DOUBLE RESPONSE - A crash in the roundabout on U.S. Highway 17-92 in June 2021 draws response from both the DeLand Fire Department and Volusia County Emergency Medical Services, under the county's two-tier system.

Looking for a career in a field with plenty of growth potential and unrelenting demand as others are prone to human frailties? Are you able to thrive in a high-stress environment where the difference between life and death is just a heartbeat or a millisecond?

If you can answer yes to both questions, you may be a candidate for what may be the most demanding order of public service.

Like many private businesses and government entities, Volusia County’s Emergency Medical Services has openings, and the agency wants to add even more jobs later this year.

“We are able to respond to our calls, but at some point, we’re going to have to get more employees,” county EMS Director Michael Colman said.

Consider:

If you are involved in a wreck, a violent crime, a house fire, or some other unforeseen occurrence, or if you suddenly feel a tightening pain in your chest, and if someone calls for help for you, you most likely will get a visit from people trained to render medical aid and, if necessary, to rush you to the nearest hospital or a hospital of your choice.

Twenty-four hours a day, seven days a week — including holidays — the men and women of Volusia County’s Emergency Medical Services are standing by somewhere, ready to serve a county whose population is now 574,833.

Throughout a county as large as the state of Rhode Island, which is attracting new settlers every week, skilled EMS personnel are on duty to save lives and ease suffering. The county’s emergency medics are often the first to arrive on the scene of someone in dire need, whether they live in the unincorporated area or inside a city.

Volusia County provides a two-tier emergency-medical response. When someone calls 911, the dispatcher will alert the county’s EMS and the fire department closest to the scene.

If the firefighters, who are also cross-trained as emergency medical technicians or paramedics, arrive first, they will treat and stabilize the patient, while the ambulance is en route. In some instances, a municipal fire department with ambulances may rush a patient to a hospital, but the EMS crew is usually the one to provide transport to the emergency room.

The two-tier response system, with its inherent backup of personnel, is quite often stretched thin. During the height of the coronavirus pandemic, and with the surges of infections from new variants of the virus, the medics were called upon to do even more.

The county’s paramedics and EMTs worked overtime and then some, to fill gaps left when the contagion sidelined their co-workers.

For these first responders, overtime becomes a standard part of their schedule — even if they would prefer to work fewer hours.

“The average employee gets 300 hours of overtime per year,” Colman said.

The numbers tell the story of the critical need for more help in a time of population growth and aging. “Business” is brisk, or virtually nonstop. The EMS agency’s resources, especially the human capital, are finite and strained.

How long will you wait?

How long does it take between dialing 911 and seeing an ambulance or a firetruck at your home or business?

Response times are key measures of the effectiveness of an emergency-service provider.

In a city, the average response time in a life-threatening emergency is 4 minutes 45 seconds. Either a fire/medical-rescue unit or a county EMS unit will arrive, on average, at the scene in 4 minutes 45 seconds. That is below the county’s urban-response-time goal of 8 minutes 59 seconds.

In a rural setting, the average response time, according to the county’s records, is 8 minutes 22 seconds. That beats the county’s response-time goal for the rural areas, which is now 17 minutes 59 seconds.

The county uses what is known as a hybrid model for stationing its units. That is a mix of posting at fixed locations, such as the EMS headquarters in Holly Hill, and the placement of ambulances at or near places where accidents may occur or in large concentrations of population or activity, such as close to business centers or nursing homes.

What’s the pay, anyway?

Amid a nationwide shortage of qualified EMS workers, Volusia County is making extra efforts to recruit them. The county is working to draw more of the graduates of Daytona State College’s paramedic program, including accepting applications from students nearing graduation.

Volusia County is also bolstering its social-media presence to lure medics.

The county is ready to show its new hires the money. The hourly pay range for an EMT is $14.71-$25.22, while a paramedic earns $20.50-$35.16 per hour.

Newly trained and seasoned EMS personnel are highly sought-after.

“Hospitals are hiring our paramedics,” County Manager George Recktenwald said.

This is in addition to the competition from the fire and emergency-medical departments in neighboring cities and counties.

The shortage of people working in the high-stress world of saving lives and easing suffering puts extra demands on those already employed. A 40-hour workweek is a rarity. Overtime becomes routine, as daily staffing vacancies must be filled.

During extra-busy times, off-duty medics may be summoned to work.

“If somebody doesn’t volunteer for it, somebody else will be ‘voluntold’ for it,” Colman said.

The guarantee of extra work may be an obstacle to hiring.

“There are some people who don’t want to come to work for us because of overtime,” Colman said.

High-stress workers need places to rest

Because EMS personnel are working under high-pressure circumstances and sometimes see and experience what could be scenes from a horror film, Volusia County officials propose to establish certain “respite” sites for them. Council members plan to use some of the stimulus funds from the American Rescue Plan Act to set up at least three EMS rest facilities.

“The ones we’re looking at now are modular buildings that could withstand [winds of] 175 miles per hour,” Colman said, adding the exact locations have not yet been selected.

These places would allow the medics to clean up, change into fresh uniforms, grab a meal, relax and de-stress from rounds of constant calls or from an especially difficult emergency.

“Just to take five minutes and go outside and not be a paramedic,” County Chair Jeff Brower said.

While some have suggested the county EMS could probably use fire stations in the county and even perhaps in the cities as respite facilities, Recktenwald discounted the idea.

“The firemen basically don’t want you in their refrigerator,” he said. “We’ve had complaints.”

Numbers tell the story:

70,455 — the total number of EMS calls for service during the 2021 fiscal year, which began Oct. 1, 2020, and ended Sept. 30, 2021

77,958 — the number of units dispatched, including municipal fire/medical rescue agencies

389,610 — the number of miles driven by the county’s EMS vehicles during the 2021 fiscal year

84 — the number of county EMTs in Volusia County EMS, not including those working in the county’s Fire Services

98 — the number of county paramedics in the county EMS, not including those working in the county’s Fire Services

15 — the number of vacant EMS positions

5 — the number of additional planned openings for EMTs for the 2023 fiscal year that begins Oct. 1

5 — the number of additional planned openings for paramedics for the next fiscal year

2 — the number of EMS division commanders sought for the 2023 fiscal year to provide greater administrative support and supervision of front-line personnel on duty

$27.3 million — the budget for Volusia County EMS for this fiscal year

56 — the total number of ambulances in the county’s EMS fleet

25 — the number of EMS ambulances in operation during daylight hours

16 — the number of EMS ambulances assigned and available during nighttime hours

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