Monday, May 28, 2001

Jake Hoopai, a city and county emergency medical services
worker, checks Aiea resident Daisy Shimogawa's blood
pressure at the EMS station at Pearlridge Center.

paramedics leaving
city for new jobs

High turnover means a loss
of training costs and more
twin shifts for ambulance crews

By Nelson Daranciang

Working a double shift is a way of life for ambulance crews in the city and county of Honolulu. Supervising paramedic Norman Hahn said that in the last three years, he has worked a double shift of 16 hours at least once per week.

Why? The city has not been able to keep up with the turnover, Hahn said.

"This past two years has been a dramatic drain," he said.

Robin McCulloch, the city's Emergency Medical Services chief, said the Navy and other agencies including Hawaii County, which has its own ambulance service, and private providers like American Medical Response are luring people away with higher pay, more time off between shifts and opportunities to work outside Oahu.

"Our attrition runs about 20 per year, which I don't think is excessive. We had a spike this year because the Navy started up a paramedic ambulance service at Pearl Harbor, luring five or six people. They were experienced people," said McCulloch.

The salary range for EMTs is $26,220 to $32,076 per year. Paramedics make between $33,396 and $41,232. Supervising paramedics earn between $37,884 and $46,884.

"Some people depend on overtime. If people don't want to work overtime, that's OK. Generally speaking, there's overtime around. Some like it more than others," McCulloch said.

"It's kind of divided. The money is appreciated. Others would prefer to spend time doing other things. They make the sacrifice to provide the service to the public," Hahn said.

The Navy pays its para-medics a 25 percent cost-of-living allowance to work a 24-hours-on, 24-hours-off schedule.

McCulloch said AMR is the city's principal competitor for emergency medical workers.

AMR has 200 paramedics and emergency medical technicians statewide, and their salaries are comparable to what the city pays its workers, said AMR spokesman William "Speedy" Bailey. But he said the company offers its employees opportunities to work at special events like University of Hawaii football games and a chance to live and work on the neighbor islands, including Kahoolawe, or on the mainland. AMR also offers its paramedics flexible work schedules like two days on and four days off, Bailey said.

City paramedics work traditional eight-hour shifts, five days per week with two days off.

"It seems like we're the training agency, then other people grab them without having to shoulder the cost of training. So, they love to poach from us. It's been that way for the last 20 years I've been here," McCulloch said.

Paramedics are also moving on to other careers.

"We're losing the younger paramedics to the Honolulu Fire Department and the federal fire department and to nursing," Hahn said.

Hahn believes the shortage of city paramedics will be even greater in the next few years. He said fewer people are applying for the EMT class. And he said many paramedics who started working for the city in the mid- to late '70s are retiring.

In order to attract more people, Hahn believes the profession needs to do a better job of promoting itself.

The city has 16 ambulance units stationed throughout Oahu. Most of them are attached to a hospital or fire station. Three people are assigned to a shift per unit, with two on duty at a time. But because of staffing turnover, not all shifts have three assigned workers. And if one of the two remaining workers is not able to work because of illness or other reasons, the options are to shut the unit down or have someone work a double shift.

The city's EMS division is authorized to have 207 paramedics and EMTs but has only 183 on staff.

McCulloch said the city is anticipating hiring 10 new EMTs who have been interviewed and are undergoing physical examinations.

A person can become an EMT after completing a one-semester course at Kapiolani Community College and then passing a licensing exam.

After a year on the job and meeting certain other requirements that include being involved in 200 cases, EMTs are eligible for an 18-month paramedic program at KCC. The city pays for tuition and books for its EMTs and keeps them on staff as apprentices until they receive their associate degree.

Bailey said EMTs often leave AMR to take advantage of the city's apprenticeship program.

After successfully completing the paramedic course work at KCC and passing another licensing exam, EMTs become paramedics and are obligated to work for the city for two years. Many decide after two years that being a paramedic is not for them.

"The glamour of the job wears off real fast. You're going to get dirty," Hahn said. Hazardous working environments and exposure to diseases also turn people away from the profession.

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