The trouble with EMS

On January 26th, the Bergen Record ran a front page article entitled, "Lack of EMS volunteers hurts wallets ", and on January 30th the Herald News ran an editorial entitled, "Creativity may be needed to fill EMS crews". In both of them, they discuss the dwindling ranks of EMS volunteers and they offer the usual explanations and the usual "cures" for the problem.

I would suggest that, while the "hectic" lifestyle and "need for 2 wage-earners" are indeed contributing factors as is the 120 hour course (no need to tell me since I'm going through it now even though I'm a former EMT instructor - a future blog on the stupidity of the New Jersey Department of Health - listening Governor Corzine?), they are not the biggest disincentive.

I would also suggest that, while the stipend and pensions are incentives, they are not the biggest incentives.

I am currently in class with over 70 new EMT students (part of the 250 currently training in this semester in Bergen County - that's an average of 3.5 new EMTs per town). They are all committed and excited to get involved. They represent a new level of excitement and dedication that pours from the academies every semester. So if towns have the potential of adding 7 new EMTs every year, where is attrition coming from?

I would begin to look at the current structure of local EMS starting with the local ambulance corps and going up to the state level with the New Jersey State First Aid Council. The problem is management (or lack thereof). Every local corps is run by elected volunteers and thus the management is only as good as those who win that year. Sometimes corps are lucky and they get someone who has the time (because it's virtually a full-time job), the competency, and the fairness to do the job well. More often, they get the current most popular person or the person "who's due" and they may not have the time, skill-set, or impartiality to deal with the variety of personalities, needs, and situations that arise in this position.

In addition to that, as a non-profit volunteer organization, much of the EMT's time is spent in non-medical pursuits such as equipment maintenance, fund-raising, and politicking. This detracts from the reason that they joined in the first place which is to provide first aid to those in need. Stuffing envelopes and arguing over which bills to pay this month were not in their concept of what they were signing up for. The disillusionment over this, combined with the more hectic lifestyle, is a more probable reason for the high turnover. A professional who wants to volunteer their time to "give back to the community", does not want to come home from a day of meetings and corporate politics to have to deal with more meetings and ambulance corps politics. They want to come down to the ambulance building, spend some time training with people they enjoy and respect, and respond to emergency calls.

For this reason, the stipends and pension plans are not going to be enough to satisfy these people. What they would appreciate more is an ambulance corps that allows them to focus on the reason they signed up. It's funding/spending should be 100% from the town budget, it should have a professional, paid administrator, and the volunteer should be made to feel appreciated. The department can still elect officers to work "out on the street" while the administrator takes care of the "back office". This would include supplies, maintenance, paperwork, and any other duty that doesn't directly involve emergency response.

I think if towns were to start to do this instead of use their money for stipends, they would see an increase in the recruitment and retention of volunteers. There are a lot of people out there who want to volunteer, but they don't want to waste their time. To see more about how to care for these people, I would suggest reading a copy of The Care and Feeding of Volunteers by Douglas Johnson.

Thoughts anyone?