Here & Now

Life and Death: Rural EMTs Face Staffing Shortages

Frederica Freyberg:

Next up, in our Wisconsin look, we go to Pepin County for a look at a rural issue that’s very literally an issue of life and death in one small town. Reporter Andy Soth has more.

Andy Soth:

In a small town grocery store in western Wisconsin, a man collapses with a cardiac arrest.

911 Operator:

911. What’s the address of your emergency?

Andy Soth:

Peter Pillman who supplied the tape has both a professional and personal interest in the case. The man is his father.

Peter Pillman:

He had bystander CPR. Someone who came in right away, when he was found and started providing that.

911 Operator:

They're doing CPR right now on him.

Andy Soth:

For Pillman, the closed circuit camera caught everything going right.

Peter Pillman:

EMS were able to bring him alive to the hospital.

Ambulance Driver:

Transporting a 66-year-old male to the emergency department.

Andy Soth:

Pillman’s father made it and has recovered. But typically a cardiac arrest under these circumstances has less than a 2% survival rate. For all that the footage may say about the fragility of human life, Pillman shares it to talk about the fragility of the system that saved a life that day.

Peter Pillman:

These rural areas are totally dependent on volunteers.

Andy Soth:

Pillman is the ambulance director for Durand in western Wisconsin. A small community, like many others in the state, that’s having trouble filling volunteer positions in its emergency medical service.

Peter Pillman:

We have seen a decrease in the number of people that have time or are willing to put time into community involvement, specifically in the ambulance, probably because the commitment is quite extensive.

EMT Student:

Ok, wiggle.

Andy Soth:

To start, there’s required training, like the summer-long class at Western Technology College in La Crosse.

Peter Pillman:

We used to have janitors or others that could leave work to go on an ambulance call and had flexible hours. That’s no longer the case.

Andy Soth:

According to Pillman, downsizing and increased efficiency in business and government have made it harder for people to volunteer. And many in the Durand area commute to larger towns for work.

EMT Instructor:

Pull straight back.

Andy Soth:

Back at the EMT training class, it’s clear that public service is still a motivating force.

Deb Slaby:

In the rural areas it’s — you know, it’s helping your friends and neighbors. Doing whatever you can in those few precious minutes until you can get the patient to definitive care.

Kaylee Bath:

I just love helping people.

Mariah Gaier:

But in a small town you get a lot more of that like filling feeling when you see the people that you helped.

Andy Soth:

But these students, like many taking EMT classes today, are also motivated by their career choices. Meaning they may not work or volunteer as EMTs for long.

Kaylee Bath:

My end goal is to be a nurse.

Mariah Gaier:

My long-term goal is to be an EMT. And then maybe from there going on to medical school.

Andy Soth:

In Durand, the ambulance service is doing something that might have been unheard of just a few years ago, offering pay for what were once volunteer positions.

Peter Pillman:

I approached the city with a proposal, recognizing that this was coming.

Andy Soth:

It took not only Durand approving it, but getting surrounding areas also served by the ambulance to increase fees charged to each resident.

Peter Pillman:

That per capita rate had to be approved by all of the townships as well in the community.

Andy Soth:

But even with offering pay, positions have been hard to fill for many of the same reasons volunteer staffing has been a challenge. While it’s hard to change those societal factors, Pillman does have some ideas where legislation could help. One, making recertification easier. Another, loosening some restrictions on what qualified responders can do.

Peter Pillman:

So everything here is at EMT basic level. We have limits on what we can use.

Andy Soth:

Durand is certified as EMT Basic which means even if a volunteer has more advanced skills, they’re restricted from using them. Pending legislation could change that.

Peter Pillman:

There's a paramedic that lives in Durand wants to help out Durand ambulance. Even though we’re a basic level, they will be able to operate at that level when they’re working with Durand.

Andy Soth:

But ultimately for Pillman, it still comes down to a community working together.

Peter Pillman:

That is what made these areas so strong and so viable is that we did depend on each other. And we worked with each other to survive.