Help Wanted

Positions unfilled due to EMS labor shortage

There are several critical elements that determine medical outcomes during an emergency. A well-equipped emergency department at the local hospital, a capable team of physicians and nurses on duty and a ready supply of life-saving drugs all combine to treat serious health cases at a moment’s notice.

One healthcare component is even more important than these critical services — the EMS personnel that are first on the scene of an accident, house fire or other catastrophic event. These highly skilled individuals, providing crucial medical triage and expediting the transport of patients to medical facilities, are often the difference between life and death.

Buddy Bodenhamer, EMT/ EMS Coordinator, has been providing critical EMS medical services to the community for 19 of his 23 years in health care. For the past 18 years, he’s been on staff at Baxter Health; 15 of them have been spent in EMS roles. His services have never been more crucial than today as the hospital finds itself in the middle of a shortage of people looking to enter this life-saving field.

“The shortage is a national shortage,” he said. “In Arkansas last year, when they recertified, we lost a total of 743 licensed personnel, and a total of 478 of them were EMTs. Some of them just retired, and some of them may have moved on to nursing and just let their licenses go.

“I love what I do, and it troubles me that other people get into the profession and find a reason they don’t like it, for whatever reason. Sometimes it’s the hours that we work, sometimes a certain call can haunt them and get them out of this profession.”

James Pinkston, RN/NREMTP, Baxter Health EMS director, is quick to point out that the department has enough two-person crews to staff its trucks but admitted that hasn’t always been the case during his 25 years in the profession. He also said he’d jump at the chance to hire more people if they were available.

“Right now, I could hire five paramedics and at least six EMTs if I had the availability to do it,” he said. “It’s not just a local shortage, it’s a state shortage; it’s a national shortage. It’s all across the U.S.

“I don’t know if there’s one thing that you could point your finger at. I know when I first got into it, the culture seemed a little different. EMS has really only been around since the Vietnam era; it just hasn’t been around that long. I don’t know if it was maybe more TV shows or movies or something that really led me to it as an adrenaline-type thing, but I feel like that’s been maybe a little subdued over the years.”

Emergency medical services is an umbrella term that covers a number of roles by which a healthcare entity provides medical treatment on-scene. Per the National Association of Emergency Medical Technicians, the entry-level patient-facing role in EMS is the emergency medical responder, trained to provide on-scene interventions while awaiting additional resources. These licensed professionals may also serve as part of a transport crew.

With additional training, a person can graduate to emergency medical technician and advanced emergency medical technician, which are licensed medical professionals that conduct different levels of basic, noninvasive interventions on-site and on the truck to reduce the morbidity and mortality of acute, out-of-hospital emergencies.

The highest level of EMS positions, paramedic, is an allied health professional who possesses all of the skills of EMR/EMT, as well as training to conduct a broader range of treatments, including invasive and pharmacological interventions.

Working in the EMS field is as stressful as health care gets. Paramedics and EMTs work long hours — Pinkston said Baxter crews typically work 24 hours on/48 hours off to start, with some working 48-hour shifts followed by five days off — during which they are often faced with the most graphic of medical emergencies.

Despite these facts, most experts point to COVID-19 as the true source of the current shortage. NBC News reported as many as one-third of all on-truck EMS personnel left the profession in 2020, an exodus the medical community has struggled to recoup ever since.

Doug Wintle, director of EMS education at Arkansas State University-Mountain Home, said enrollment in the school’s programs is ticking upward, but it still pales in comparison to the need.

“Right now, we will finish 11 EMTs in December, and another class has started with eight people in it that will finish in May,” he said. “I’ll start another course in January, so over the academic year, we will conceivably put about 25 EMTs out there. Our pass rate is 88%, so roughly nine out of 10 students who study here get their license.”

Wintle said the numbers are diluted somewhat by the fact that some students are already employed by or connected to other emergency entities, such as fire stations, and thus are not looking to take their newfound training to other employers.

“Most of the EMTs we graduate want to work here locally, and many of them are employed by Baxter,” he said. “At the same time, I have a recognizable number of students that take the course who work in local volunteer fire departments.”

Training in EMS jobs can take anywhere from a few weeks to a couple of years depending on the level, and gender parity is improving as more women enter the field. The college has stepped up its efforts to recruit new students into its training programs, Wintle said, including reaching down into local high schools.

“This is about our third year now where we’ve been enrolling high school seniors,” he said. “We reach out to students at the high school level that might want to enter into the medical field — a lot go from EMS jobs into nursing — and let them know emergency medical responder and EMT training are good places to start.”

Meanwhile, Baxter Health continues to invest in the 70 or so EMS personnel it has on staff, offering programs and scheduling flexibility to help frontline employees deal with the stressors of the job or balance other obligations in an effort to boost retention.

“According to our HR department, we are paying near the top of the scale, and we try to accommodate as many scheduling requests as we can,” Pinkston said. “We also offer counseling services and other opportunities like that to help people talk about things that they might encounter on the job. We are like a family here and we’re very close-knit, so we’re always trying to find ways of looking out for our people.”