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Paramedic shortage in Nation’s Capital. TV station reports medics leaving DC at high rate due to overwork & stress.

DC Breaking Local News Weather Sports FOX 5 WTTG

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Dan Goldstein, WTTG-TV/Fox 5:

Paramedics, the most elite medical responders in the city’s fire department, are leaving the District’s Fire and EMS agency at such high rate due to overwork and stress that the department is now facing a critical shortage, multiple department sources told FOX 5 News.

Call volume in the city has been rising over the past three years as a result of increased population, but the department’s emergency medical system, especially its staffing of paramedic units, has fallen short, FOX 5 has learned.

For example, FOX 5 has learned that on many days, the department is unable to fill all its 14 paramedic-staffed ambulances that are supposed to be in service around the clock every day to respond to the most critical life-threatening calls, because it is short as many as 100 paramedics to fill the slots.

Paramedics have more than 1,600 hours of training in life-saving emergency procedures, compared to about 300 hours of training for emergency medical technicians or EMTs, who make up the bulk of the department’s EMS first responders. Unlike EMTs, paramedics can use the most sophisticated defibrillators for patients in cardiac arrest, start IVs, push life-saving drugs like insulin and insert breathing tubes to help patients in respiratory distress.

But in D.C., there aren’t enough of them. Several years ago, the city shelled out $7,000 in bonuses to recruit paramedics, but many of them have already left for other jurisdictions like Montgomery County, Md. and Annapolis, according to the firefighters union. Moreover, there hasn’t been a paramedic class or hiring effort since to replace those that have left, the union says.

“There aren’t enough paramedics in the system,” D.C. firefighter union chief Ed Smith told FOX 5 News. “We need an increase in units.”

To offset the shortage, the department has been forced to pull firefighters who are cross-trained as paramedics off engine companies to backfill the ambulance slots. Currently about two dozen fire engines, which cost more than $500,000 each, are also now serving as expensive EMS shuttles, delivering paramedics to emergency calls to get a top-level medical provider on-scene quickly on the most urgent runs when paramedic-staffed ambulances aren’t available.

But taking engine companies out of service to run medical calls is risky, says Ed Smith, the union chief.

 

“Hopefully there are no fires during the same time,” he said.

Even more serious, FOX 5 has learned the department has been forced to hold over some paramedics who have already worked a 24-hour shift for as many as 12 more hours, just to keep some units on the street, leading to fatigue and low morale.

“Somebody’s going to die or get hurt from this and I don’t want a part of it anymore,” one veteran D.C. firefighter/paramedic told FOX 5.

The D.C. first responder only agreed to talk if we hid their identity, for fear of retaliation.

The city’s emergency medical system, the paramedic said “is going to crash. Everybody knows it. We all talk about it. It’s going to crash and there’s no predicting who’s going be in its way.”

The D.C. firefighter/paramedic also told FOX 5 that because of the shortage, they are often bounced around the city from station to station every shift, depending on need. That makes it hard to learn a particular area of the city, they said, which can lead to longer response times as paramedics struggle to find an out-of-the-way address or apartment.

In addition, paramedics aren’t allowed to refuse department orders to continue work, even if they’re exhausted from working 24 hours straight.

“You cannot go home, you will be put on charges, which are disciplinary action, even if you don’t feel up to it,” the D.C. paramedic told FOX 5.

D.C. Fire and EMS Chief Kenneth Ellerbe told FOX 5 News that the city doesn’t have a paramedic shortage, saying there are more than 240 paramedic-certified employees in the department, even though not all on are on the street or available to care for patients.

“I know that we are able to respond to the community every time we have a call,” Ellerbe said in an interview.

He said that holdovers of paramedics do occur, however.

“We do have the capacity to hold folks over to reduce our overtime,” he said. “But, also to make sure that we are fully staffed to make sure that we can respond to the needs of the community.”

Still, in a follow-up interview at the chief’s request the day our story was to air, Chief Ellerbe declined to answer questions on the safety of the system, referring questions about whether a 36-hour shift for a paramedic puts patients at risk to his medical director, David Miramontes.

“I can tell you we provide really good patient care,” Miramontes told FOX 5.

To reduce the fatigue on paramedics and EMTs, the city has come up with a new deployment plan for its ambulances called “power shifts” where more units will be on duty during the daytime, when the call volume is highest, and be reduced at night when there are far fewer calls.

“That will allow us to put from 25 to 45 units on the street, particularly during our heaviest call volume hours,” Ellerbe said.

Still, union chief Ed Smith has his concerns, saying the plan actually leaves the District without a dedicated paramedic-staffed ambulance from 1 a.m. to 7 a.m. The power shift was to go into effect this month, but FOX 5 has learned it has been delayed, at least until next year.

Marie Bates, who lives in Southeast Washington, is one District resident who has witnessed the struggles of the DC EMS system up close and personal. In August, she called 911 from her home on Good Hope Road, SE for chest pains, a top priority call for the D.C. emergency medical system. But since there were no close-by units available, a paramedic-staffed fire engine from Station 29 on MacArthur Boulevard in Upper Northwest had to answer the call, more than seven miles away. The response time was nearly 20 minutes, more than twice what it should have been by department protocol.

“They told me that first they were coming,” she told FOX 5 News. “Then they said they were uptown, they couldn’t get through.”

She worries though about other District residents who may not be so lucky when they call 911 and have to wait for a paramedic to arrive.

“People could be on their deathbed,” she said.

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Comments - Add Yours

  • hydro engineer

    The city offered the $7000 to bring in Firefighter/Paramedic to the city from other states(since we do not train anyone to that level), then once they joined they never paid them. They still owe several members the $7000 signing bonus. So at least give them what is owed!

  • Anonymous

    When you keep doing the same thing, you get the same results. Change will come when the public gets sick and tired of being sick and tired. Break this plate in half and go seperate service once and for all. That is about the only thing that has not been tryed. Do it you may find that it works. I was there when you got tech pay and five points for a tech exam. 18 months at Amb. 3, whe their was only nine units.

  • firefighthero

    Does Ellerbe EVER speakl the truth?

  • E McG

    Holding someone over doesn’t reduce overtime – it means that the individual being held over gets OVERTIME PAY.

  • h deezy

    Sounds like most urban fire-based EMS systems. LA, Seattle, Orlando, etc etc.

    • MJ

      Can’t speak for the others, but definitely does not sound like Seattle. Medic One has one of the highest retention rates around, and a very well respected ALS program.

  • Anonymous

    “If you look at our patient care, remember, I come from other lands and I can tell you we provide really, really good patient care,” Miramontes told FOX 5.

    Thats a relief!

    • Anonymous

      And far from true….

  • Matt

    We are currently forced to hold FF/Medics over on “Continuation of Duty” just to meet minimum staffing of our ALS resources. We SHOULD have extra medics coming to work on a daily basis, to allow for members on training, evaluation, etc. The FF/Medics would like to be like everyone else that has come through this department; get to ride ladder trucks and rescue squads, drive the wagon without having to switch out onto an ambulance every run, be an officer without being the medic, etc. Give us that and you’ll see a vast improvement in morale.

    That’s an easy fix. Solving the problems at OUC (dispatch) is another animal that unfortunately the Fire/EMS department has no authority to fix.

  • HOOKMAN

    Im just curious why FOX 5 blacked out the teacher from Charlie Brown….Waaw wa wa….wa wa waw

  • MegaDoritos

    240 medics – I dont really see the problem

    • Bogus

      About 120 on the streets, the rest are in OUC, traing school,

  • Anonymous

    @ h deezy

    Point taken, but I’d exclude Seattle.

    Unless something has changed, Seattle Fire partners with private BLS to handle lower acuity calls.

    Might help DC to give that a try?

    • ltfd seattle

      In Seattle, ALS calls get the closest Fire BLS unit- Aid Car (2FF/EMTs), Engine, or Truck, and the closest Medic Unit (FF/Medics).

      BLS calls get the closest Fire BLS unit, who requests an AMR ambulance if transport is needed. AMR closely monitors Seattle Fire dispatching, and moves units to stage/cover depending on BLS call location & volume.

      • Brooks

        sounds like Seattle’s system depends heavily on Fire Apparatuses responding to Medical calls and waiting for a transport. How busy are SFD engines? Many of DC’s engines already run 5000 runs a year.

        Do Aid Cars ever call for AMR?

      • http://tooldtowork.com Too Old To Work

        Wouldn’t it make sense for Seattle to have BLS ambulances for transport? Not only is it likely to be faster, but there is some revenue to be made. If the engines are staffed with medics, in a pinch a medic could use a BLS ambulance to transport.

        Just a thought.

  • Anonymous
  • Anonymous

    On average, half the medic units are downgraded to bls on a daily basis. “We’re fine”. Really chief??? Maybe you should spend more time looking at the real issues facing this dept instead of looking a how you can change the uniform policy again, or chasing ambulance crews on runs so you can lecture them on siren use, or playing video games on your iPod at ANC meetings(remember that picture?) Maybe you should spend some more time listening to your people(I realize that’s a lot to ask of someone so well educated and better then the rest of us)instead of figuring out how to bully those who speak out against you.

    You literally know absolutely nothing.

  • InfamousJ

    at about the same time everyday, the city is in ‘Stand by for the transport unit’ mode… but has anyone noticed other than me that its not being said over the vocal on 01 dispatch?? ‘beep, Eng 4 respond for the bravo animal bite at …..’ once on EMS 12, Eng 4 ask’s who is the transport unit? the Reply, which takes over a minute, ‘we have none available’ or ‘you’re on the list’.
    at 1300hrs?!?! how does such a big department, function like this DAILY??
    I’ll tell you how, upper management covers it up as they always do, to make his/her job performance look great. If DC wants the Truth and a fix to the ongoing problems,they need to listen to the men and women that are on the streets.. since LRB took office it has gone down hill at a faster pace. nothing has been fixed. But that’s right, wearing my uniform shirt with collar brass and removing ‘DCFD’ has fixed everything.. how can I forget.

    • http://tooldtowork.com Too Old To Work

      Don’t worry. Management will go to encrypted communications so that the public can’t hear any of this disturbing radio traffic. That will solve the problem.

  • Anonymous

    Good to see DC Fire in the news again. Same story it has always been. EMS system doesnt work, the chief sucks/members dont like him, working conditions suck (overtime, hours worked, low morale). Different year, same problems. 5 years ago these were the problems. 5 years from now they will be the same problems.

  • the ear

    Heard a rumor there is a memo out about removing TV’s and cable, Xboxes from firehouses.I hope that is not the case.This clown is off the wall and has to go.

    • Lineman

      Its true, getting rid of all internet, cable and satellite that members pay for themselves

  • Steve in NJ

    Why doesn’t DC just privatize their EMS system? I know thats the nasty “P” word but face it, nobody who takes a job as a DC firefighter wants to ride the ambulance, right? They can’t staff their medic units. The people who are forced to ride the ambulance hate it. Just give it up. Contract it out and let it be someone else’s problem. Then DCFEMS can go back to being DCFD. I am a union guy. But whats the point of saving “union jobs” that nobody wants anyway?

    • a concerned taxpayer

      I agree

    • http://tooldtowork.com Too Old To Work

      The question would be if a private could make money there.

  • AbsoluteReality

    Hey Steve…

    It’s all about numbers, cause numbers = more dues being paid.

    Course like the school systems more money does not mean more positive results.

  • Anonymous

    Ellerbee has to be the most arrogant or naive Fire Chief ever. We have the ability to hold people over that saves us overtime. Wow, I never knew it worked that way. When will the madness stop?

  • DCFDmember

    This was an underwhelming report. The TV station had been running commercials about this story about a week in advance of it being shown, and I thought that was because there was going to be something to this report.

    It missed on so many areas where it could have been very informative, and the way some of the items were presented they missed their mark.

  • DCFDmember

    The $7000 bonus was an item which helped to attract many new FF/PMs to DC a few years ago. The city has failed to pay that bonus to a number of the people who were promised that. That is one reason for having less medics as some of them have left the department, and a few others gave up their paramedic certification and became EMTs due to not being paid their bonus. This, of course, has adversely affected the morale of those members.

    A number of medics left the department because of the way LRB is treating members of the department, especially those of certain races, gender, and based up where they reside. This has actually been an issue which has affected all of the members which has caused an increase in personnel resigning or retiring, though it has especially affected the paramedic ranks.

    The threat of a shift change to a much lesser shift by LRB is another big reason why a lot of the paramedics have left the agency.

    The way they are treating medics via discipline is also out of control. They are trying to jam up paramedics for anything and everything.

    The constant holding over of medics on forced overtime is also way out of control. It is now an everyday occurrence. The part about that which is contradictory, is that they hold them over for 12 hours in the AM, but when the 12 hours of the PM part of the shift begins they have no problem having FF/EMTs fill those slots for the remainder of the tour and thus causing those units to be downgraded from ALS to BLS.

    There are a number of current paramedics in DC contemplating leaving the department due to the reasons listed above. With the rate they have been separating from the department, it’s only a matter of time before more of them leave.

  • DCFD Forever

    EMS should be third service, bring back DCFD and Ellerbe would be the best Fire Chief DC Fire has ever seen!!

  • HOOKMAN

    @DCFD Forever…really…..almost 2 years as King FEMS…..i think you’re a bit late on that being a possibility……remember DCFD…..if you didn’t film or recod this idiot during his firehouse imtimidation visits or when he self invokes himself as an MPD/FEMS patrol officer and pulls your apparatus over because of who’s on board (not because you did anything), it didn’t happen…

  • i’m just saying

    We have at least 20 medics that could be on the street but are at other divisions.

    Office of the medical director has 2 EMT’s and 9 medics of which 5 are on the street calls unit. (Street calls could be handled by Dept. of Social Services)
    Internal Affairs has 1 Medic
    IT has 1 Medic
    Training Academy has 9 Medics
    2 EMT’s
    Some of these individuals can be placed back on ALS transport units and plug some of these vacancies. I’m just saying

    • Pipeman27

      Then those individuals might actually have to do some actual work so that’s out of the question. I’d reall like to see those a hole ELO’s back on the street.

  • What your saying is…

    Rob Peter to pay Paul and semantics is the answer…NO. You can’t take from here and place over there without creating a huge hole. This mentality is exactly the same as our illustrious administration. They have stripped the training academy, Fire investigations, and the Medical directors office to fill spots. Well guess what you now have the same amount of vacancies just in a different location. THE ANSWER IS HIRE, AND STOP THE CULTURE OF FEAR AND RETALIATION.

  • mac

    what is yall calling a paramedic ambulance in dc

    • JustSayin’

      A long wait.??

  • mac

    whats the different from a medic unit and a paramedic ambulance

    • Doing it.

      A medic unit has a paramedic assigned to it for the 12 hour shift. A paramedic ambulance is a bls ambulance that a medic has “traded out” with a bls provider on. They are only in service from the time they clear the hospital to the time they reach the engine company the paramedic is assigned to. Sometimes the 3 mile ride can take 6+ hours depending how many runs you catch trying to return the medic.