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Volunteer EMS shortage hits the South Plains of Texas

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I found this article and wanted to pass it along, especially since I first

became interested in EMS while living in the Lubbock area.

-Wes Ogilvie

Austin, Texas

Small towns struggle with shrinking pool of volunteer emergency medical

technicians

A critical need

HENRI BRICKEY

AVALANCHE-JOURNAL

Wanted: Rural residents who want to save lives and receive free training to

learn how.

It might seem like an offer no one would refuse, but finding volunteer

emergency medical technicians is becoming increasingly difficult in small towns.

" Volunteers just aren't there anymore to do what we do, " said Russ Perkins,

director of Idalou Emergency Medical Service, which added its first paid EMT

position in May due to the shrinking number of volunteers. " We've been beating

our heads against the wall trying to get people. We will even pay for the

school if they'll give us one year of service. "

Ten years ago, Idalou's EMS department had 10 volunteers. Today, there are

four.

And it's not just Idalou facing the volunteer shortage.

Towns throughout the South Plains are struggling to fill volunteer positions.

Some towns have been forced to add paid positions, costing their residents

more in taxes. In other towns, officials simply hope a major emergency

requiring more than a couple trained medics never happens.

, EMS director for the town of sburg, said the volunteer pool

began to dry up about seven years ago. Today, there are two certified

emergency technicians in town - and the fire chief.

has about a half-dozen volunteer ambulance drivers, but not one

certified EMT on the volunteer roll.

The situation gets interesting on Friday nights, when the sburg

Buffaloes play home football games that are supposed to be attended by at least

one

emergency crew. Sometimes, an EMS crew from Abernathy will come into town for

the games. But that's not always possible.

" Most of the time our town newspaper editor, who is also an EMS volunteer,

will take the truck to the game, " said.

, EMS director for the town of sburg, said the volunteer pool

began to dry up about seven years ago. Today, there are two certified

emergency technicians in town - and the fire chief.

has about a half-dozen volunteer ambulance drivers, but not one

certified EMT on the volunteer roll.

The situation gets interesting on Friday nights, when the sburg

Buffaloes play home football games that are supposed to be attended by at least

one

emergency crew. Sometimes, an EMS crew from Abernathy will come into town for

the games. But that's not always possible.

" Most of the time our town newspaper editor, who is also an EMS volunteer,

will take the truck to the game, " said.

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Now I may start something here, but I guess I will anyway. This is a prime

example why the state should take charge of the certification process back

from the National Registry.

This state has a diverse population and backgrounds that require the

educator to assess and " tweak " , if you will, the program to match the

learning curve for that audience. I can tell you I have some great gravel

pit operators, mechanics, ranchers, Walmart greeters that would make great

basic responders. Yes, there is a certain aptitude that is needed to absorb

and relate the information and skills, but common sense along with an

instructor who can relate the information using the class' background will

produce a good, basic medic. Unfortunately, when one or two challenge the

National Registry test that is based on an assumed set educational level

that is not present in that class and fail, the stories spread and those

that passed the class lose hope of passing the test and never show. It is

hard to build any confidence level back up to the original level when the

rug is pulled out from under you. Especially when they rationalize that

they don't really have to do this. Now, we are back to square one.

I want to train medics, not NR test takers. The story related by Wes, I

believe, will continue to multiply unless Texas takes charge of our own

destiny and provide flexible avenues to address this situation. The " let's

contract with NR and they can handle it " is failing and, in my opinion, is

laziness on the part of DSHS. We pay our renewal fees and taxes. The funds

are there, in the state couffers, to maintain personnel and a test bank. I

would ask DSHS to cowboy up and give us the tools to take care of this

state, not NR.

I'm sorry, but when we allowed an outside entity to dictate who does and who

does not operate within our state, we lost control to address regional

issues and provide needed services and care. We know what we need.

With Soap Box In Hand,

Chuck

Colorado County EMS

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Could I hear a huge AMEN, Brother? A little known fact is that the NR exam is

designed to FAIL 30% of those that take it and should not be used as an entry

level certification exam. I hope that everyone who agrees with Chuck's point of

view speaks out, but I fear that it will fall on DSHS......pops, I mean DEAF

ears.

Rick

________________________________

From: texasems-l [mailto:texasems-l ] On Behalf

Of CCEMS

Sent: Thursday, October 18, 2007 12:42 PM

To: texasems-l

Subject: Re:Volunteer EMS shortage hits the South Plains of Texas

Now I may start something here, but I guess I will anyway. This is a prime

example why the state should take charge of the certification process back

from the National Registry.

This state has a diverse population and backgrounds that require the

educator to assess and " tweak " , if you will, the program to match the

learning curve for that audience. I can tell you I have some great gravel

pit operators, mechanics, ranchers, Walmart greeters that would make great

basic responders. Yes, there is a certain aptitude that is needed to absorb

and relate the information and skills, but common sense along with an

instructor who can relate the information using the class' background will

produce a good, basic medic. Unfortunately, when one or two challenge the

National Registry test that is based on an assumed set educational level

that is not present in that class and fail, the stories spread and those

that passed the class lose hope of passing the test and never show. It is

hard to build any confidence level back up to the original level when the

rug is pulled out from under you. Especially when they rationalize that

they don't really have to do this. Now, we are back to square one.

I want to train medics, not NR test takers. The story related by Wes, I

believe, will continue to multiply unless Texas takes charge of our own

destiny and provide flexible avenues to address this situation. The " let's

contract with NR and they can handle it " is failing and, in my opinion, is

laziness on the part of DSHS. We pay our renewal fees and taxes. The funds

are there, in the state couffers, to maintain personnel and a test bank. I

would ask DSHS to cowboy up and give us the tools to take care of this

state, not NR.

I'm sorry, but when we allowed an outside entity to dictate who does and who

does not operate within our state, we lost control to address regional

issues and provide needed services and care. We know what we need.

With Soap Box In Hand,

Chuck

Colorado County EMS

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I don't have all of the field experience that a lot of the folks on this list

have. What I do have (besides a big mouth) is a ton of education. In that

life as an overly educated person, I've taken a plethora of standardized tests.Â

What NR seems to be concerned about is a " statistically valid " exam, not

necessarily in measuring actual competence. The two are not necessarily

related. I too, would love to see a different exam process. (And not just

because I bombed one of the skills on last week's NREMT-P skills test...)

The status quo is that the state has put EMS under the purview of the Department

of State Health Services. With the current political climate in Texas, health

and human services agencies shouldn't expect much in the way of additional

funding. So, with the reality of the state budget, the fact that DSHS has

anyone involved in EMS is a miracle in itself. So, we're stuck with National

Registry. A separate EMS regulatory board like the cops, firefighters, nurses,

and doctors have might work, but it'd take a heck a lot of grassroots lobbying

from us in EMS, which we seem unwilling to do. Additionally, the Legislature

usually expects regulatory licensing boards to be " revenue neutral, " which means

we might all pay more for our patch -- and the licensing exam might still be the

National Registry.

Chuck's pointed to a real problem. In my opinion, the temporary, stop-gap

solution is for EMS educators to ensure that their students aren't just ready to

practice EMS, but also have the academic foundation and the test-taking skills

necessary to clear the NR hurdle.

That's probably more than any of y'all wanted to hear from this lawyer.

-Wes Ogilvie

Austin, Texas

Re:Volunteer EMS shortage hits the South Plains of Texas

Now I may start something here, but I guess I will anyway. This is a prime

example why the state should take charge of the certification process back

from the National Registry.

This state has a diverse population and backgrounds that require the

educator to assess and " tweak " , if you will, the program to match the

learning curve for that audience. I can tell you I have some great gravel

pit operators, mechanics, ranchers, Walmart greeters that would make great

basic responders. Yes, there is a certain aptitude that is needed to absorb

and relate the information and skills, but common sense along with an

instructor who can relate the information using the class' background will

produce a good, basic medic. Unfortunately, when one or two challenge the

National Registry test that is based on an assumed set educational level

that is not present in that class and fail, the stories spread and those

that passed the class lose hope of passing the test and never show. It is

hard to build any confidence level back up to the original level when the

rug is pulled out from under you. Especially when they rationalize that

they don't really have to do this. Now, we are back to square one.

I want to train medics, not NR test takers. The story related by Wes, I

believe, will continue to multiply unless Texas takes charge of our own

destiny and provide flexible avenues to address this situation. The " let's

contract with NR and they can handle it " is failing and, in my opinion, is

laziness on the part of DSHS. We pay our renewal fees and taxes. The funds

are there, in the state couffers, to maintain personnel and a test bank. I

would ask DSHS to cowboy up and give us the tools to take care of this

state, not NR.

I'm sorry, but when we allowed an outside entity to dictate who does and who

does not operate within our state, we lost control to address regional

issues and provide needed services and care. We know what we need.

With Soap Box In Hand,

Chuck

Colorado County EMS

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that was supposed to be oops, not pops, darn spell check!

________________________________

From: texasems-l [mailto:texasems-l ] On

Behalf Of , Rick

Sent: Thursday, October 18, 2007 12:51 PM

To: texasems-l

Subject: RE: Re:Volunteer EMS shortage hits the South

Plains of Texas

Could I hear a huge AMEN, Brother? A little known fact is that the NR

exam is designed to FAIL 30% of those that take it and should not be

used as an entry level certification exam. I hope that everyone who

agrees with Chuck's point of view speaks out, but I fear that it will

fall on DSHS......pops, I mean DEAF ears.

Rick

________________________________

From: texasems-l <mailto:texasems-l%40yahoogroups.com>

[mailto:texasems-l <mailto:texasems-l%40yahoogroups.com>

] On Behalf Of CCEMS

Sent: Thursday, October 18, 2007 12:42 PM

To: texasems-l <mailto:texasems-l%40yahoogroups.com>

Subject: Re:Volunteer EMS shortage hits the South Plains of

Texas

Now I may start something here, but I guess I will anyway. This is a

prime

example why the state should take charge of the certification process

back

from the National Registry.

This state has a diverse population and backgrounds that require the

educator to assess and " tweak " , if you will, the program to match the

learning curve for that audience. I can tell you I have some great

gravel

pit operators, mechanics, ranchers, Walmart greeters that would make

great

basic responders. Yes, there is a certain aptitude that is needed to

absorb

and relate the information and skills, but common sense along with an

instructor who can relate the information using the class' background

will

produce a good, basic medic. Unfortunately, when one or two challenge

the

National Registry test that is based on an assumed set educational level

that is not present in that class and fail, the stories spread and those

that passed the class lose hope of passing the test and never show. It

is

hard to build any confidence level back up to the original level when

the

rug is pulled out from under you. Especially when they rationalize that

they don't really have to do this. Now, we are back to square one.

I want to train medics, not NR test takers. The story related by Wes, I

believe, will continue to multiply unless Texas takes charge of our own

destiny and provide flexible avenues to address this situation. The

" let's

contract with NR and they can handle it " is failing and, in my opinion,

is

laziness on the part of DSHS. We pay our renewal fees and taxes. The

funds

are there, in the state couffers, to maintain personnel and a test bank.

I

would ask DSHS to cowboy up and give us the tools to take care of this

state, not NR.

I'm sorry, but when we allowed an outside entity to dictate who does and

who

does not operate within our state, we lost control to address regional

issues and provide needed services and care. We know what we need.

With Soap Box In Hand,

Chuck

Colorado County EMS

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Rick, would you please let all us know where that " little known fact "

comes from? Could it be there is another little known fact the NR is

designed to pass 70%?

Why do we have the NR as the certification exam? If we don't use it,

what do we use? Do you know why the NR started being used in Texas?

Just curious.

From: texasems-l [mailto:texasems-l ] On

Behalf Of , Rick

Sent: Thursday, October 18, 2007 12:51 PM

To: texasems-l

Subject: RE: Re:Volunteer EMS shortage hits the South

Plains of Texas

Could I hear a huge AMEN, Brother? A little known fact is that the NR

exam is designed to FAIL 30% of those that take it and should not be

used as an entry level certification exam. I hope that everyone who

agrees with Chuck's point of view speaks out, but I fear that it will

fall on DSHS......pops, I mean DEAF ears.

Rick

________________________________

From: texasems-l <mailto:texasems-l%40yahoogroups.com>

[mailto:texasems-l <mailto:texasems-l%40yahoogroups.com>

] On Behalf Of CCEMS

Sent: Thursday, October 18, 2007 12:42 PM

To: texasems-l <mailto:texasems-l%40yahoogroups.com>

Subject: Re:Volunteer EMS shortage hits the South Plains of

Texas

Now I may start something here, but I guess I will anyway. This is a

prime

example why the state should take charge of the certification process

back

from the National Registry.

This state has a diverse population and backgrounds that require the

educator to assess and " tweak " , if you will, the program to match the

learning curve for that audience. I can tell you I have some great

gravel

pit operators, mechanics, ranchers, Walmart greeters that would make

great

basic responders. Yes, there is a certain aptitude that is needed to

absorb

and relate the information and skills, but common sense along with an

instructor who can relate the information using the class' background

will

produce a good, basic medic. Unfortunately, when one or two challenge

the

National Registry test that is based on an assumed set educational level

that is not present in that class and fail, the stories spread and those

that passed the class lose hope of passing the test and never show. It

is

hard to build any confidence level back up to the original level when

the

rug is pulled out from under you. Especially when they rationalize that

they don't really have to do this. Now, we are back to square one.

I want to train medics, not NR test takers. The story related by Wes, I

believe, will continue to multiply unless Texas takes charge of our own

destiny and provide flexible avenues to address this situation. The

" let's

contract with NR and they can handle it " is failing and, in my opinion,

is

laziness on the part of DSHS. We pay our renewal fees and taxes. The

funds

are there, in the state couffers, to maintain personnel and a test bank.

I

would ask DSHS to cowboy up and give us the tools to take care of this

state, not NR.

I'm sorry, but when we allowed an outside entity to dictate who does and

who

does not operate within our state, we lost control to address regional

issues and provide needed services and care. We know what we need.

With Soap Box In Hand,

Chuck

Colorado County EMS

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Chuck has hit it on the head. When we have a system that is designed to create

failure 30% of the time, we are forcing ourselves to function in a 'back to the

wall' mode. We can't afford to set up situations where 30% of our potential

future is flushed away at the first stop.

What is the pupose in designing failure? Answer- generating revenue from

retesting. That is the sickest part of it all.

Those of us who are instructors have to adapt, adjust and overcome. We always

have, always will, but it would be nice not to enter a rigged game.

" A prudent man foresees the difficulties ahead and prepares for them; the

simpleton goes blindly on and suffers the consequences. " Proverbs 22:3

__________________________________________________

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Here is an idea...lets make state certification just like ACLS...it is better to

make sure everyone passes than?to make sure they?know the material.? I mean

maybe we should just let the course instructors test their folks and attest to

their ability to " be a good medic " .?

When we look at our counterparts, I see that.? I mean we are all talking about

J & J promoting nurses...I was just reading on the nursing email lists about how

unfair the state nursing test is and how they are working to make sure that even

those who can't read and write can still be nurses...

And then the physicians...I mean when they ain't cuttin hair, they are really

working on being better care providers.? Good thing they moved away from those

medical boards, I mean that high school drop out couldn't be doing my brain

surgery next week had they kept that pesky hard test out there.

We want everyone certified, but then we will sit and complain about how care

isn't what it should be and we aren't seen as professionals.? We can't have it

both ways.?

Another example...we want EMS to be a mandated service, but for this to honestly

happen, the poorer areas (and lower tax base areas) are going to need state and

maybe even financial help...but as soon as that happens, the larger areas (read

BIG cities with functioning EMS Systems) are going to be standing in Austin with

their hand extended wanting money and leaving these poorer areas out in the

cold...and then when the cash gets to the outlying areas...who will be the most

opposed to paying for EMS????? Yep...the volunteer agencies who are beating

themselves to death just to get diesel and one or two people to answer a 911

call during the Friday night football game.?

We want what we want but not what we want.

Dudley

RE: Re:Volunteer EMS shortage hits the South Plains of

Texas

Chuck has hit it on the head. When we have a system that is designed to create

failure 30% of the time, we are forcing ourselves to function in a 'back to the

wall' mode. We can't afford to set up situations where 30% of our potential

future is flushed away at the first stop.

What is the pupose in designing failure? Answer- generating revenue from

retesting. That is the sickest part of it all.

Those of us who are instructors have to adapt, adjust and overcome. We always

have, always will, but it would be nice not to enter a rigged game.

" A prudent man foresees the difficulties ahead and prepares for them; the

simpleton goes blindly on and suffers the consequences. " Proverbs 22:3

__________________________________________________

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