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Covid stress, staffing shortages burning out first responders

First responders didn’t work from home when the coronavirus pandemic altered schedules in many professions.

“While many people bedded down and stayed away, we suited up and went to people’s houses and we still continue to do that to this day,” Hendersonville Fire Chief D. James Miller said. “People are dialing 911 and saying ‘I have Covid and I can’t breathe’ and we’re going into their houses, we’re going into the assisted living facilities, we’re going into the hospitals and having long-term direct exposure with someone you know is Covid positive and giving them breathing treatments and assisting Henderson County EMS.”
The cost of emergency response and strain on those who provide it over the past 18 months was cast into stark relief over the past three weeks as elected leaders heard urgent requests from their police, fire and ambulance leaders for funding to hire more help, add sign-on bonuses and provide mental health coverage. In successive meetings a week apart, the Henderson County Board of Commissioners and the Hendersonville City Council heard that:

  • The county’s emergency medical services has had to park ambulances and activate its forced overtime policy to staff those that remain. “We are have a staffing shortage,” Jimmy Brissie, the county’s emergency services director, told commissioners on Sept. 15. “We’re seeing an increase in strain on our supervisory staff and we’re seeing an increase in competition in our region for recruitment and retention and that’s basically from other EMS services as well as private hospitals or private services.”
  • The death of young children, vehicle crashes with serious injuries and suicides are among the stressful situations that firefighters and police officers see routinely on top of the now everyday stress of Covid. “We had three children under the age of 4 die within three weeks,” Miller told the City Council when he and Police Chief Blair Myhand asked for funding for a two day a week mental health counselor for the city’s first responders. “Seeing that — seeing suicides, seeing drug overdoses, seeing vehicle crashes — after a while that cumulative effect tends to keep adding up and adding up and adding up.”
  • The city police department is shorthanded because of competition for new officers, the city’s high cost of housing and a steady dose of negative publicity about police. “Early October, I’ll only be down four positions,” Myland told the council. “I’ve seen a dramatic decrease in the number of police applicants in the last 12 months. Many factors are responsible for that. This profession is not very attractive. It’s been vilified a lot in the last 18 to 24 months.”

In each case, the elected leaders responded. County commissioners agreed to Brissie’s request to spend $455,000 in federal American Rescue Plan money to hire seven more paramedics — two devoted to vacation and sick leave coverage and five to staff ambulances and free up front-line supervisors for training and quick-response management of acute emergencies such as heart attacks, trauma and vehicle crashes with multiple injuries. The City Council granted the request of its police and fire chiefs to embed a mental health counselor to respond to firefighters’ and police officers’ needs and also tentatively committed to fund hiring bonuses across all city departments.

‘We’re experiencing burnout’

The strain of emergency work in the now long-term Covid environment is taking a toll across the ranks of first responders.
“We have been experiencing consistent decreases in availability of staff to pick up overtime on shifts as well as absences,” Brissie told commissioners. “A lot of that is related to Covid. More staff are out due to having Covid or being a close contact as well as injuries. … Basically we’re experiencing that burnout like the hospitals are experiencing burnout with the staff. They’re tired and they would much rather have their time off.”
Increased absenteeism results in “us having to take trucks out of service.” Dropping from the full fleet of eight ambulances down to seven “just increases our response time countywide,” Brissie said. “We take one resource out, it puts that same call volume on the other resources that are in play.” EMS has had to park an ambulance 87 days since May 1. If there’s still not enough EMTs and paramedics to staff the trucks, the department resorts to forced overtime, which puts EMTs and paramedics on the street 24 or 36 hours straight.
“We’ve had to do that 16 times in July and August and I think we’ve even done it two or three times this week already,” Brissie told commissioners.
Commissioners approved $128,000 for the two paramedics to cover gaps caused by vacation and other time off and $327,000 for the five paramedics on regular duty, enabling supervisors to manage instead of covering gaps.
“We’ve seen a growth in the rank and file of our paramedics but we’ve not seen the leadership grow to manage that,” Brissie said.
Finally, Brissie asked commissioners to fund a comprehensive study of EMS salaries.
“At the end of the day, right now we have about 50 percent of our staff with less than five years of experience,” he said. “It’s going to take a while to fill these” new positions. “With the competition in the region and just the general stress surrounding health care, that’s going to compound it.”


Police applications plunge

Both Myhand and Miller said first responder agencies across the region and state had seen emotional and mental health stress increase markedly as Covid cases have increased call volume, absenteeism and seriously ill patients. The City Council said yes to their request to add a mental health clinician from a company in Asheville that provides counselors with a first responder background. Instead of a nameless, faceless counselor they would reach by phone, police officers and firefighters will have regular access to an “embedded” mental health clinician who would get to know them and be ready to handle mental health needs that arise.
“We want them to have a relationship with somebody that they see on routine basis that understands our job,” Miller said. “Our hope is that we create that relationship rather than them having some difficulty and we say, ‘Here, dial this number,’ and on the other end of that number is someone you’ve never seen in our offices and you’ve never interacted with them.”
Myhand told the council that the starting rookie cop pay and local housing costs “coupled with everyone else trying to take our great men and women away from us to come to work for their organization” makes this a difficult hiring environment.
Historically when it had an opening, the city would get 50 applicants over a 30-day period, he said. In a 30-day period this past summer, “I got 11 applicants and only three had any police experience whatsoever,” he said. “It’s just not the time to want to be a police or maybe even in local government.”

City adds public works employees

The pay scale, shortage of labor supply and competition from larger jurisdictions makes hiring more difficult beyond first responder agencies, City Manager John Connet told council members last week when he recommended hiring and retention bonuses.
“A lot of cities across the state are looking at these bonus programs,” he said. “However, it’s so competitive they’ve not been sharing their bonus numbers with us. And we’re seeing that in the private sector, too, up to six or seven thousand dollars for somebody to come work for them. We’re looking at a portion of it when they’re hired, a portion of it six months later and a final portion if they’re here after a year.” Connet, who projected a bonus payment of $4,500 to $5,000 per hire, won the council approval to come back with a formal recommendation in the coming weeks.
The City Council also agreed to bolster the public works force after the department’s director, Tom Wooten, described additional work the city will need to cover in the coming months and years.
Public works maintains streets, sidewalks, parking lots and stormwater pipes, collects garbage, picks up leaves and brush and maintains the city’s buildings, parks and cemetery. When the city adds Edwards Park, Fire Station 1, the new police station and potentially a downtown park on the Dogwood parking lot land, Wooten projects the workload to grow to from 21,244 hours to 29,400 hours a year, the equivalent of six new employees.
The council approved Wooten’s request to add an assistant public works director and a new employee in environmental services, one in grounds maintenance plus one in the streets department when the new parking deck opens and Main Street parking meters go live in January 2023.
“Not only are we seeing the growth but we also, for better or worse, are seeing increased expectations from the public and as we started looking at how can we meet those expectations we couldn’t do it with the personnel we had,” Connet said. “Typically we would not bring this request in the middle of the budget year but we’re at a point with the growth that Tom and (assistant director) Chad (Freeman) have established a high standard, and a high level is expected by the City Council and we appreciate that, but in order for us to maintain it and do it and be responsive we need to add some of these positions so we can keep moving forward.”