Official Says EMT Shortage A Challenge For Small Towns

YANKTON, S.D. (AP) -- As the number of emergency medical technicians continues to slide, South Dakota's smallest communities are among those being hurt the most, an emergency services worker says.

A declining rural population means fewer people are becoming or remaining EMTs, said Gordon Dekkenga, the ambulance administrator for Yankton County emergency medical services.

``In a lot of small towns, people burn out because they are on call all the time,'' he said. ``It's not that they have a high volume of calls, but they are tied down to their towns. You have got to have a balance between being on call and having time for your family and another life.''

Dekkenga, who serves on a statewide advisory panel, is among those compiling a list of candidates for a new committee dealing with the shortage.

A recent audit of the South Dakota EMS system revealed the need for a number of changes, Dekkenga said. The committee is charged with making recommendations for reaching the state's goals.

For many small town residents, becoming an EMT is a way to help the community.

``In Avon, they are in dire need of EMTs,'' said Cherilyn Mudder, a nurse who responded to a recent advertisement in the Avon Clarion seeking EMTs. ``My son, Jay, is an EMT, and he was telling me how short they are,'' Mudder said. ``We had a married couple who lived in town and were EMTs, but then they moved to Sioux Falls. That really hurt.''

Sarah Abbott, 17, a high school junior from Irene, said she has served as a first responder for more than two years.

``When I joined as a first responder, I was only 15 and they had to make sure I was old enough to do this,'' she said. ``I just like to help people. I want to be a paramedic.''

Cathy Cuka of Tyndall, a secretary in the Yankton County EMS office, said exposure to her colleagues' lifesaving role got her thinking about becoming an EMT.

``I was helping a lady whose husband was killed in an accident, and she said, 'You shouldn't be a secretary. I could see you in an operating room. That's what you were meant to do,''' said Cuka.

Dekkenga said he is heartened by those who are willing to sign up. But he says challenges remain.

``I wish I knew the answer (to finding more EMTs). It could be the size of the community, not any interest, or it could be a matter of not educating the people that there is a need,'' he said.

Some say a contributor to the decline is the amount of continuing education required.

To remain certified in South Dakota, a basic-level EMT needs 24 hours of continuing education every two years, along with CPR certification, Dekkenga said.

The national-registry level requires 72 hours of training every two years, along with the CPR certification, he said.

Although there are many opportunities for EMT training, many rural communities cannot meet the basic state requirements for staffing and are requesting hardship waivers, Dekkenga said.

``You don't need to be an EMT to drive an ambulance, but the state wants a driver to take the course,'' he said. ``Even if the driver is EMT certified, you still have to have two EMTs with that driver to be licensed as an ambulance. A lot of towns come up with one EMT and a driver, but it still doesn't meet state requirements, so they are asking for the hardship waiver.''

Finding new EMTs is essential if ambulance services are to survive, Dekkenga said.

``There has to be new blood. There is nothing wrong with people who have been there 20 years, until they get to the point where physically they are not able to do some things,'' he said. ``You need to have some young people around _ people who will take it over in the next five years.''

If South Dakota and other rural states don't respond to the EMT crisis, they may be forced to make changes, Dekkenga said.

``Is it possible that we don't need ambulance service in every single little town?'' he asked. ``That wouldn't be a real popular statement, but it may be something that we need to look at.''