Norfolk Ambulance Is on Life Support

By Bevan Ramsey

There have been a number of great articles in recent years about Norfolk’s ambulance service, about what we do and how we do it. These articles have always shared an invitation for much-needed volunteers. Sadly, the time has come to put a finer point on that need and to spell out the possible consequences if it is not somehow met.

To start, it’s important to note that on some levels the ambulance service is doing great. It’s been well funded through generous private donations and the fundraising efforts of the Norfolk Lion’s Club. Those funds have been carefully managed; the service is solvent, with money saved for contributions to major expenses, such as our upcoming need for a new rig (the ambulance vehicle itself). The headquarters is stocked with everything necessary for effective patient care. This service also has the proud distinction of being one of only a handful in the state that is provided totally free of charge.

The problem we face is a lack of trained volunteers in active duty to go out on calls. This problem has only been getting worse. Many in our active service are reaching an age where they can no longer realistically fulfill the duties required of them, while others may be retiring for a well-deserved rest after years or decades of service. In the coming years, demographic trends indicate that more will follow. Since I joined the Norfolk ambulance 10 years ago, there has been significant net attrition on the force.

Additionally, at the state level, ever-increasing training requirements are being legislated for volunteers in emergency medical services. For example, Emergency Medical Technicians (EMTs) must now re-certify every two years. As the barriers to entry and maintenance of active service continue to grow, the number of people considering the calling diminishes.

In practical terms, without adequate staff we cannot complete calls. An absolute minimum of two responders is needed to legally complete a call. This includes a full EMT and a driver, provided that the driver is also a licensed Emergency Medical Responder (EMR). Otherwise, a third person with medical training is needed. Ideally, there would be three responders to every call: two in the back attending to the patient and one driver. Failing the assembly of a full Norfolk crew, calls then go out to the Winsted or Canaan services for mutual aid, which increases the response time significantly. In emergency medicine, time is a critical factor in achieving positive outcomes.

Beyond being a point of civic pride for Norfolk to have one of the state’s few fully volunteer ambulance services, it is also a matter of significant economic benefit to its residents. The true cost of having a paid ambulance staff working from only 9 a.m. to 5 p.m., Monday through Friday, would be roughly $750,000. For the 24-hour coverage the town currently enjoys, the cost would be more than half of Norfolk’s total current operating budget, which includes roads, Botelle School and everything in between.

Unfortunately, the seemingly obvious solution of a partially paid service does not really work in practice. In response to its declining numbers of volunteers, the Winsted ambulance service decided to bring one paid team on board to help staff a rig. The result: several volunteers left, and Winsted suffered a net loss of staff. The reality is that the work, while sometimes immediately gratifying, is also emotionally and psychologically taxing. Most people, understandably, would rather someone else were doing the job and, given an out, will gladly take it.

All is not doom and gloom, however. On the positive side of the ledger, the active volunteers in Norfolk’s service are a dedicated team. Despite our challenges, we are by many measures doing better than most volunteer services. We field more EMTs than many area services and pick up more calls. In fact, due to the changes in Winsted’s circumstances, we are responding to a growing number of calls for them.

The reason for this letter, and the point that must be retained, is that unlike in the past, we are currently only just managing to cover the demand for our services. Following the trends of the last decade, and in the absence of some new action, this tenuous balance is unlikely to last. At some point, the fact that we may be doing better than other services will be meagre consolation for people who may not get the care they need when they need it.

This guest editorial was written by Bevan Ramsay, a volunteer with the Norfolk Lions Club Ambulance service.