionally together. So when I was looking for an area and a department to hold my courses at, Ashley was kind of just a no-brainer. Um, with you guys being central to Northeast Indiana, um, with 69 so close, it's whole road. We were able to pull in a lot of different clients from not only our area, but from Michigan, Ohio, Illinois. Um it was kind of just a strategic partnership, but then also a working partnership as well.

unknown 16:50

I see.

SPEAKER_00 16:51

Looking at the scheduled dates on the flyer, it shows a commitment to year-round accessible training. What drove the decision to schedule Stop the Bleak classes across several dates throughout the year, and how does that support your mission for accessible training?

SPEAKER_01 17:04

Again, it goes back to everyone's schedule. We're all busy. Um so we felt that I would rather have six or seven courses throughout the year and then just have one or two, it gives the average individual more options. Gives them options to figure out what works for their schedule. Um I feel that if an individual is rushed or is forced into something, they're not gonna want to put that whole effort into it. So giving the ability to pick what time they want, what day works best for them throughout the year, gives them more of a sense of ownership and also the ability to focus on that situation in the course.

SPEAKER_00 17:46

So if an individual signs up for this this training, what what does a typical class look like? What what what kind of things will they be subjected to?

SPEAKER_01 17:55

Yeah, so um really the first the first probably 15-20 minutes of the of the class is kind of a PowerPoint introduction to what we're going to learn, kind of the course objectives. Then it's more getting the hands-on, um, introducing them with what tourniquets are, that the application of the tourniquet, how they work, why we put them in certain locations. Um then we kind of progress further into wound packing, which is going to be kind of where we treat with the junctional areas where tourniquets can't go cannot be applied. Um then we go into the hypothermic state on why we want to keep complications warm. So this course is very hands-on um student-driven. Um we do use PowerPoint, but most of the time it's just as a guide, and I want the students to kind of drive which course goes, and what do they want to learn from that course? Um so we try to make it as real-world scenario so we can all that as possible to kind of tie in everything. Um, and then they get it's again very hands-on. I see.

SPEAKER_00 18:54

Since this program has been launched for several years now, have you gotten any feedback from former students where these real-world techniques have come into play?

SPEAKER_01 19:04

Yeah, we we've had a few over the years. Um I'm glad it's not we don't we we're not getting you know monthly reports. Hey, I'm gonna use your stuff. Um a few years ago, we we dig an individual, took my class, uh, did say he came up on a motor vehicle accident uh from southern, he was down in southern Indiana, and where he actually applied a tourniquet um to a another individual who had a large laceration in the lake. So, again, that's something that you know is very rewarding to me that I know my education is getting out and being used. Uh, but at the same time, I'm also glad that we're not getting, you know, again, monthly reports of use for stuff. Right. Um so it's it's good. So yeah, we we do get positive feedback from that. Um in the same time, uh, we do an industrial class from a bunch of construction companies throughout northeast Indiana, and we've sold kits to them, and we've got reports of them using you know our equipment on industrial accidents and all that. So, yeah, our stuff is getting out there being used in the public spotlight, and it's it's it's saving lives.

SPEAKER_00 20:06

With your instructor certifications and stop the bleed, PhDLS, and the tactical combat casualty care, how do you tailor the civilian courses to be practical yet not overwhelming?

SPEAKER_01 20:18

Great question. So, again, with all those courses, it can be extremely overwhelming at times because that could be a lot of information thrown at them. So, what I do is I try to pull out the most important things of each course that I have taught to the first responders and simplified it so that civilians who are not potentially not trained medically can understand medical terms and how medical things work in a more refined situation and setting so that they can actually learn from that and just not be overwhelmed with just terminology and you know a five, six hour course. We can take these courses and an hour, two hours for a civilian, get them the meat and potatoes they need to be able to say we're gonna have to. I see, I see.

SPEAKER_00 21:14

Looking ahead, the next year, five, ten years, what's the vision in the future of these programs for you?

SPEAKER_01 21:25

Continue to grow. That's my big vision is we continue to grow um not only our our current programs, uh, but I'd like to get into more some other programs like search and rescue, tailor stuff more to the civilians, um, being more self reliant and just continuing to see what the civilians want. Um for fire EMS, we kind of all have our our niches and we kind of have everything that we always know what we want and how to progress down that road. Civilians don't always have that niche, or don't always always have that self reliance. So we're trying to you know offer as much as we can. Some of the things that we just started offering are like ham radio courses. Um so to get individuals interested in great communication, stuff like that. So it's always involved in possibility for the brain shopping.

SPEAKER_00 22:18

That sounds really good. That's a that's a really clear, clear plan ahead for the future. As the podcast is coming to a close, we only have a couple couple questions left. Um for our listeners inspired by your work, whether aspiring EMS professionals or civilians wanting to get trained, how can they get involved with med training and consulting, Stubin County EMS, or similar programs? Where should they start?

SPEAKER_01 22:42

Great sources of social media. Um for like med training consulting, our Facebook presence is really big. We also have an okay presence on Instagram, but our main goal, our main focus is Facebook. Um looks up on Med Sports LLC on Facebook and Instagram, and we try to post weekly on there of some type of educational thing, event going on, and just kind of keep our our clientele up in the know. Um as for Stuben County EMS, if you're looking to get more, potentially more interest in EMS, our career in EMS, again go to our social media page, Facebook, it's Stuban County EMS on there. Um also our county website, uh the Stuben County it's co.stuben.in.us. That's a great source of information. We have a whole page just dedicated to EMS on there. And then all of our job postings are on there if you're if you're interested in flying or position with us, that's all on there.

SPEAKER_00 23:42

All right. Sounds great. Um one last question for you. If you had anybody that you could recommend for the podcast, who would that be and why?

SPEAKER_01 23:51

I actually have two. Two? It's actually that they co-host a podcast themselves called Debrief. Um so Cody Randall and Tyler Burns. So they they both are Tyler um is out of EMS and Fire now, but did have a long established background in that. Um he's kind of repressed into the public side of things or the private side of things, um, but is very big on mental health and things like that. So those two together, um actually Cody also works for West Central Fire, he's a captain down there. Um, but those two have a really good podcast. Um I've been on their podcast in the past, um, but it's those are two individuals that would be very, very awesome to think of.

SPEAKER_00 24:36

Well, thank you. Thank you, Andy. Uh again, thank you for coming by, stopping by the Frontline Voices podcast. Uh, we appreciate everything you do, and we we look forward to seeing how the the Stop the Bleed classes progress and how med training goes forward. Yeah, so thank you.

SPEAKER_01 24:52

Appreciate your time. Thanks for having me today.

unknown 24:54

Thank you.