Durham County’s continued population growth and corresponding need for emergency services are putting a strain on EMS workers.
In this fiscal year, the County is on track to have a record breaking 60,000 911 calls for service; that growth means without new positions, emergency medical services staff are being stretched thin.
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The Durham County Manager’s Proposed Budget includes twelve new full time employee positions in EMS. Six are paramedic roles, and six are emergency medical technician roles.
Durham’s Director of the Office of Emergency Services, Mark Lockhart, said the new positions are needed.
“We have not added any staffed transport units to Durham County EMS since 2018. Our call volume, in that same time, has increased over 24%,” Lockhart said.
At times, radio traffic among first responders will show calls for service in a holding pattern, with EMS units tied up in other situations.
"No units available is a little bit of a misnomer, because it means at that point in time, no units are available. It doesn't mean that the next ambulance isn't clearing the hospital in the next minute and a half,” Lockhart explained. "It also doesn't mean that there isn't a mutual aid unit available."
Durham County EMS both gives and receives mutual aid to surrounding counties daily.
Between five and seven percent of 911 calls are “held,” meaning the EMS response is put on pause due to capacity.
Lockhart says the majority of those “held” calls are low priority, and the practice keeps a handful of units available for serious, high-priority calls.
“It's not ideal, but at the same time, we need to keep our resources available for those most critically in need,” he said. "We did have one day last week where we actually held 35 calls on the day shift."
Lockhart said Durham County EMS is doing the best they can with the resources they have, but the tough work and lack of staff can take a toll on first responders.
“They're listening to the radio, and they hear that we four calls holding, or that we have no units available. At the heart of every EMS provider, every first responder is the desire to help somebody. When you can't do that, that wears on you,” he said. “For our folks, they're doing the best they can, but they're getting their tails kicked on a regular basis. We're doing the best we can to try to improve that situation, but it is a function of people and money."
Durham County EMS has looked at alternative staffing models to deal with the issue.
They’ve employed a paramedic response vehicle, allowing a paramedic to use an SUV equipped with advanced life support technology to act as an additional unit.
They have also utilized basic EMTs to staff a basic life support unit, and they are looking at options to better triage 911 calls.
Lockhart says the EMS career field has changed vastly over the course of his 40-year career, and not as many people are entering the field anymore.
He sees a significant need for EMS providers across the country.
"Our priority is to make sure we have the resources we need to meet the community requests. And part of that is ensuring that our recruitment effort is strong and we're putting forth our best effort in recruiting folks to come to Durham,” Lockhart said. "I think we're all one bad day away from having a really bad day."