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Training to save lives: Islander TJ Dalton is on track to be a paramedic

Think you’re busy? Then don’t compare yourself with Islander TJ Dalton.

He’s an EMT with the Shelter Island Emergency Medical Services — named EMT Volunteer of the Year last October at a gala awards dinner — and is in the middle of a 15-month training program to become certified as a paramedic.

While still on call on the Island with the EMS Friday through Monday morning, Mr. Dalton travels Monday and Wednesday evenings to either Lake Success or Bay Shore for lectures, and classroom demonstrations in a paramedic training program run by Northwell Health.

On Tuesday’s and Thursday’s he’s back up-Island on what is called “rotations,” being on ambulance calls, in hospital emergency or operating rooms.

Life has become a juggling act. Four days a week he’s not sleeping at the Island home he shares with his fiancée, Kristina-Li Neknez, who is also a volunteer with the Shelter Island EMS. “A lot of the time when I get out of the classroom or come off rotations, the ferries have shut down or I won’t be able to make the last boat,” he said.

So he overnights with Ms. Li Neknez’s parents in Southampton or bunks in with his brother in Queens. In addition to his intense regimen of study and training, he works for Musicivic, Inc., an online organization involved in teaching and community work, where he works in video production.


Music and medicine have always been twin passions, he said, beginning in high school. He has a Masters degree in music from Stony Brook University, specializing in classical guitar. He’s taught guitar and music, and has been part of the Stony Brook Baroque Ensemble, teaching and performing across the country. He especially likes giving seminars on the music to students and at retirement homes, with instruction, master classes and performances.

“My life was good, and music is great, but I needed something more, to give back to my community,” he said, which led him to the EMS.

He joined the Island EMS about two years ago. A lover of the  water — he’s a certified dive master and surfer — and the outdoors, he had taken a wilderness Emergency Medical Technician (EMT) course run by the SOLO School in New Hampshire.

“When I finished, it just seemed natural to join the EMS at home here,” he said.

EMT of the Year went to TJ Dalton, flanked by EMS Director Jack Thilberg, left,and Chief Mark Kanorvogel, at the EMS annual award’s dinner on Oct. 5, 2022. (Credit: Adam Bundy)

The distinction between EMTs and paramedics is often confused. EMTs generally receive 170 to 200 hours of training, while paramedics receive 1,200 to 1,800 hours. Paramedics are educated in “advanced life support,” which means they can employ advanced medical procedures in emergencies, including administering medication intravenously, monitoring electrocardiograms, and what is called “airway management,” which can include intubation (inserting a tube) and performing tracheotomies.

The Island’s EMS has had no paramedic on its staff since Phil Power retired in 2021. But advanced life support medical aid by qualified paramedics is provided for a daily 12-hour shift through the Southampton Hospital Foundation.

The classroom work in the Northwell program has lectures, and “skill sessions,” hands-on demonstrations of emergency scenarios, Mr. Dalton said. “It’s simulations of what goes on in the real world,” he added, including the use of mannequins, which are startlingly real.

“They look human and breathe, speak, have a pulse, blood pressure, you can use an EKG and put in IV’s,”  Mr. Dalton said.


On the rotations with ambulance services, the real world is not simulated. The work is intense and sometimes close to non-stop. The on-call shifts range from 8 to 13 hours. “A slow day for an 8-hour shift will be three calls, but that’s a slow day, ” Mr. Dalton said. The ambulance crews can arrive at a scene to find everything “from a tummy ache to trauma.” 

This week he’ll be in an operating room to learn skills, including observing anesthesiologists on how to administer medication, monitor patients’ responses, and keep airway passages clear.

For all the long hours and shifting schedules and travel, Mr. Dalton said he finds training fascinating and rewarding. “I’m learning about symptoms, and about the diagnostic process,” he said. “There can be up to 10 symptoms and you have to play detective, using the diagnostic tools like EKGs, and how to treat someone during transport, and relieve their stress.”

The program is attuned to the pressure that trainees are under and how it can affect their well-being. They are required to keep a journal of their week, “and especially tough calls,” he said, and it is then reviewed. Burnout is a real danger, and “we regularly discuss it with our instructors. They keep track of us and we all check in to see that we’re in a good spot.”

There is a shortage of paramedics regionally and across the country. Research by the American Ambulance Association found that 55% of part-time paramedic positions were unfilled because of a lack of trained candidates. An article on the Pew Charitable Trust website noted that “a lack of work-life balance and burnout are among factors driving emergency medical services personnel around the country to quit ambulance duty.”

Mr. Dalton is unsure where he will land when he is certified this December. There are many options open for him to practice the profession he’s chosen. But one thing is certain — his bond to Shelter Island and the community he serves and loves. “I’m not going anywhere,” he said.