It should come as no surprise, but working in emergency medical services during a global pandemic is quite an undertaking.
Macon County EMS Director Warren Cabe wrote a letter to Highlands-Cashiers Hospital CEO Tom Neal last month that was publicly presented at Highlands’ called town meeting Aug. 27. In the letter, Cabe explains that the prevalence of the virus has put extra pressure on his crews. The time and effort required to decontaminate equipment and isolate patients adds up quickly as cases surge locally.
“There is almost no shift that goes by now that our EMS crews are not evaluating, treating and/or transporting a COVID patient,” reads Cabe’s Aug. 23 letter. “Even during the surge of the virus last winter, we were not seeing this number of patients with this diagnosis or presenting with these signs and symptoms.”
This extra work is made even harder by staffing shortages. EMS has eight vacancies out of 41 full-time positions and had to resort to funding extra overtime pay and using part-time, as-needed and even administrative employees to cover ambulance duty just to maintain the bare minimum number of staffed ambulances at some points. Cabe says that the entire team is working hard to make up the difference, but it could take months to fill all the open positions. In the meantime, something as simple as a bout of illness spreading between coworkers could be a major setback for the system, and for obvious reasons, these employees are more at risk of getting sick.
“We have been able to maintain our services through the use of overtime, part-time staff, admin staff, etc.,” Cabe said last week. “We are concerned that an illness or other event that depletes our staff any further could cause delays in responses, but our staff has been dedicated to maintaining our levels.”
There are several barriers to improving the staffing situation. At 911, for example, operators are working longer hours. The chaotic nature of the pandemic also adds a psychological impact to the job that isn’t shared by non-healthcare related fields, at least not at the same level.
“The unrelenting number of and constant influx of emergency calls for assistance takes a mental toll on 911 operators over time and either drives some from the profession or limits their interest in joining the profession,” reads a Sept. 14 statement from Macon County 911. “When private businesses can offer a higher salary with less responsibility attached, obviously some people will look elsewhere.”
The silver lining is that the county government is making an effort to get the department more money. In addition to a pay study, the Macon County Board of Commissioners recently offered Cabe support in seeking a grant from Vaya Health worth $11,200.78 to fund 13 weeks of the community paramedic program. The community paramedic program offers home vaccinations to about 90 patients, and the program’s the services keep many patients out of ambulances and free up other resources.
“It’s hard to keep the data of how many people that program has kept out of the ER… but I know for a fact that it’s numerous,” Commissioner Ronnie Beale said. “Not many people in the community know about it, but the ones that have the service know how important it is.”
At this point, every little bit helps. There’s a tough road ahead for the county’s emergency operations, so Cabe expects they’ll need all the support they can get.
“The pre-hospital healthcare system, all the way from the call takers to the transport crews, are as close to a single point of failure as I have ever seen in my career,” reads Cabe’s letter. “Any measure that can be reasonably taken to help us maintain the availability and effectiveness of the pre-hospital healthcare system would certainly be supported by our office.”
For more information on Macon County EMS, call their office at 828-349-2548 or go online to www.maconnc.org/ems.html.