'Nightmare scenarios': Maine fire, EMS providers struggle with vaccine rule, staff shortages
The state is set to begin enforcing its mandate for medical workers on Oct. 29
LEWISTON, Maine — Across the area, the mood in fire and rescue stations is glum.
Most paramedics and firefighters can already tell you horror stories about difficulties that arise as they try to get fast emergency treatment to patients in distress.
EMS services everywhere have suffered staff shortages for years now, and with a vaccine mandate going into effect for medical care providers, the problem has gotten worse.
"We're trying to turn around calls as quickly as we can so we can get the truck back in town for the next call," says Lisa Bennett, rescue chief at Turner Rescue. "But we're having 55-minute wait times in the emergency room to transfer the patient. You feel horrible taking a patient to the ER, knowing they're going to sit there for hours."
Turner Rescue is presently down two positions. Two employees recently left the department, although it wasn't altogether clear those departures were related to the mandate.
Being down two workers is bad enough, but Bennett, like other station chiefs, talks quite a lot about the "trickle down" effect that makes a bad situation worse.
Many of her medics also work full-time at bigger departments, like the Auburn Fire Department. The Auburn department is also desperately short EMS workers, so when they need someone to fill in, that someone may come from Bennett's crew, and that's one more person not available to help people in Turner.
For men and women who have dedicated their lives to helping people in medical distress, the worsening staff shortage brings about nightmare scenarios.
"We talk about it every day here," Bennett says. "We just hope and pray that the patients that we're taking in are getting really good care. We worry about our own family members and friends and people that we care about in our community. And yes. It's scary."
With Buckfield rescue department, Deputy Chief Heather Bowlin expects she is going to lose three people due to the vaccine mandate. And that's out of a staff of 17 workers.
"Losing three is huge for us," Bowlin says. "We're already strapped pretty badly for people. We've been battling it for over a year now. This isn't helping matters."
Most station chiefs say they would like to let their employees decide for themselves whether they want to be vaccinated. But with a government mandate in effect, that's no longer possible, and the final deadline for medical workers is coming up in just a matter of weeks. The state is set to begin enforcing the mandate for medical workers Oct. 29.
The hardships for rescue workers are many as their numbers continue to drop. They can still get medics out to emergency calls, but the quality and speed of care they can provide depends quite a lot on what's going on at the hospitals, or at other departments.
If a person has been in a car wreck, has suffered a heart attack or is the victim of any of countless possible calamities, the process of getting help and getting to a local hospital for treatment is no longer a clear-cut deal.
Many hospitals are no longer taking certain patients — Central Maine Medical Center in Lewiston, for example, has suspended admission for pediatric and trauma patients — and that means that rescue crews don't always know where they need to go.
"We're constantly getting text messages about diversions at different hospitals because they're not taking certain patients," Bowlin says. "Then we have to explain to the patient, 'Sorry. You can't go to the hospital you wanted to go to because they're not taking anybody right now.' So they go to an unfamiliar hospital, and that's hard for them."
Diversions also create problems for the EMS crews. If an ambulance crew has to wait at a hospital with a patient for a long period, that's one more crew that's not available to respond to other emergencies.
And it's happening pretty much everywhere.
Lisbon Emergency is down four people. Lewiston-based United Ambulance is down by three. In Wales, the rescue department is also down three people — one lost to retirement, the other two to the vaccine mandate.
"At the end of October," says Wales Rescue Chief Scott Dimmick, "I will be the only member responding to EMS calls for Wales Rescue. Beyond Wales Rescue Department, the vaccine mandate has caused delays in getting patients advanced life support as well as hospital care."
Typically, Wales emergency responders will call on other agencies, such as United Ambulance or Lisbon Emergency, to transport patients who need to get to a hospital.
But since those agencies are also shorthanded, medics in Wales often have to call around to find somebody to transport those patients. And with hospitals declining to accept some cases, the process gets even more muddled.
It's that trickle-down effect Bennett was talking about.
"So for example, with CMMC temporary shutting down trauma and cardiac admissions, that causes ambulances to have to transport longer distances, which causes longer transport times, which causes less time a ambulance is available to respond on a call during shift," Dimmick says. "... the cycle just keeps going. So you can see when one agency has a issue or problem, it causes problems and issues for every agency."
Dimmick said the shortage of EMS workers has been going on for years. He finds it ironic that some of the medics now losing their jobs are those who worked the hardest when things got rough.
"... (A)nd now we have to let those EMS providers that choose not to get a vaccine they don't feel is safe go," Dimmick says, "even though they have done amazing work during the COVID pandemic while protecting themselves and their patients."
The situation at the Auburn Fire Department, which provides EMS services, seems to impact all other agencies around it.
And the situation in Auburn is not good.
"For the past several months, we have had seven vacancies," said Auburn Fire Chief Robert Chase. "We were fortunate enough to have been able to hire four in August. They have just completed their training school this week and started helping to fill our void. That still leaves us with three vacancies."
The Auburn Fire Department used to get more job applications than they could handle, but that has changed. Filling open job slots is no longer an easy matter.
"We have been accepting applications with the hope of filling those positions as soon as possible, but those new hires would likely not be trained and able to respond until February," Chase says. "While I do believe there are some good applicants, the very small number of applications we are receiving is scary."
The vaccine mandate, most EMS officials agree, has brought an already bad situation to a head, and the result will be felt directly by those who require emergency services.
Auburn has about 66 employees in the Fire Department and 27 in the dispatch center. All of them are covered by Gov. Janet Mills' mandate, because they're licensed EMS providers.
"The strain of the COVID-19 pandemic and other pressures associated with the vaccine mandate have resulted in more vacancies," Chase says, "only adding to the strain on the EMS system as a whole."
Chase has pointed out in the past that a lot of those firefighters choosing to leave rather than get a vaccine are firefighting veterans. When that happens, the department doesn't just lose a few firefighters, it loses all the experience those firefighters take with them, which is another blow to the department and the people it serves.
The chief has said that the loss of manpower and experience due to the mandate will likely cause problems "for years and decades to come."
Auburn Mayor Jason Levesque says city officials are constantly searching for ways to manage the crisis before it reaches a breaking point.
"It's a fluid situation," the mayor said. "Thankfully we have great staff that have developed dynamic contingency plans that will help mitigate potential degradation to our residents health. But the situation is serious and avoidable."
For some fire departments, though, the breaking point is closer at hand.
Earlier in the month, Livermore Fire Chief Donald Castonguay requested that his department's EMS license be suspended because of state-mandated COVID-19 vaccinations.
The town selectpersons agreed and it seemed a done deal, but the situation was later clarified, with Castonguay saying his department can continue to respond to emergency medical calls as long as there's a written standard operating procedure that prohibits unvaccinated personnel from doing patient care.
In the town of Woodstock, the fire department announced in September that it would end its first responder program.
"This decision was based on the lack of available licensed first responders," Fire Chief Kyle Hopps explained, "and a significant reduction in medical call responses due to this staffing issue."
At some departments, the effects of the mandate are less severe. In Sabattus, for instance, the fire department has not lost any of its staff and doesn't expect to.
In Greene, Fire Chief John Soucy said that although he does not agree that vaccines should be mandated, all of his EMTs are vaccinated so he has not lost any staff. He said his town is more likely to be impacted by factors such as the shortages at United Ambulance and the decisions by some hospitals to stop admitting certain patients.
At the Dixfield Fire Company, chief Scott Dennett pointed out that his department does not run EMS services, so the mandate doesn't have as direct an impact. He has not lost any firefighters over it yet, he said, "but then, we are already severely understaffed."
The decision to make vaccines mandatory for emergency responders was controversial from the start. When it was first announced in August, an emergency meeting of the Maine Emergency Medical Services board had to be postponed when more than 200 people tried to participate online, which exceeded the technical capacity for the session.
When the meeting was held days later, at least 750 people joined a Zoom call to hear testimony about Mills' mandate, with many criticizing it for denying workers the right to make their own health decisions.
Officials from Maine EMS did not return numerous messages left over the past week.
Bigger emergency departments have taken to offering big wages in hopes of attracting more medics. That hurts the smaller departments, which can't compete with those heftier wages.
Most emergency medical care providers fear the problems are only going to get worse rather than better. It's that trickle down effect again, they say. It leaves them with a sinking feeling.
At Turner Rescue, Bennett says she knows several people within the medical field who have lost their jobs over the mandates already and more are falling every day.
Call it a butterfly effect: In hospitals or on the streets, when a medical worker leaves the profession, ripples are felt across the entire medical community, and the people who will feel it most directly are those in dire need of medical attention.
"I don't know how this gets fixed," Bennett says. "It's just horrible."
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