Pa. city faces lack of paramedics, high emergency call volumes
"For the amount of calls our paramedics run, there should be eight [ambulances] in service, and right now we are fighting for a fifth"
Reading Eagle, Pa.
READING, Penn. — When Reading's paramedics respond to a call from their Walnut Street station they pass under a sign that reads “The only easy day was yesterday.”
For the city's paramedics, truer words have never been written.
"We have one of the highest call volumes for a city this size," said EMS Deputy Chief Walter Bauer.
He said the ambulance crews responded to more than 20,000 calls in 2018. That's in a city with a population of 88,423, according to 2017 census figures. That compares with 15,814 EMS response calls last year in Allentown, a city with 121,283 residents.
Bauer said about 80% of the calls Reading receives are for basic life support, such as scrapes, bruises and broken bones. Advanced life support make up 20% of the calls and are for issues such as gunshot wounds, difficulty breathing and chest pains.
Fire engines are dispatched along with ambulances for those most critical calls, Bauer said.
"With the high call volume, our ambulances respond from the hospitals a lot of the time," Bauer said. "Having the engines respond cuts down on the time until someone gets help."
Crews spend an average of 45 minutes on each call, Bauer said.
'Running all night long'
EMS Lt. Craig Sweigert said dealing with the high number of calls is exhausting.
“You gotta give these guys credit because they still come in,” he said on a recent Tuesday morning. “Like right now, night shift is supposed to be home. They have been out all night doing calls, and they are going to come back and be tired. It makes it rough.”
City firefighters and paramedics work two 10-hour day shifts, followed by two 14-hour night shifts and then four days off.
Firefighter/EMT Ken Licwinko, who normally is a tillerman on Ladder 1, was partnered with Sweigert for an overtime shift and acknowledged the paramedics are overworked.
“The joke is, 'Sh-h-h, we ladder guys are sleeping after 10 o'clock at night,'” Licwinko said. “And these guys (paramedics) are running all night long."
Paramedic/firefighter Tom McClafferty said he responds to eight to 10 calls during an average 10-hour day shift.
The average for the country is one call every two hours, he said.
McClafferty said the ambulance service he worked for in Carbon County was much slower.
“If I did four calls in 12 hours that was a busy night,” he said. “Here, a busy night, I've done 17 calls in a 14-hour night shift.”
The most was 19 calls during a night shift, McClafferty said.
Despite the high call volume, McClafferty doesn't want to leave the department.
“If I'm actually being a paramedic for a full shift, I love it," he said. "I've done 10 calls where I had to do the charts and everyone was sick. I love it because I get to be a paramedic."
McClafferty said most people who call 9-1-1 do not actually need an ambulance. Such as the time he responded to a call at 3 a.m. for someone who stubbed their toe.
"A lot of the times it's just like driving a taxi cab," McClafferty said.
Sweigert and Licwinko recently went on a call that was dispatched as a fall victim. When they arrived, the woman who'd called 9-1-1 said her aide was running late. She asked the two men to turn on a fan, help her make some phone calls and get her a drink.
McClafferty knows the job will eventually burn him out.
“This place will do it to you,” he said. “There's guys that have been on the job for five years and they're burned out."
Bauer said he's looking to implement programs that address fatigue.
Seeking a fifth crew
To help with the abundance of calls, Reading Fire Chief William Stoudt Jr. is once again asking City Council to approve hiring four additional medics to staff a fifth ambulance for next year.
He's made the request for 2018 and this year but was turned down. The city budgeted $176,584 to cover the costs of hiring four additional paramedics.
Mike Shoumliksy, president of Reading Fire Fighters International Association of Fire Fighters Local 1803, said the additional medics would help, but would not be enough.
"For the amount of calls our paramedics run, there should be eight (ambulances) in service, and right now we are fighting for a fifth," Shoumliksy said.
Adding to the staffing problems, the city is having trouble recruiting new hires because of a nationwide paramedic shortage, according to city officials.
The shortage was addressed in a September article in JEMS, the Journal of Emergency Medical Services. "The data are clear," it said, "in that fewer people are entering EMS when compared to a decade or two ago."
It's a problem the Reading department is feeling acutely. It has had 24 paramedics, nine short of the 33 budgeted positions. Bauer expects to lose a few more next year due to retirements.
"This problem is not unique to the city of Reading," Acting Managing Director Osmer S. Deming said. "This is a nationwide trend."
There were 6,948 paramedics in Pennsylvania in 2018. A decrease of 169 from 2017, according to the Pennsylvania Department of Health.
Sweigert said the start of a national paramedic certification was where he believes local departments started to see their ranks thin.
For example, a person no longer has to go to Maryland to become a certified paramedic in Maryland.
“They can just go down the street to Reading Hospital and get certified with the national registry and then go down to Maryland and apply,” Sweigert said.
Before, a person was a Pennsylvania paramedic and that was it, he said.
Paramedics are also leaving because they get burned out or find better paying jobs.
"Many paramedics, after doing it for five or 10 years, start looking for other positions in health care," Bauer said.
"We have had some leave for other health programs," Stoudt said. "Not even as paramedics but as teachers."
The city attends job fairs at local schools and in other states to recruit paramedics, Bauer said.
Deming said he would like to start a paramedic Explorer post in the city. It would be a program open to boys and girls from high school age through 20 who are interested in the fire and ambulance service.
"If we can go out to the high schools and tap them directly I think we can increase our forces here," Deming said. "We have a lot of good people here and we don't want them moving away and taking a job somewhere else."
The paramedics have their own ideas to increase recruitment.
“You need to open up the firefighting to paramedics," McClafferty said. "I've talked to numerous paramedics throughout the county and they said, 'Make firefighting more accessible and I'll come.'"
McClafferty came to Reading because of the opportunity to do more firefighting. He's able to pick up overtime shifts on the fire engines or switch shifts with other firefighters.
On paper, the city's paramedics are also firefighters, however, their assignments are pretty much set in stone, Sweigert said.
If you're a paramedic then you're working on an ambulance and not doing much firefighting, he said.
"The younger generation doesn't want it that way," Sweigert said. "They want to go to places where you can do more."
Stoudt said the number of firefighter and paramedic positions are negotiated through the union's contract.
While the city is struggling to attract paramedics because of the nationwide shortage, Act 47 isn't helping either.
Act 47 woes
Under the state program designed to help financially distressed municipalities, most city employees had their salaries frozen for three years under Act 47, which hurts Reading's ability to attract paramedics, Shoumliksy said.
"Right now the grass is greener every where you go," Shoumliksy said. "It is tough to get someone to come to the city of Reading, especially a paramedic, for the amount of calls they run for what the city is willing to pay them."
The city's firefighters and paramedics have a starting salary of $43,279.
Shoumliksy said pay in surrounding municipalities isn't that much different than Reading but benefits can be better.
"Maybe other cities offer different pensions or a bonus for their paramedic skills," Shoumliksy said.
The biggest hurdle to attracting paramedics occurred when the city eliminated health coverage for fire department retirees, Shoumliksy said.
"I understand it's not the cheapest thing, but when these guys come in and absolutely destroy their bodies for their community for 20, 30 years," he said. "He or she isn't going to be the same person when they leave here.
"To have them walk out the door and say, 'You're on your own now ' (isn't right)."
Another benefit frozen under Act 47 was the longevity bonus. After five years on the job, a person would receive an increase of $85 per year. The 2011 contract froze that bonus until the city recovered financially.
“I've been here for 12 years and I was due to get longevity," Licwinko said. "I don't get that. That wasn't enough to break me, but it's been a salty thing.”
Stoudt agrees that the program's tight fiscal reins of Act 47 are hurting the city's ability to compete for paramedics.
"This all ties together with some of the recruitment issues," he said. "When you take a look at everything else — pay, call volume and the difficulty nationwide. Those that are paramedics already can look farther and wider because they are in demand."
The city is negotiating a new contract with the fire and police unions, which includes a pay raise and other incentives.
"A lot of stuff has been beat around and thought about how to address this," Stoudt said. "We don't have all the exact answers."
Administrative Services Director Jamar Kelly said the city is trying to find modest incentives to retain or encourage employment.
Despite the financial challenges, the men and women who work as paramedics in Reading agree it's still the best job in the world.
"It's what you make it," Sweigert said. "I love my job. Maybe that's my calling. Being a street medic."
©2019 the Reading Eagle (Reading, Pa.)