One of our friends sent me this link to a news report from central Pennsylvania about a long-established volunteer ambulance squad planning to shut its doors and close down.  The leaders of the rescue squad make the point that money is not the issue, funding remains sufficient.  But the number of volunteers has dropped drastically in the past couple of years.

The community squad runs about 400 calls per year, a very modest number that was easily handled when they had 20 active members.  But now they are down to five qualified EMT’s and the outlook is bleak, so they are phasing out their response availability with a target of complete withdrawal from service at the end of May.

This is happening all over the country and we have talked about this before.  I believe that this problem of a lack of volunteers is largely due to two factors.  First, there is an obvious cultural shift taking place with a younger generation growing up thinking that the world owes them a living and “someone else” will take care of them.  The sense of community effort for the common good is lacking with these people.  Some of them put on a show of “volunteering” for the local VFD or rescue squad by  dropping by and doing some landscape gardening or a bit of cleaning up around the station.  But I suspect that is more for their own self-grandisement than anything else.  They just want to tell their friends that they “volunteer” down at the firehouse.  In the video above, a soccer-mom is being interviewed as she is bemoaning the fact that it will take a lot longer for an ambulance from another township to arrive and treat her child if he falls down and cuts his chin.  Never once does the thought  enter her mind that perhaps she could take an EMT course and then a) take care of her own kid, and b) keep the ambulances in service for her community.

Not surprisingly, I was looking at the website of a volunteer squad a couple of weeks ago and they were actively seeking “Associate Volunteers” to join the organization to do the other stuff “around the station” other than run calls.  What happens when you reach the point where you have 20 housekeepers stopping by, but no EMT’s?  I guess you just sell off the ambulances and set up some ping-pong tables in the bays.

That other factor that I believe is affecting the sustainability of the volunteer organizations, both fire and EMS, is the continued upgrading of the minimum qualifications to serve.  This is especially evident in the EMS side where more and more localities are demanding paramedic-certified people on the ambulances.  No matter how dedicated you might be to wishing to serve on the local squad, asking somebody to dedicate their entire weekends for a full year to get paramedic certified is asking a lot.  Some people do it, but not nearly in the numbers needed to sustain the roster.  When the local medical authority demands that higher level of care, they have good intentions, but they are not being realistic about the ability to provide enough people to staff the ambulances.

Going hand-in-hand with the onerous qualifications is the necessity of practicing your paramedic skills in order to retain your competence.  It is a vocation that demands repetitive use just to maintain your ability to perform adequately.  And in many areas, the call volume is not there to make this possible, and that is contributing to the poor retention rate.  Add in that  most paid ambulance providers are constantly hiring paramedics, and you have  another reason for someone who genuinely likes the work to leave their local squad and start earning some pretty good money doing it.

Some states have recently lowered their ambulance standards to allow for the driver to be nothing more than that.  Usually they are requiring the driver to take and pass a 16-hour CPR course, but that’s it.  Only the attendant has the qualifications to administer any sort of patient care.  You’d think that they would at least demand a basic EMT certification, wouldn’t you?  Way back in my volunteer days, there was no such thing as an EMT certification.  The highest, and only, level of emergency care training was a basic American Red Cross first aid course that was required and then you learned the rest on the streets.  Now we are regressing to those past practices.  Airway, Bleeding and…..I forgot what the “C” stands for.

Let’s get the equipment checked out now.  I’ve got to get the coffee started.  See you back in the day room.