By Mallory Parker
“The White Paper” was a piece of legislation that formed the Department of transportation and birthed what EMS is today. It allowed for an emergency response to traumatic injury and transportation to the hospital. Today, over 240 million calls are made into 911 nationwide to roughly 21,000 ambulance services employing approximately 260,000 EMTs and paramedics.
Ambulance services across the country are facing shortages of both EMTs and paramedics. EMS has a turnover rate of close to 30% and an average career span of an EMT or paramedic is less than 5 years. With a 48-hour workweek, overtime makes up close to one-third of a medic’s paycheck. If a medic gets sick or takes vacation they are taken down to a 40-hour workweek, ultimately losing income they may depend on. Many medics work several overtime shifts or work a second, and sometimes third job to feed their families and pay their bills. In addition to the poor salary, medics do not have a pension, like their other emergency response counterparts. In fact, Medics are not considered an essential service by the federal government. During the COVID-19 pandemic, Paramedics and EMTs did not even receive much-deserved hazard pay due to lack of funding.
Fifty-four percent of EMS services still work 24-hour shifts. This means that for 24 hours, medics are at a station and “on-call” to respond to 911 calls. In this time frame, medics will struggle to find time to eat or sleep, as they can only do these things when they are not running calls. After their shift, medics often return home exhausted and in desperate need of sleep, further keeping them from their families. The five-year-old daughter of a local paramedic once came home from a sleepover and said “did you know, my friend’s dad is home every night?” This shows the effect the long hours of first response has on even the youngest members of the community.
When asked “what do you see as the biggest problem in EMS?” one 11-year medic responded with “I think the biggest problem in EMS is the internal negative culture. There are a number of factors that contribute to this problem: low staffing, high call volume, relatively low pay, history of negative or ‘burn out’ culture, poor retirement, and high turnover due to aforementioned issues.”
Another response to this same question, answered by an “old-timer” of 22 years with experience in Fire and EMS said the problem wasn’t the profession itself, but how it is perceived. “EMS itself does not need much changing,” he said. “The profession needs to be recognized for the specialty it is. Clinically, paramedics are considered equal to nurses. The average nursing salary in the US is 2.5-3 times that of a paramedic when paramedics apply their trade in the worst imaginable conditions (such as the on the side of the road in a mangled car during a rainstorm on a barely breathing trapped patient, CPR on an infant in a drug house at 3 a.m with no electricity, or a shooting victim in the streets where the shooter is still at large.) Meanwhile, nurses consistently get to work in the hospital is always a cool 76 degrees with proper lighting and teams of experts, as well as highly sensitive and expensive diagnostic tools at their disposal.
“There also is no future currently in EMS,” they continued. “Because of its notoriously low pay, combined with exponentially increasing call volumes and staffing shortages across the nation, it has become a stepping stone profession. EMTs very soon are looking into more schooling to move to a better-paying career. If the profession was able to gain the financial recognition it deserves, along with the respect it deserves, that would go extremely far in retaining EMTs for an entire career. But that also leads to the question of retirement. Unless an EMT/ambulance service is attached to a fire department, there is virtually no retirement or pension nationally for EMTs. Aside from a passion for the job, and compassion for the citizens they serve, there is sadly very little to keep EMTs in the field for long-term careers.”
Another medic was asked “What would you tell a current EMT/Paramedic student before they enter the field?” and the 5-year veteran EMT responded with a litany of answers. “Make sure it is something you want to do. Make sure you’re okay with missing holidays, family events, etc. Be ready to work overtime. Don’t expect to make a lot of money unless you’re willing to sacrifice a lot of time to overtime or have another job. Understand there are some things that can’t be unseen. Don’t get burnt out.”
First response has evolved from the early use of trauma-only response to now include sickness, minor injury, and in some cases, simply not having a ride to the hospital. In part two, we’re going to explore possible solutions for this epidemic in our EMS.
