Area Emergency Services struggle to staff; seeing longer wait times on ER calls

Local Coronavirus Coverage

TRI-CITIES, Tenn. (WJHL)- From changing protocols to more patients and short staff, the healthcare industry has taken the toughest hit throughout the pandemic.

“We’ve been having fewer and fewer students come out of the EMT and the paramedic programs come out of our local colleges and fewer applications,” said Washington Co./Johnson City EMS Chief Dan Wheeley. “With COVID, we’ve seen not necessarily any decrease in the number of applicants but we’re seeing more people that are close to that retirement age going ahead and retiring that probably would have otherwise stayed on a little longer. We’re seeing people just leave the EMS industry.”

Both Wheeley and Unicoi Co. EMS Chief Adam Copas say the state of Tennessee is currently retiring more EMT and paramedic licenses than what it’s issuing each year and more people are simply leaving the industry.

“Used to, we competed with each other, other ambulance services would just kind of trade around, and we competed with each other for the employees, but now we’re competing with the people outside of healthcare,” explained Wheeley. “It’s one thing if we lose a paramedic or an EMT and they go to Unicoi County or they go to Carter County, somewhere like that. The system itself doesn’t lose anybody. When we lose somebody that goes to Eastman or goes to McDonald’s or wherever they may go when they leave this industry it hurts, not just us but it hurts everybody.”

At Washington Co./Johnson City EMS, EMTs, and Paramedics are working half a dozen more 24-hour shifts than their required ten each month.

“Now, we have this staffing shortage. In order to cover that, we ask them to work more. We post an enormous amount of overtime every pay period and beg and plead for people to fill those open spots. We still have to cover football games and standbys and things like that,” said Wheeley. “We’ve had to do some creative staffing with some administrative people and move them to trucks for certain periods and things to cover spots but we haven’t had to take any trucks out of service.”

As hospitals are becoming short-staffed and backed up, so are emergency services.

“We are seeing some wait times at the hospitals, some extended wait times. With the COVID patients that we’re bringing in, we can’t just take those right in the door. We have to make sure that there’s a spot for them. So, we’re spending a little bit more time on that. The nursing shortages are causing delays in the ED (Emergency Department) as well,” explained Wheeley. “We’re seeing some delay time in trucks that are having to respond from further out to cover those calls and take those calls while those trucks are either deconning or waiting on placement in the [Emergency Department].”

That wait time being so great, Unicoi County added an additional truck to their fleet six days a week creating and filling two full-time positions.

“We have a turnaround goal time of 20 minutes from the time that truck arrives at the hospital until they are back available in service and we saw those times grow between 90 and sometimes upwards to 180 minutes or longer,” said Copas. “We were running two primary ambulances. Having one unit tied up for ongoing time and that ongoing time made it very difficult for us to meet the need here.”

Those promotions now creating a need for part-time staff.

“Based on our business model, we hire our full-time employees off of our part-time roster. So, we’ve depleted our part-time roster in filling those vacancies,” said Copas. “If we can utilize our part-time staff, we don’t overwork our full-time staff to fill vacancies.”

Another issue for Unicoi County EMS is the distance to the acute care hospitals in Johnson City.

“We have a hospital inside Unicoi County and we transport about 60% of our patients there, but that other 40% it takes us well over an hour to run that call from end to end whereas we can run a call from end to end and stay inside our county in about 45 minutes or less,” Copas said. “From an EMS standpoint, we see ambulances just waiting around for an unknown period of time until they can become available again. It just creates a little bit of chaos for us in the fact that when we have ambulances responding back from Johnson City Medical Center, Franklin Woods, or from other large facilities outside of Unicoi County, back into their home county to respond to an accident or respond to an emergency, it very much could have been avoided had we not been experiencing those turnaround times.”

Both Chiefs partially attribute the pandemic and its stressors for people leaving.

“The longer they spend in the [Emergency Department] either waiting on a placement or just having to decon and clean up after transporting a COVID patient that’s less downtime they have, less time they have to decompress,” said Wheeley.

The time in between calls is needed for paramedics and EMTs to clear their minds.

“The job being as physical as it is is one element of it but the mental aspect of this job is equally as strenuous,” said Copas.

Wheeley also contributed other factors such as generational differences, the lack of pay increases, and now lack of ability to get additional time off to the issue of people not wanting to enter the industry.

Both Chiefs agree that the industry will have to hit a turning point to recruit a new generation.

“The state of Tennessee retires more EMS licenses each year than they do put new licenses in activation,” said Copas. “So, we have to take care of the employees that we do have and make sure that they enjoy coming to work.”

No one at Ballad was available for an interview Monday but a spokesperson sent a statement to News Channel 11 saying:

“The role of emergency medical service providers is absolutely vital to our communities – they’re often the first line of care for sick and injured people.

Our EMS partners are crucial to Ballad Health and our hospitals, especially our emergency departments. We rely on them to help us provide emergency and life-saving care, and their benefit to patients and community members cannot be understated.

Ballad Health is supportive of all our regional EMS providers, and we’re committed to working together to improve care and access for everyone in the Appalachian Highlands.”

Ballad Health Spokesperson

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