EMT shortage forcing county to consider new staff options

“People are used to having an ambulance around, yet if we don’t have the people to staff the crews, we may have to look at a central center. Then people would really have to wait,” said Deanne Olsen, office manager for Marion County Emergency Medical Services.

The county’s emergency medical technicians (EMTs) are a special group. Besides being the largest volunteer service in the state of Kansas, and, having, according to staff, an “outstanding director” in JoAnn Knaak, the service is beginning to show the signs of fading into a lost future.

After nearly 30 years of service you might think they would “burn out” or get “fed up” or simply “worn out.”

But they don’t seem to do any of those things, in fact, they continue to be concerned about the people they tend to, and the future of the department they have served over the years.

“We don’t lose members to burnout,” said JoAnn Knaak, director of the EMT program. “We either lose them as they move on to further their medical education or because they retire.

“We take good care of their emotional side, and that’s how we keep them. We debrief after a tough time. We get on the phone and talk to each other and we listen.”

Knaak, who has at least two former students in medical school, several paramedics across the state, countless nurses and various other medical “children,” takes pride in the program she has developed in the last 30 years.

As EMT instructor for a class that goes through about 200 hours of instruction, Knaak said she makes sure students are ready to take the state exam.

“You bet I make sure they are ready for that test. Someday they may be taking care of me and mine!”

Knaak explained students learn the material in class, and once they demonstrate a level of proficiency they are allowed to put into practice what they have learned under the watchful eyes of a certified EMT, thus balancing “book learning” with “hands-on” experience.

But new people are not signing up to replace those who have moved on, or to fill the spaces by those who must work regular “day jobs.”

For example, the city of Hillsboro currently has 15 members on its EMT crew who divide nighttime and weekend duty. But only five are available for daytime hours, with three of those five available on a regular basis due to work schedules.

Peabody has 14 on the crew for night and weekend calls with three available for daytime calls.

Tampa has six crew members with two available for days.

Marion, the city in the most need of help, has seven members on the crew. But due to injury and other circumstances, Marion has only four active members to divide the seven day 24-hour call time.

Olsen pointed out that EMTs must be within five minutes of the ambulance while on call duty.

“So they can’t just run to Newton or over to Hillsboro, they have to stay right here in town,” she said.

Olsen said she feels the EMTs working so many extra hours are giving up a good portion of their life just to enable Marion to continue with the service.

Gene Winkler, Marion, has been a part of the EMT program since 1972, is concerned about the current worker shortage.

“We’ve tried to do everything,” he said. “People just don’t have time. They need second jobs, but this just doesn’t pay enough for a second job. I don’t know what the answer is.”

The current pay for the service all over the county is $1 per hour per call time, and $25 per hour when a call is made.

According to Knaak, the state requires two people to be certified to transport a patient. One of the two must be an EMT; the driver can be a first responder.

“If we could get one first responder for each EMT in Marion, that would relieve the situation a little bit,” Knaak said.

A class for training first responders requires about 40 hours of instruction and is a first step in the EMT “ladder.”

After becoming an EMT-B, an Emergency Medical Technician-Basic, a person can do cardiopulmonary resuscitation (CPR) and first aid, correctly apply a splint, and use esophageal intubation-a tool that helps people to breath-to name a few of their emergency skills.

A person has the option to add hours of specialized training to acquire other certifications:

n An EMT-I is trained to start an intravenous line without medication. This provides a way for more skilled technicians to give certain medications under a doctor’s order as necessary.

n An EMT-D is trained in the use of a cardiac defibrillator.

The next certification available, which Knaak received several years ago, was formerly known as the paramedic certification. Today it is called mobile intensive care technicians or MICTS.

Randal Claassen, a Hillsboro physician, is the medical director for the Marion County EMT program, and is responsible for the written medical protocols.

“Dr. Claassen is a good medical director,” Knaak said. “He has allowed us to be progressive.”

With excellent staff support, good equipment and strong balanced training, where are the people willing to participate in the program?

“I don’t know what else to do,” Knaak said. “But it won’t be long until we have to look at other options.”

Olsen added: “This really can’t change too much until spring of 2002. If someone wants to come on board right now, they have to wait to take the course which starts in the fall of 2001, then the state exam in 2002.”

Knaak said she would be willing to consider a daytime class, but few people are able to give leave their jobs to participate.

“We are fortunate to have the crews that we do have, they work together so well,” Olsen said. “They are human, and I have seen them put aside any differences they have to work together as a team for the good of the patient they are caring for. We just really need more people to be a part of that team.”

Two options have been considered if new people don’t become a part of the program.

One is a centralized ambulance service, which Knaak says will require a full-time paid position and a house.

“The state has standards,” she said. Those standards include having a place to cook and eat, and sleeping quarters for those on call duty.

A second option is to have other EMTs come and help Marion during daytime hours to relieve those four.

“We currently have someone from Canton coming into Hillsboro for a day to help out,” Olsen said. “They just are in town and available for call.”

Knaak said: “We need to help people realize they could be doing something positive for their community. We’ve had new people in the area take the class just to get to know people and to begin to get involved.”

“The best part of being an EMT,” said veteran Gene Winkler, “is the helping people. That’s the best.”

For more information about the program or classes, contact JoAnn Knaak or Deanne Olsen at 316-382-3271.

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