Labor of Love: EMS Has Changed, but Rewards Remain

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INteresting article.

Labor of Love: EMS Has Changed, but Reward Remains Same

Natasha Lee

The Stamford Advocate (Connecticut)

STAMFORD -- Paramedic Jessica Crowley worked quickly to inject the sugar water solution into the elderly woman's vein.

The call came in on a recent Thursday afternoon of a hypoglycemic emergency at a house on Hackett Circle South in Glenbrook. Crowley, and her partner, Kevin Burwell, an emergency medical technician, found the 86-year-old diabetic unresponsive on the floor next to her bed.

"I was so scared, she was just lying there," said the woman's niece, who called 911 after coming home for lunch.

The emergency call was the fourth that day for the Stamford Emergency Medical Services team. Crowley, 26, and Burwell, 30, had already treated a pediatric seizure, a car accident and a man suffering stomach pains. Calls can vary from two to more than 10 during a 12-hour shift.

Though critical, the diabetic call was not unusual, particularly among the elderly.

"A lot of diabetics know the routine. Their blood sugar drops, we give them some dextrose and they feel better," Crowley said.

Dextrose is a concentrate of sugar water that helps elevate a person's blood sugar level. Seconds after the injection, the woman awoke as if an alarm clock had buzzed.

"They are really amazing, they saved her," the woman's niece said.

Crowley and Burwell say they don't often get that type of praise.

"I don't think people understand what we do," Crowley said. "People think we're just ambulance drivers, that we'll throw you in the truck and we're your taxi cab. We're saving peoples lives."

Over 30 years, EMS work has evolved from bandaging bleeding wounds to jump-starting the heart with a single shot of medicine. Once a first aid service run out of funeral homes, EMS agencies are now mobile emergency rooms, with professionals trained to respond to hazardous material explosions and terrorist attacks.

As the industry has grown, so have the demands and challenges, workers and advocates say.

"We're definitely a lot busier than people imagine," Burwell said.

SEMS paramedic and EMT union workers have been in a contract dispute with SEMS management for more than a year over wages, and have twice rejected contract proposals they said failed to offer competitive wages. Union workers have been without a contract since June 2005.

Last year, SEMS, responded to 11,000 calls. Call volume at the department increased modestly at 3 percent over the last decade, said Executive Director Patricia Squires, who oversees the private, nonprofit company.

But as the city's population continues to age and grow, so do concerns of staffing and funding.

Similar to the nursing shortage, EMS departments nationwide are struggling with staffing shortages, attrition, heavy workloads, and reimbursement from state and federal health care and insurance programs such as Medicaid. Last year, SEMS wrote off $924,000 in uncollected payments.

The department's operating expenses for last fiscal year were $5.7 million, 15 percent of which was funded by the city.

According to the National Association of Emergency Medical Technicians, the industry boasts from 800,000 to 900,000 paramedics and EMTs, but advocates say the number is rapidly decreasing as workers use their experience as a springboard to higher-paying professions such as physician assistants, firefighters and medical administrative positions.

With 27 paramedics and EMTs, SEMS is three positions short of full staff, but maintains high-level service, Squires said.

The department has 20 volunteers who are required to complete a basic level of EMT training. Paramedics require 18 months of training; an EMT from three to six months.

Under a contract with the city, SEMS is required to respond to 93 percent of advanced life support calls in under eight minutes, and has repeatedly met the time, Squires said. SEMS also has a contract to provide paramedic assistance to Darien.

Staff is required to attend monthly continuing medical education courses and SEMS requires new hires to have a minimum of one-year job experience.

Still, as the number of active volunteers fluctuates and enrollment at medical training schools dwindles, it is expected to become more difficult to attract new employees. Last month, SEMS hired a training director to help run CPR and AED training courses for the public, and generate interest in the profession.

"We're beginning to see a squeeze," Squires said.

Paramedics and EMTs are often underpaid and pensions are small, a primary reason for attrition, NAEMT president Jerry Johnston said.

"It is difficult to make a career out of it depending on where you live. Traditionally, public agencies pay better than private agencies, but a private provider only can pay their staff what they can afford to pay them," Johnston said.

The starting salary for a SEMS EMT is $32,146 and can reach $44,501 after 12 years. A paramedic starts at $41,664 per year, and makes $57,657 after 12 years.

The state average runs $15 to $25 per hour for an EMT, and $60,000 to $65,000 for a paramedic, according to the Southwestern Connecticut EMS Council, which represents EMS in 14 towns and cities in the state.

Fairfield County EMS agencies offer some of the more competitive salary rates, but the industry overall is low-paying, said council president Robert Petty.

"The pay raises for medics and EMTs have not been amongst the highest considering the kind of training and responsibility that people take and find themselves in," he said.

Fairfield County's high cost of living discourages most workers from living here. Many have hourly commutes and juggle second jobs to make ends meet.

"People think we're asking to be rich," Burwell, who commutes from Milford, said of the contract dispute. "We're just asking to make enough to live and take care of our families."

The physical demands also are taxing.

"It's a profession that beats on the body," said 37-year-old paramedic John Corris. "I wouldn't be in this shape if I had just taken that accounting class."

Corris and his partner, Steve Speanburg, 56, discussed battle wounds on a recent Friday night between calls. Corris has been with SEMS for four years.

Speanburg, a veteran EMT, has been with SEMS since 1986 when it was Stamford Ambulance Corps., a primarily volunteer-based organization that worked with three of city's fire departments to provide limited medical services to parts of Stamford. SEMS was incorporated in 1987.

Speanburg's sprained his shoulder and injured his back carrying people on stretchers down stairs.

Paramedics and EMTs carry more than 70 pounds of equipment to each call including a cardiac monitor and defibrillator, oxygen devices and a bag of dozens of vials and medicines.

While rain and snowy conditions can make for difficult driving, maneuvering an ambulance through Stamford's congested streets is often their greatest challenge. Despite flashing lights and a siren, motorists are often slow to move out of their path, Speanburg and Corris said.

"My head is like a swivel," said Speanburg, who drives the ambulance. "My eyes are constantly looking in all the mirrors."

They face other obstacles reaching a patient: family members often try to intervene; sometimes houses are not numbered; driveways might not be shoveled.

A call can take anywhere from 45 minutes to nearly two hours to complete, and every one is a gamble.

"You never know what you're walking into," Corris said. "You always prepare for the worst and hope for the best."

Just before 10 p.m. that Friday night, Corris and Speanburg were sent to Atlantic Street to check on an intoxicated man. They arrived to find one of their "regulars" passed out on the cold sidewalk next to the store. It was about 20 degrees outside, and the man, believed to be in his early 30s, was mumbling in Spanish.

"We pick him up every day," Corris said, preparing an IV of saline fluids.

Speanburg and Corris wrapped the man in thermal blankets to raise his heart rate.

The man is among a group of homeless day laborers who spend their earnings on alcohol and are regularly rescued by SEMS, they said.

"He gets lost in society. He gets poisoned every day," Corris said. "His liver will eventually go."

The SEMS crew faces many forms of death. There are senseless accidents: children inside mangled cars without child seats; overdoses; suicides.

"It's another thing that comes with the job that you have to get through," Burwell said.

They rely on humor, and each other, to get by.

Between calls, at medic station 3 at the Tully Center, Burwell and Crowley watch television, surf the Internet and talk about weekend plans. TV cooking celebrity Rachel Ray is a favorite.

At times, their banter echoes sibling rivalry.

"We're like two brothers," Burwell said of their friendship.

Despite the challenges Burwell said he can't see himself doing anything else. In April, he'll graduate from the Joint Hospital Planning Council in Bridgeport with his paramedic license. He's the sixth-generation in his family to go into public safety.

"After 16 years of doing it, I still absolutely love it," he said. "It still feels like the first time every day."

[paratrooper75 41]

And thats exactly why I do it. I love the job. I couldn't picture myself doing anything else. I could have went through nursing school instead of paramedic school and graduated in the same time but earning twice as much. But I love what I do. I could put on a suit and tie and go work for my dad as a financial consultant making a lot more than I do now but I won't. the only thing that will get me out of my medic job is a fire or police career. Like they said in the article the money and benefits just aren't there for medics/EMT's. But I will always be in emergency services one way or another. Hopefully one day it will be possible to support a family on medic pay/benefits.

[Goose 188]

Like trooper, i don't see myself doing this full time for the rest of my life. Right now i can suffice, but i already have to start thinking about the future. Paramedicine is the next step, but after that i have no choice but to look towards a higher level of hospital based health care or something entirely different. Between the cost of living, mortgages, fuel costs, insurance costs and everything else making 15 bucks or 20 bucks an hour simply doesn't cut it. God willing ill still do EMS in some capacity, probably as a part-time job mostly for fun, but its unfortunate that what we do is not viewed as worth a decent salary.

[Danger 160]

$15-$25 an hour?! WOW, maybe I'll start commuting to Stamford if they'll triple my pay.

[Guest paramedico987]

Seriously! I've been commuting from norther Fairfield to f*ing Yonkers for over a year?! I'm gonna have to get that reciprocity I've heard so much about!

I'm glad to hear that it's the same nonsense in fany pants CT though... Hey here's a question that's been bugging me. What the hell ever happened to public intoxication being a crime?!

If we get these guys in the system then at least we'll be paying for them AND have control over every aspect of their lives. [by this I mean prison]

[JJB531 652]

Seriously!  I've been commuting from norther Fairfield to f*ing Yonkers for over a year?!  I'm gonna have to get that reciprocity I've heard so much about!

I'm glad to hear that it's the same nonsense in fany pants CT though...  Hey here's a question that's been bugging me.  What the hell ever happened to public intoxication being a crime?!

If we get these guys in the system then at least we'll be paying for them AND have control over every aspect of their lives.  [by this I mean prison]

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There is absolutely nothing in the NYS Penal Law regarding public intoxication being a crime. If a person is intox in public and acting disorderly, they can be charged with disorderly conduct which is only a violation.