Escambia County EMS suffering from staffing shortages, sometimes forced to ‘hold calls’
Pensacola News Journal
Calls to Escambia County Emergency Medical Services have increased during the past year, and on Sunday night, a text to EMS staff seeking relief crews noted the department was “beyond critical staffing levels” for the night, forcing supervisors to run calls.
Interim Public Safety Director Eric Gilmore said the situation Sunday was caused by a combination of issues, including the shift being short-staffed after some call-ins and an entire ambulance crew having to remain on scene while Escambia County Fire Rescue fought a fire at Ascend Performance Materials.
A situation where there aren’t enough EMS crews in trucks can lead to a “10-75” in which the county dispatch holds calls. Gilmore said when the county holds calls, it prioritizes sending ambulances, referred to as “boxes,” to the most critical calls first.
“Maybe I have 15 calls, and I’ve got 12 boxes,” Gilmore said. “So the full boxes are responding to the higher acuity calls, and then we’re going to hold three. It might be a transfer out of a facility, or it might be an alpha level call where somebody called in with back pain, or ‘I feel sick.’ We get those all the time, ‘I’m sick, I’ve got a headache,’ so that one will hold until a unit frees up, and then we’ll put that unit on it.”
Gilmore said holding calls occurs sporadically and may only last a few minutes. But he also said some days can be worse. He said the department plans to have shifts fully covered with 15 ambulance crews, but people can call out of work sick. In those situations, the county puts out calls for relief crews.
“Some days, it feels like the entire county has called in (to 911) at one time,” Gilmore said. “So it depends on what’s happening with the county.”
Gilmore said sometimes calls come into 911 that aren’t a true emergency but add to the demand on EMS crews.
Escambia County released this graphic to inform the public about when to call 911 as frivolous calls can tie up EMS crews while the county is dealing with a staffing shortage.
Prior to this weekend’s bottleneck, Escambia County Commissioners discussed the issue of holding calls during their meeting last Thursday and focused on EMS having to hold calls while an ambulance crew was transferring patients between medical facilities.
Commissioner Doug Underhill noted that 390 times this year, ambulance crews have had to wait 15 minutes or more with a patient at the hospital for a hospital bed to open.
“I was under the impression that if you’re flying through traffic with the lights on that you get somewhere and, like you see on TV, right, you come right out of the box and into the ER,” Underhill said.
Gilmore told commissioners that EMS is working to develop better communications with hospitals so an ambulance crew can go to the hospital with an open emergency room bed.
Underhill suggested also perhaps scaling back medical facility transfers.
Commissioner Jeff Bergosh said he agreed with Underhill that it was a problem, but there may be better solutions.
“Doug, there’s a lot of things we don’t agree on, but I do agree with you on that to a point,” Bergosh said. “The only thing where I would step in and maybe have an issue is if it’s going to negatively impact our revenue.”
Gilmore said that Escambia County charges lower rates compared to its neighboring counties and EMS would be asking for a rate increase for transfers from the County Commission as soon as next month.
Gilmore told the News Journal on Tuesday that when calls are being held, the EMS staff is “all hands on deck,” which is what happened Sunday.
“The supervisors got up there and caught the calls up,” Gilmore said.
Escambia County EMS has long been short-staffed and Gilmore said the county is working to hire more staff.
“Staff come and go,” Gilmore said. “We have lost people, and we need to hire more people to get our levels up. We need some more staff right now, there’s no doubt about it.”
The county’s EMS division has struggled for two years with a scandal involving training documents, leading to a wave of resignations and a state investigation that resulted in the arrest of four former employees. The trial for the four former staff members is still pending.
Then came the COVID-19 pandemic, which only added to the stress of the crews.
But, Gilmore argued, the biggest factor leading to staff shortages has been pay compared to other ambulance companies in the area.
“Our competitors, next door to us, offer two more dollars an hour,” Gilmore said. “We have people who go for that two more dollars an hour. I’m hoping to get a pay increase for our guys and be competitive, that way we can retain them.”
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Gilmore said working for the county comes with benefits and retirement packages that private ambulance companies can’t offer, but he said a young paramedic or EMT can opt for the higher pay earlier in their career.
Gilmore said EMS has transported more than 15,000 patients since Jan. 1 and calls are running at an all-time high. He said the biggest increase in calls this year has been emergencies related to drug overdoses followed by cardiac arrest.
“We really have resilient staff,” Gilmore said. “We do have really good trained people, and they’ve had a lot to overcome, but we’re stabilizing, and we’re going to get even better.”
Gilmore added that despite any issues, EMS crews will respond when someone calls 911.
“If you call 911, you’re going to get taken care of,” Gilmore said.
Jim Little can be reached at firstname.lastname@example.org and 850-208-9827.