Overworking volunteers may force changes

By ADAM STEWART

Staff writer

Paramedic Larry Larsen of Peabody has seen a lot in the 24 years he has worked on ambulances. He’s been on more than 13,000 ambulance runs and treated patients from birth to 108 years old.

“I’ve delivered seven babies,” he said Tuesday.

He has also missed a lot of his children’s sports and activities, especially when they are out of town. That is one of the commitments that go along with volunteering on an ambulance crew.

Marion County Emergency Medical Service has an ongoing shortage of emergency medical technicians and paramedics to take on-call time on the five ambulance units in the county — Florence, Hillsboro, Marion, Peabody, Tampa.

Because of the shortage, the department is increasingly reliant on a small number of stalwarts who take 300 or more hours of time on-call per month, EMS Director Steve Smith said.

Kim Ross of Marion is one of those stalwarts. She has been an EMT in the county nearly 25 years and averages between 350 and 400 hours on-call per month.

“Just to make sure our corner of the county is covered,” she said.

But she can’t find fault with people for not volunteering for the ambulance service. Working as an EMT is tremendously stressful and time consuming, and EMTs are frequently injured, she said.

“There isn’t an EMT in this county who doesn’t have a bad back, bad knee, or bad hip,” Ross said.

She hurt her back on an ambulance call during the weekend and was still moving gingerly Monday morning.

Like Ross, Larsen devotes a lot of his time to volunteering on an ambulance. He said he averages about 500 hours of time on-call each month. The total number of hours in a month is 672 to 744 hours.

“What keeps me going is my community,” he said.

Most of his patients are people he knows — friends, family, and friends’ family — and he wants to help keep them healthy.

Time commitments for an EMT are enormous. Ambulance crews often transport patients to hospitals in Newton and Wichita. A transfer to Wichita usually takes three hours round-trip, plus all of the paperwork and restocking afterward.

There also are requirements for EMTs to continue training so they can remain certified. That has recently been exacerbated by changes to EMT certification in the state, Smith said. The changes allow EMTs to provide a greater range of care to patients, which will save lives, he said. However, it takes significantly more training, which is more complicated.

All of those time commitments put a strain on both business and family, Ross said.

“It’s hard on your family, and your relationships, and your jobs,” she said.

She said the department was fortunate that many business owners in the county allowed employees to take time to go on ambulance calls. But it remains difficult for self-employed EMTs such as Ross, who dispatches her husband, as he drives a truck throughout much of the country.

Perhaps the biggest strain is on family time.

“Sometimes you’re not here when I need you to be,” Ross’s youngest son, Christian, said.

She frequently is called away from family meals and school events, he said.

“There is no such thing as family time when you’re an EMT. There isn’t,” Ross said.

Being an EMT in a small community adds extra stress.

“Most of the patients are people you really know,” Ross said.

That is a double-edged sword. While it can be comforting for patients and their families for the EMTs to be people they know and trust, it is more stressful for the EMTs, she said.

Larsen agreed that treating friends and family can add stress, but it is worth it to see them doing better later, he said.

He said he never regrets volunteering for the ambulance crew. He is more likely to feel bad about not being on-call.

“You feel guilty when you’re on vacation and something bad happens to someone,” Larsen said.

Larsen said anyone interested in becoming an EMT should make sure they are doing it for the right reasons.

“The first question I would ask is why you’re interested,” he said.

Excitement, lights, and sirens are the wrong reasons to volunteer on an ambulance crew, Larsen said. People who join for those reasons have a history of giving up soon after getting their certification, if they even make it that far.

The right reasons to volunteer on an ambulance are a love for people and a desire to help them, he said. Even then, it’s important to know that a patient’s survival isn’t entirely in the hands of the EMTs and paramedics. All they can do is give a patient the best chance to survive.

Unless the trend of having fewer and fewer EMTs reverses, Smith predicts changes will be needed in the near future. He said he sees three options.

The first is to see whether an outside, private service would set up in the county. He said that was unlikely because there weren’t enough calls to profit.

The second option, which he said is most likely in the short term, is to downsize the EMS department. That would probably involve having only two or three centrally located ambulance units staffed at all times. Ambulances could remain in other cities, but EMTs would not formally be on-call.

When an emergency happens, both the local and the closest staffed ambulances would be paged. If the local crew responded, the staffed ambulance would be canceled. Such an arrangement would probably result in having fewer committed EMTs because EMTs in outlying communities wouldn’t be paid for on-call time, Smith said.

The final option, which Smith described as financially “unthinkable,” would be to have a service with full-time, professional EMTs on staff at all times.

He said the county would probably need three ambulance crews, based in two stations, at all times. Fully staffing three ambulances would probably take 18 to 20 full-time employees. The average salary of a full-time EMT is $25,000 to $30,000 for the lowest level of EMT certification, with advanced EMTs and paramedics having higher pay rates.

Another major cost of a professional ambulance service would be the stations. Current ambulance barns would be insufficient, because the crews of a professional service would basically live at the station while on duty. That means they would need sleeping quarters, a kitchen, and other facilities not necessary in an ambulance barn.

“We’d like to put that off as long as possible,” Smith said.