Can the hemorrhaging be controlled?


MARTINSBURG, West Virginia – In a today’s society emergency medical service workers, firefighters, and police more specifically are coming under fire for doing their jobs… protecting society, responding to emergencies, stabilizing emergent medical needs, extinguishing fires, rescuing victims from burning buildings or simply saving a kitten from a tree.

You would think it would be a job people would be knocking down the door to sign up for, right?


Locally and nationally, emergency medical service providers are having trouble keeping highly trained and experienced providers…whether it is provider fatigue, frustration with an employer, call volume, pay, co-workers, supervisors actions, all the above or some combination.

After conducting employee surveys, one Texas department is taking the bull by the horns.

The survey by Austin-Travis County EMS, Austin, Texas management identified the need to address the reasons behind high provider resignations, high paramedic position vacancies, and employees increased use of sick time, in turn requiring supervisors to hold paramedics over to cover shifts.

Currently, Austin-Travis County EMS has 45 paramedic vacancies according to KXAN, local NBC affiliate who detailed the struggles of provider fatigue.

“We want to give our personnel six hours of their lives back so they can use that for recovery, so they can use that time to spend with their families and they can press reset for a little while,” Austin-Travis County EMS Chief Ernie Rodriguez said during an interview with KXAN.

That story later went viral, with thousands of shares across the country. The story was likely shared by providers who feel the same way as many employees of Austin-Travis County, but because of their agencies’ policies and procedures have no way to make the drastic changes needed at their departments to improve their work life.

According to KXAN’s report, the cornerstone of the plan will begin in October and will transition employees to a 42-hour work-week. This comes after 10-years of a 48-hour work-week with built-in overtime.

A 2006 study, found 44 percent of medics reported nodding off several times a month during their shifts, 29 percent said they provide less than optimal patient care near the end of a 24-hour shift, 50 percent had accidents or near misses due to fatigue and 5 percent had fallen asleep while driving an ambulance.

Followed by a study performed in 2013 that found nearly 90 percent of ATCEMS employees said they “often experience fatigue.” The survey also showed around 50 percent of the respondents believed fatigue often impacts their quality of work.

Rodriquez told KXAN that he is worried the medics who are currently stationed in busier areas receive less down time during their shifts, which could lead to fatigue.

What?! Providers are fatigued in other places. Why is that? What has your local agency or department done to help improve this?

Rodriquez said that supervisors will track medic units and their workload in real time and if a unit is busy, the supervisor is supposed to call and ask if the crew has taken a break.

“We want our employees to have the confidence to say, you know what, I am just too tired, I’ve had it and I need a break,” Rodriquez told KXAN.

Truer words have never been spoken Chief Rodriquez.

Chief Rodriguez admits a bulk of the departments cultural changes stem from a 2015 city of Austin employee survey, according to KXAN. The news station obtained a copy of these results.

“Right now, we are facing a challenge to recruit, hire, and retain great people. We are also facing the challenge of work-related fatigue caused by shift work. We will face these challenges. We will find solutions. We will be better and stronger when we do,”

Chief Ernesto Rodriguez wrote.

KXAN reported one medic commented, “The morale and protocols keep declining to the point that the system is becoming a joke, and it will be inevitable that tragedy and lawsuits will result.”

What?! Morale and protocols keep declining to the point the system is becoming a joke.

Another provider is quoted, “paramedics are overworked, this leads to suicide, heavy alcohol abuse and divorce.”

Over a six-month span during mid-2014 into January 2015, two Austin-Travis County EMS paramedics took their own lives. Rodriquez points out there are no studies positively connecting suicide solely to job workload, he was shocked with the loss of two employees in separate incidents.

“Personally, it was probably the toughest thing I’ve ever had to endure…I don’t know that any chief of any organization could ever be prepared for that,” Rodriquez told KXAN.

Chief Rodriguez writes in fiscal 2016-2017 budget documents that his staff is his department’s “most precious resource.”

When was the last time that your department, made you feel like you are its “most precious resource?”

The more likely scenario is, as you are charting after a high priority call or after your seventh call in a row, barely having time to use the bathroom at the hospital, you hear another unit alerted for a call in your area. At that point, you get phone calls and text messages and at times radio requests to know why you aren’t in service. There is no time for breaks!

When was the last time that your shift officer, chief level officer, or board of director member acknowledged that your crew was busy and appreciated you for the important service you provide everyday.

I challenge policy-making chiefs and board of directors to revisit the ambulance where they came from.

You’ve never been on an ambulance before? You’ve never been an EMT or a paramedic? You don’t know what the men and women do that are on the street 24/7 that you make policies for? Ride along. See what we see. Feel what we feel.

Critics of ATCEMS new program suggest that retaining seasoned medics should be more of a priority than filling gaps with new hires.

Take a seat!

“The retention issue is the first issue we have to address otherwise we’ll fall behind, ATCEMS Association President Anthony Marquardt said.

Retaining seasoned medics? Retaining seasoned providers, both EMTs and medics in general are important.


Having seasoned staff at your agency is vital! These providers are able to train and mentor new hires and volunteers alike. Through their years of experience, they are able to show and teach young, new aspiring providers.

ACTEMS needs to have to ability to expand and recent changes have added 53 new paramedic positions. Rodriquez admits that it will likely take a full two years to get to that level because of cadet training being limited.

Marquardt is “reservedly hopeful,” for the changes from EMS management.

Paramedics and EMTs locally and likely nationally are reservedly hopeful that their decision-making-level chiefs and board of directors realize and quickly that improving morale, working conditions, provider fatigue, and pay is vital to having a progressive and successful business that is able to retain and add new providers. Other policies are important, but take a step back, stop in a station, learn your provider’s faces and names, sit with the crews, address their needs and concerns and do whatever is in your power to make it better. Otherwise, one day, you are going to be sitting at that table alone.

I commend Chief Rodriguez and Austin-Travis County EMS for having the ability to identify they have a problem and then developing a solution…identifying you have a problem is the most important part to finding a solution.

Todd Bowman is a social media anchor, journalist and paramedic/firefighter in Maryland. Follow him on Twitter @todd_bowman87.

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