Pa. Dept. Experiences Shrinking Pool of EMTs
Source The Times-Tribune, Scranton, Pa.
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Dec. 11--The ever-decreasing ranks of volunteers at the Dalton Fire Company have been an unsettling fact of life for President John Holbert for decades.
The trouble with staffing volunteers, particularly EMTs, is not any lack of interest, but a combination of several aggravating factors -- starting with intensive, time-consuming training -- that compound over the course of a volunteer's career, forcing a choice between earning a paycheck and serving the community.
The numbers started to fall in the early '80s, Mr. Holbert said, but in the last 10 years, the company he has served for the majority of his life has hit its breaking point.
In the late '70s, Mr. Holbert said, the company had around 75 to 100 active volunteers it could rely on when the calls for medical assistance came in.
But by about 10 years ago, the number had dropped to 35.
Today it hovers at around 25.
"It's just dwindled every year," he said. "Every five-year period it seems like we lose two or three people either through someone passing away and we have nobody to replace them with or someone moves and you have nobody to shore up your members."
The problem is hardly unique to the Dalton Fire Company -- which recently entered into a cooperative agreement with the Factoryville Fire Company to maintain ambulance coverage of the two communities without the two companies going broke.
"The real shortage in volunteerism is on the ambulance side," Mr. Holbert said, adding that five to 10 years from now "you're probably going to see the volunteer ambulance disappear."
"It's going to be all paid because there's not enough people," he said.
Drop in numbers
Mr. Holbert said he started to notice the number of the Dalton Fire Company's volunteer EMTs drop off significantly in the 1990s.
Year after year, the number of teenagers coming in to sign up and start training to become emergency medical technicians continued to dwindle. While the terrorist attacks of Sept. 11, 2001, sparked a brief surge in emergency volunteerism across the board, the inspiration did not last very long, Mr. Holbert said.
For Mr. Holbert, emergency volunteerism is a "calling." But a lot is asked of those who heed to the call -- a life-altering commitment of time and availability that, for local companies, has pushed many existing volunteers out and kept new recruits away.
Whatever the specific cause of a given volunteer's decision to hang up their gear -- higher education, a second job, relocation -- the shrinking ranks of volunteer EMTs across the area has forced ambulance companies to rethink what it means to be a volunteer company.
In October, the Dalton Fire Company entered into a cooperative agreement with the Factoryville Fire Company in which each company pays for one EMT and the pair covers either company's ambulance on alternating weeks, responding to calls in both communities during the weekday daytime hours.
In South Abington Twp., the Chinchilla Hose Company pays for two EMTs of its own to work those hours as well, said James Waters, assistant chief of emergency medical services for the Chinchilla Hose Company.
The Old Forge Ambulance Company went that route about 10 years ago, President Bernie Smicherko said, but as time went on the arrangement to cover the daytime hours created a Catch-22 for the company.
"Once you start paying somebody to do a job, it's kind of hard to get them to volunteer and do it," Mr. Smicherko said
Today the only volunteers at the Old Forge Ambulance Company are the administrators.
Tough sell
When prospective volunteers hear the calling, the odds of actually becoming certified EMTs are against them.
For young teenage recruits, traditionally the most reliable source of volunteers, the problem in large part is the difficulty in sustaining interest and availability over the years of training required before one can actually sit down in the back of an ambulance and feel their heart pound as the siren screams above their head.
"Say we get 10 new members when they're 14," Mr. Holbert said. "When they reach 21 years of age, if we have one or two of that 10 that last we're doing good."
Mr. Holbert said about six years ago the Dalton Fire Company had eight volunteer certified EMTs join the company.
A couple went to college, a couple more went on to start careers and another took a paid EMT job elsewhere.
"The next thing you know, from eight guys you're down to three," he said.
But even for older recruits, the demands of training often prove too high a hurdle.
"The time for training is phenomenal," said Assistant EMS Chief Waters, of the Chinchilla Hose Company. "It's not just a 16-hour class and you're done. It's 160 hours just to start."
Older volunteers who come in cold, without any training whatsoever, have at least a year if not 18 months of training to go through before they can begin to contribute from inside the ambulance.
"Are you going to keep them after that year and a half? I don't know," Mr. Holbert said.
The price of volunteerism
Despite the diversions, the intensive training, there are those who become volunteer EMTs and help to keep their company's calls answered.
But volunteers have their own bills to pay.
"The biggest problem is the economy," said Wanda Schofield, ambulance captain for the Factoryville Fire Company. "A lot of people have to work two and three jobs just to make a living for their families."
Mrs. Schofield stands by her volunteers, whom she describes as "dedicated" individuals who hold the community as their "main concern" -- "getting them help when they need it," she said.
But, at the same time, "people have to work."
"In some households both wife and husband have to work so if the wife is a volunteer EMT, she has to watch kids while the husband works and vice versa, so a lot of times they can't," Mrs. Schofield said.
Like anyone else, volunteer EMTs have lives and jobs and sometimes they don't have the time to respond to the myriad of calls for medical assistance in their company's coverage area.
"That's where the problem comes in," Mr. Holbert said. "That's why we hired the EMTs for the day time."
Some employers allow volunteers to respond to calls during work hours, but that isn't very reliable.
When he was still a responding firefighter, Mr. Holbert remembers times when calls would come in and, depending on his employer at the time, he would have to ask himself a simple question -- "What's more important?"
"I would take chances and go ... but I didn't want them firing me," he said. "It gets very frustrating at times."
At this point, the ideal outcome for a volunteer company like Dalton would be to at least "maintain attrition" of older members hanging it up by keeping those one or two rare volunteers that keep coming back year after year until they're fully certified.
At the Old Forge Ambulance Company, after introducing the two paid EMT positions during the daytime hours, the combination of a weakening economy, competition with paid companies and the unwillingness to volunteer for a role others are paid to perform has eradicated volunteer EMTs entirely.
"You're seeing less and less younger people getting involved in it. Most of them are going right into a paid service," Mr. Smicherko said. "It's a problem that just about every ambulance company in the area has."
Necessary as it has become for many volunteer ambulance companies, in Old Forge the concept of paying EMTs has compounded the problem of attracting volunteers.
"It's harder to attract someone and say 'You got to do this, this and this -- and by the way you're not going to get paid for it," Mr. Smicherko said.
Today, every EMT that jumps out of the back of an Old Forge Ambulance gets a paycheck at the end of the week.
Out of the pool of 18 EMTs on the company's payroll, two staff every shift, as per state law, Mr. Smicherko said.
The Chinchilla Hose Company's experience with that arrangement has been different, though.
When the company began to staff two EMTs for weekday daytime shifts, it afforded its volunteers a reprieve to spend the work week working and having the time to report to the company at night or on weekends, Asst. Chief Waters said.
"We actually saw an increase in people coming out," he said. "Some people felt obligated to be there the whole day and it's taking a burden off."
Whether the solution is combining coverage areas, hiring EMTs for some shifts or transitioning into an entirely paid service, every company is faced with the same dilemma.
"You can't call that rig unless you have qualified people," Mr. Holbert said.
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