As Jasper County residents continue to debate the need for more funding for ambulance services, hiring and keeping qualified personnel becomes all important to the county’s EMS (Emergency Medical Services) to continue to operate, while giving the community a high quality of care.
In order to be a licensed emergency medical technician, one must go through a six- to eight-month program that includes classroom and practical learning. After passing and receiving their licenses, EMTs must have continuing education and re-certify every two years.
Indiana now requires emergency medical personnel to pass a stringent national registry exam for licensing. To keep the licensing, the EMTs must meet the following requirements every two years:
• 16 hours airway, breathing and cardiology.
• 8 hours medical emergencies.
• 6 hours trauma.
• 16 hours obstetrics and pediatrics.
• 2 hours operational tasks.
• 24 hours of additional/miscellaneous hours.
• 12 hours of audit and review.
This has to be accomplished while most work two or more jobs to support themselves and their families.
For Keener Township EMS workers, they all have full-time jobs at other ambulance services, and also work for Keener, which only offers part-time positions. Even the ambulance director works part-time.
It is the same for paramedics. They, too, must have continuing education after completing their courses, which requires two years experience as an EMT before taking the two-year paramedic course. Classes are normally 16 hours a week plus clinical hours learning hands-on practical experience.
The clinical hours include working in a variety of specialty areas of a hospital including obstetrics, pediatrics, ICU, and intubation in an operating room setting. The requirements also include a specific number of hours working in an emergency room as the medics learn to become more independent and capable of critical thinking in stressful situations.
Corrie Myers, EMS director at Keener Township EMS, said, “Surrounding states have lower standards than Indiana. We have to do more if we want to work here.”
He said the ambulance services must be competitive to get qualified staff and keep them.
“We all have full-time positions elsewhere,” he said.
He said it can be difficult to fit continuing education into their schedules and many try to do it while they’re on shift. Some of the continuing education can be done through webinars. He said Indiana offers a website for the mandatory education it requires.
Paramedics have to learn skills in medical/trauma assessment and management, ventilatory management, cardiac arrest management, bandaging and splinting, medication administration, IV therapy, spinal immobilization, obstetrics and gynecological, communications and documentation.
Continuing education includes the same requirements as EMTs plus additional six hours in audit and review, and skills including cardiac arrest management/AED, airway management, immobilization/splinting, bleeding control and much more.
Myers said being an EMT or paramedic is often a stepping stone for those who want to continue on to nursing or even becoming a physician. These careers can often “make or break” a person who wants to pursue a higher medical career.
These days, the medics are able to determine patient care in an emergency setting, and rarely have to call in for permission to perform a life-saving task or give life saving medications. They are required to follow the protocol of the physician who allows the ambulance service to practice under his/her license. If they have followed every protocol and still need to do more, then they will call and ask for instruction.
He said the ambulance service has to remain a non-profit, but it also has to be self-sufficient, and with the insurance companies not wanting to pay and low reimbursements by Medicare and Medicaid, it is difficult to keep up.
“We’re not in it to make big bucks,” he said. “But we also don’t want it to cost taxpayers, either.”
Filling the roster for every day of the year can be a daunting task, especially when all the staff are part-time.
“It takes a lot to fill the shifts when everyone is part-time,” he said. “We have to have a minimum of one ALS (requiring a paramedic and an EMT) truck.”
Keener staffs a second truck during the day as well, so if one ambulance gets called out, there is a second unit ready to go if needed. The service answers the call 24/7, every day of the year, even on holidays. The service never closes.