What happens when the minutes — when the seconds — that decide between a funeral and recovery are put at risk because our emergency responders are being stretched too thin?
Staffing has been tough for years, but with the added stress of the ongoing COVID-19 pandemic, there are now hundreds of EMS vacancies in counties all around the Tampa Bay area.
This is one worker shortage impacting the entire country that’s a matter of life and death.
“EMS is a calling,” says Valentin Del Orbe, an operations supervisor with American Medical Response. “You genuinely want to do this. Those who last long, it’s because it’s in them, it’s in their person…But the burnout? The burnout is there.”
Day after day, call after call, our emergency medical teams step up to save lives.
But this industry-wide worker shortage is wearing down crews across the country, and now they are the ones who need help.
“The workforce is tired,” said Terence Ramotar, the president of the Florida Ambulance Association. “They’re working overtime to cover those slots that can’t be filled. We’re seeing this exhaustion, we’re seeing this fatigue in the workforce.”
He says the shortage of EMTs and paramedics is worse now than it has ever been in his decades-long career.
“Not many people walk around during the day planning that they’re going to have an emergency that day,” he said. “But when it is, their expectation is that someone is there to help. So, not always, during these times, and not everywhere in the state of Florida, are we going to be ready to have an ambulance waiting around the corner for your emergency.”
Del Orbe has been in the industry for more than 20 years, and says, while emergency crews across the country are dealing with shortages their jobs are also impacted by worker shortages at the hospitals.
“That domino effect from the nursing shortages, and the staffing shortages in the hospital, to us having staffing shortage, it just continues to trickle on and trickle on,” he said.
Let’s say you call for an ambulance, but there are no more beds available at the hospital because of staffing. Depending on the urgency of your issue, you may just have to wait in the ambulance until a bed opens up.
It’s called “wall time.”
And it can take hours.
“That wait can be extraordinary,” Ramotar said. “Sometimes we’re waiting [for] 1,2,3,4, upwards of 6 hours, and that’s an ambulance that’s tied up that can’t respond to someone else’s emergency.”
So what’s causing the shortage for our emergency medical responders?
EMS crews tell us, it’s not just one thing.
Some left because they didn’t want the potentially high exposure to COVID.
Some retired early when the pandemic hit.
Others left for other medical fields with higher pay.
And others left the industry altogether after getting burnout from covering the extra shifts.
“They’ve been working under conditions they never imagined they’d be working in,” Ramotar said.
He explained how wearing PPE for an entire shift can be brutal for a job as physical as emergency response…especially when Florida heat kicks in.
Del Orbe says, not only are people leaving the industry, but they also aren’t getting the typical influx of new EMTs.
“The schools themselves have been shut down or delayed,” he said. “So their programs have been delayed.”
And what crews get paid in the industry often doesn’t help.
We asked for county data from places in the bay area to take a look at the average starting salaries for EMTs.
They ranged from the highest in Highlands County at about $44,000 a year to Hardee County at about $26,000 a year.
Here are the responses we received from around the bay area:
Citrus County: "EMTs on a 24-hour shift have a starting wage of $13.45/hour and an EMT on a 40 hour week have a starting wage of $18.53/hour."
Hernando County: "$37,666.72 annually ($13.96/hour)."
Hardee County: “Current starting pay per Union contract ending September 2021 is $12.96 per hour, we are actively in negotiations for 2021-2024 contract term.”
Highlands County: “$44,129.28" a year.
Hillsborough County: “We do not hire only EMTs, we hire firefighter/EMTs at $18.55.”
Manatee County: “Annual MID $43,796.00.”
Pinellas County: “EMTs are now starting at $39,491, as of 10/01/22 it will be $44,067 and as of 10/01/23 it will be $46,355.”
Polk County: “Firefighter/EMT is paygrade F22 Step 0 (Starting Pay) $14.44 per hour”
Sarasota County: "$41,000. Additional pay provided for paramedic certification.”
Pasco County has not yet responded with the data requested.
“We need funding, we need assistance,” Ramotar said. “Most of how we get reimbursed are by fixed fee schedules…we now have a minimum wage mandate that was voted in a few years ago. So now we’re looking at moving this workforce to a minimum wage of $15 an hour. We don’t have the means to secure more funding to do so.”
In October, leaders from national groups representing these emergency workers wrote a letter to Congress asking for help combatting the shortage and the problems that came with it.
The letter said, “overall turnover among paramedics and EMTs ranges from 20 to 30 percent annually.” Going on to say “staffing shortages compromise our ability to respond to healthcare emergencies, especially in rural and underserved parts of the country.”
“There’s only so much overtime you can do before you’re physically and mentally exhausted,” said Bruce Evans, the president of the National Association of Emergency Medical Technicians
Evans says they need Congress to step in and help with funding and benefits to help bring in more workers.
“Something very similar to the GI Bill,” he said. “We would be proposing that potentially, somebody that works on an ambulance and they’re there for 3-4 years…that the Department of Labor would fund their paramedic training in it’s entirety.”
But even with the threat of COVID exposure, the days spent working overtime, the pay and the stress, Ramotar says, these crews still love what they do.
“Every day. Each and every day,” he said. “This is what we wake up to do…this is probably the most rewarding career that you could ever have. It’s a starting point into healthcare. It’s a starting point of making a difference in patients’ lives, each and every day.”
Now, these crews are asking for people to get in contact with state lawmakers and representatives from their areas to help push for federal and state assistance before things get even worse.
We’ve reached out to the counties to find out what their average response time was for EMS calls in 2021.
Here are the responses:
Citrus County: (did not provide an answer for the 2021 calendar year) “The average response time from October 2, 2021 – December 31, 2021 was 9 minutes and 27 seconds.”
Hernando County: “6 minutes 44 Seconds (ALS Engine or Medic Unit on scene). 8 minutes 7 seconds (ALS Transport Capable Medic Unit on Scene).”
Hardee County: “0 to less than 5 minutes- 49.86%. 5 to less than 10 minutes- 27.97%. 10 to 15 minutes- 14.11%. Over 15 minutes- 8 %.”
Highlands County: “7:52.”
Hillsborough County: “8 minutes 49 seconds.”
Manatee County: “Last Year the Average Response Time for Emergencies was 7 minutes and 48 seconds, and 10 minutes and 25 seconds for non-emergency responses.”
Pinellas County: “Fire Rescue average response time to medical calls in 2021 was 5 Minutes 18 Seconds.”
Polk County: “489 Seconds, or 8:09 (Total Response Time, Dispatch to Arrival).”
Sarasota County: "The average response time to the Emergency 911 EMS calls from the time the incident is received into the 911 call center to arrival of the first fire department arriving unit is 6.57 minutes."
Pasco County has not yet responded with the data requested.