A Good Place to Work

Of the many problems facing EMS, recruitment and retention can seem among the most intractable. Google the term paramedic shortage, and you'll get more results than you can stand to read. There are no easy answers to this situation, but there are agencies out there that have had success in finding and keeping people. What are they doing right, and what can we learn from them? Here we examine some success stories featuring solutions to personnel paucities that are worth replicating.

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Putnam County, FL, isn't on the beach and doesn't have a big city. The county seat, Palatka, barely has 10,000 people. But Putnam County EMS, a paid third service that split from the city fire department 15 years ago, has a waiting list of providers wanting to join.

"We have a lot of good people, and our people keep people here," says Chief Mike Patterson. "You get a bunch of folks with bad attitudes who hate their jobs and their lives, and people aren't going to hang around."

Times weren't always so plentiful or so pleasant. In the early part of the decade, as the service felt the same personnel squeeze as so many others, many employees didn't have shiny, happy outlooks to their jobs. Mandatory overtime, the consequence of a lack of people power, left many unhappy.

"There's nothing more miserable than people being forced to work who want to go home," recalls Patterson.

The first step toward a turnaround came through a campaign of personal outreach to newly minted paramedic students. The department printed recruitment flyers and distributed them to students at state test sites in packets that also included a congratulations letter, a new paramedic patch, county demographic information and a job application. This put Putnam County EMS fresh in the minds of enthusiastic new job-seekers, and distributing the packets face-to-face lent a personal connection that other kinds of recruiting--for instance, mailing information--might not. What's more, there was an unanticipated secondary benefit: Many of those not interested in the packets passed them on to others who were.

"We got quite a few people just on referrals," says Patterson. "I even got some experienced paramedics out of it."

The department has employed the same approach at tech schools around the region. These have become valuable pipelines of students. Putnam County is centrally located, with Jacksonville and its suburbs to the north, St. Augustine to the east and Gainesville to the west. These are all growing areas, and the service facilitates courting their populations by not requiring county residency. As a result, it employs providers from all over North Florida.

As well, those providers aren't required to get their fire certifications (though doing so gets them extra money). The broad idea, in both cases, is flexibility--if you're short on people, you can't be hidebound with requirements that aren't really essential to delivering service.

"You can't paint yourself in a corner with your demands," says Patterson. "If your requirements are unrealistic, you're not going to meet them."

Like an increasing number of services, Putnam County EMS offers opportunities for educational assistance in exchange for a commitment to service. The Florida Association for Rural EMS (FAREMS), of which Patterson is president, also offers grant aid for those willing to work rurally. Putnam also reaches prospective young providers by sponsoring an Explorer post that has yielded current employees.

Workforce studies suggest that career ladders are important to workers. Recognizing that, Patterson doubled the number of officers in his department, from six to 12. They all ride the ambulances, preventing the department from being top-heavy, but the positions represent a road for advancement--the opportunity to "get somewhere" with the service.

When possible, people's talents and interests are incorporated into their jobs. Beyond a direct benefit to the department, this helps keep them passionate about their work.