08/02/09 — Duplin's pay hike attracts new crop of EMTs

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Duplin's pay hike attracts new crop of EMTs

By Catharin Shepard
Published in News on August 2, 2009 2:00 AM

More than half a dozen new recruits have signed on with Duplin County emergency medical services since county commissioners raised the pay rate for Duplin paramedics.

In the weeks following the vote, which increased EMT pay by 8 percent, the potential shortfall of paramedics has been more than eliminated, said Brian Pearce, director of Duplin EMS.

The county hired three new full-time paramedics and another three part-time paramedics, and several intermediate and basic medical workers since the pay increase. Officials received even more applications than they could accept from EMTs wanting to work with the agency.

The below-average pay could have made it challenging to keep enough paramedics on staff, despite the opportunities the agency strives to provide for its employees, Pearce said.

"We have a great training program. Our medical director is very pro-active and always wants us to use the most up-to-date technology and treatment, and so that attracts a lot of employees because they want to use the newest equipment and they want to be able to function to the highest level. So that's helped," he said. "But then when your pay was far behind, sometimes it's hard to retain employees."

The size of the county and the rural nature of Duplin, with people spread out across the entire space rather than clustered together in a central location, means the eight ambulances that run during the day and the seven that run at night are often busy trying to provide service to all areas.

That didn't significantly change despite the lower pay, but the service was starting to feel the effects of it, Pearce said.

"For the most part, we've been able to staff those (ambulances) through the entire time, we were just starting to lose some paramedics," he said. "Some of our paramedics were having to work more overtime, and we were having to use part-time people more. We didn't have enough full-time employees. The change has already helped us overcome that."

Employee Susan Johnson, paramedic with Duplin County EMS, said the commissioners' move was a good one.

"It was an awesome decision. They made a very, very good decision," she said. "We've got good retention here, and we've got a lot of people who want to come to work here, especially now that we've got our pay raise. That's all the more incentive to stay."

The Duplin County EMS is not a small agency but has a fairly low call volume. Emergency workers respond to about 8,000 calls a year in the county, Pearce said.

Of the 60 people employed with the EMS, 36 are qualified paramedics, while the rest are "intermediates" and "basics" -- people who have not completed as many training hours as actual paramedics, but have still received levels of certified medical training.

Since the Duplin EMS underwent an administration shift about three years ago, the service has focused on training and equipment. Rob McDuffie oversees EMS operations for the county and has worked in emergency services for more than 20 years.

McDuffie previously worked with agencies across the state, and considers Duplin County is an excellent place for paramedics to work.

"You're using state-of-the-art equipment, learning state-of-the-art medical proceedures, you're receiving state-of-the-art training," he said.

Even after leaving for several years to work in private service, he returned to Duplin EMS two years ago and plans to stay.

"I like being here, I think I might've found home," he said.

One example of the new equipment is an advanced electrocardiogram, or EKG machine, used for monitoring the heart. The updated monitor is so sensitive it can detect multiple types of heart attacks.

The new design is a tremendous improvement over the old style of EKG, said Dave Cuddeback, training director for Duplin EMS.

"We'd put them on an EKG, and we'd see that their heart was fine. We put them on an advanced EKG like this, and we would actually see that they are having a heart attack in a certain area of their heart," Cuddeback said.

The Duplin EMS is using the more sensitive equipment in conjunction with a partnership with several area hospitals to get heart attack patients the treatment they need as quickly as possible. When someone has a heart attack, the paramedics can print out information about the patient's heart and take it directly to a cardiologist, often saving precious time by bypassing the hospital emergency room.

Thanks to the training, equipment and hospital arrangement, about 20 heart attack patients this year have been diagnosed and treated in record time, Pearce said.

"We've actually had people from the time that they've called and were having a heart attack, the paramedics have recognized it, taken them to the appropriate facility and actually had the problem fixed in the cath lab in approximately an hour," Pearce said. "It's good communication with the hospital, but it's really exciting to us that the paramedics are actually interacting, not just picking a patient up and taking them, but actually saying, OK, I can determine that this patient is probably having a heart attack, and the physicians, the cardiologists, are trusting our interpretations and allowing us to go straight to the cath lab."

The transport program and the new equipment have combined with the paramedics' training to save more lives than before and to minimize damage to the heart in the event of a heart attack.

"We've had great success. How do we define success? These people's hearts are in better shape because of it, and they are alive. We literally have a couple patients that are alive today because of this process," Cuddeback said.

Besides the extensive training to deal with heart attacks and strokes, the Duplin County EMS claimed last year first place in a regional paramedic competition, beating teams from across eastern North Carolina. The Duplin team even went on to compete at the state level, and this year will host the 13th annual Carolina Competition, a two-day event pitting the skills of EMS agencies from North and South Carolina.

The EMS agency was able to pay for the equipment and training by shifting money around, Pearce said, and by increasing collections. The increase in collections means charging patients, or their Medicare or Medicaid, more when they have to go to the hospital in an ambulance. But it also means that the EMS hasn't had to request more money for training and equipment from other sources.

"Some of it has actually been put back in the fund balance, or given back to the county. So increased collections was a part of it, and that's why they've been able to shift money instead of having to actually having to ask for more money from the commissioners," Pearce said.

The EMS has also applied for grants and state funds to secure the equipment and training, he said.