In early October 2022, Columbia resident Julianna Fisher jumped into an emergency responder vehicle with a seasoned paramedic and rushed off on her first medical call.
Fisher had been on the job only a week as a brand-new emergency medical technician, but now she was speeding across Richland County with a siren wailing overhead – and as vehicles parted to let them pass, she felt her entire being growing tenser by the second as she hoped and prayed they would not arrive too late.
“My very first call was an overdose. There was so much going on, and the next thing I knew I was bagging the patient and keeping him alive on our way to the hospital,” Fisher said. “The paramedic with me was so calm, but I knew my eyes were as big as Jupiter – and it was the biggest adrenaline rush I have ever felt.”
Despite her early anxiety, Fisher came through the moment with the satisfaction of helping to save someone’s life in a crisis.
While she has gotten used to being taken for granted by people need her help, Fisher is now in the position of being one of a dwindling number of people in the emergency medical field throughout South Carolina and the United States. Unless the trend reverses before the end of the decade, responses to medical emergencies will continue to take longer, raising the possibility that, in many cases, help will not arrive in time.
“Our nation’s EMS system is facing a crippling workforce shortage, a long-term problem that has been building for more than a decade,” said Shawn Baird, president of the American Ambulance Association, in a 2021 letter to congressional leaders. “Overall turnover among paramedics and EMTs ranges from 20% to 30% annually.”
He added that this high percentage not only indicates 100% turnover in ambulance services over a four-year period, it means fewer responders like Julianna Fisher.
“Staffing shortages compromise our ability to respond to health care emergencies,” Baird stated in the letter, “especially in rural and underserved parts of the country.”
Earlier this year, the National Association of Emergency Medical Technicians conducted its first-ever national survey to recognize problems and determine solutions to the EMS personnel issue. The survey was held in conjunction with recent reports by both The American Ambulance Association and the South Carolina EMS Association. A total of 450 respondents from 47 U.S. states, Northern Mariana Islands, the U.S. Virgin Islands and one Indian reservation participated in the survey.
Findings complied from both the survey and the reports delved into:
• New career opportunities outside of traditional EMS that are able to offer higher salaries;
• Increased workload due to COVID-19 precautions and hospital overcrowding, which has required more staff to handle the same call volume;
• EMS personnel frequently having to isolate or quarantine due to on-the-job exposure;
• High COVID-19 infection rates, even among vaccinated personnel;
• Hospitals hiring EMS personnel to help ease the nursing shortage;
• The hiring of EMS personnel by other segments of the health care industry, such as mobile IV companies, dialysis clinics, FEMA COVID-19 testing/vaccination clinics and oil and gas companies.
• Personnel leaving the field out of fear of COVID-19 exposure to themselves and their families.
• Personnel leaving the field due to burnout related to COVID-19 and the increased workload because of staffing shortages.
• South Carolina EMS agencies facing a shortage of new EMS recruits.
“Training has gotten so expensive – it’s about the same as becoming a nurse,” said longtime Emergency Medical Technician D.J. Thatcher. “We have about 100 million more people in the United States now than when I started my career in 1970. And we have fewer people to answer those calls.”
Henry Lewis, executive director of the South Carolina EMS Association, added that while “Morale across health care is fatigued in the post-pandemic era, South Carolina is actually doing better than many other places in the country in terms of addressing the shortage.”
This past May, to illustrate Lewis’ point, South Carolina brought in 12 experienced paramedics from Australia on a two-year work visa to help alleviate the shortage.
“Australia is the only country the United States has engaged in this agreement,” Thatcher said. “These 12 are the first group in the state and one of the first in the country.”
A second group is being considered for later in the year. But for now, their addition will provide time to review and implement changes to the industry’s pay scale and work/life balance and to create awareness among younger people about career opportunities in the industry.
“I love what I do, and I encourage others to join,” Fisher said. “There will be days where it is difficult, and there are days where I still shed tears. But every day I get a chance to save a life. Every day I get to make a difference.”
By L. C. Leach III