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When Illinois paramedic Nick Fensom talks about serving his community, he’s talking about a lot more than going on calls to help the sick or injured in the towns that he serves on the outskirts of St. Louis.

He’s talking about being a part of the community: educating senior citizens and high schoolers about health and safety; providing CPR training; teaching classes that range from stopping serious bleeds to safely installing car seats. He’s talking about standing proudly with firefighters and police officers at city festivals and community events.

In short, Fensom, the president of AFSCME Local 2817 (Council 31), is describing the hopes of many AFSCME members, who wish to serve their communities in the broadest ways possible.

But short-staffing is preventing Fensom and his fellow EMS professionals from fully achieving that dream.

“We cover 45 square miles. We run 5,500 calls a year, so it’s a very demanding pace for somebody who’s working a 24-hour shift,” says Fensom. “When I first started, we’d average 10 to 12 calls a day. Now, it’s 20 to 24 calls a day. Over our last five years, we’ve had a roughly 20% increase in volume every year.”

It’s a constant grind, says Fensom, who has worked for the City of O’Fallon since 2017.

“For the last five years, we’ve operated on minimum staffing,” says Fensom, “If someone calls off, you have the potential to be mandated for those shifts. That creates fatigue and exhaustion.”

It puts the safety of both the EMS professionals and the people they serve at risk.

Short-staffing in EMS reflects the national staffing crisis in public service, but Fensom says EMS faces unique challenges in recruitment.

Fensom traces the decline in the number of qualified EMS professionals to several factors: a wave of workers who joined EMS after 9/11 are now retiring or close to retiring. Competition from other health care fields that may offer better pay and benefits is luring qualified candidates away.

Also, unlike other public safety professions, EMS doesn’t have as clear a career ladder, so people who get into the field for the right reasons, says Fensom, often can’t afford to stay if they start families.

“You’re a licensed paramedic until your career’s over,” says Fensom. “In the fire service, you have lieutenants, captains, chiefs. There’s not as much of that in EMS.”

Fensom also acknowledges the often-thankless nature of public service jobs; crucial though they may be, the public doesn’t always see or recognize the work of these front-line heroes.  

While he says that’s not why he got into EMS, they don’t yet share the rich traditions of police or fire departments, and those traditions can go a long way in retaining workers.

And that doesn’t begin to describe the toll that COVID took on those who work in EMS.

All those factors have left him and other EMS departments across the country struggling to recruit qualified candidates.

So, what can be done to recruit and retain people to EMS?

“You need the pay, the benefits package, but you have to have a good culture. You have to get your staffing to a level to make you feel like you’re having some quality impact on your community,” says Fensom.

A “creative” benefits package that might attract EMS talent includes things like uniform allowances, per diem meal allowances – “Just making it more attractive as a comprehensive package. Not just wages.”

But among the most powerful tools that EMS professionals have to fix short-staffing is their union.

Fensom and his fellow Local 2817 members have worked hard to improve staffing, building strong professional relationships with the City of O'Fallon, and they have added additional resources to help mitigate the burden of higher call volume and increased mandatory shifts.

“I think it’s important for AFSCME members to understand how important it is to build a working relationship with our counterparts in negotiations,” says Fensom. “We have to get involved. … People have to understand what their union does for them and how to utilize it as a tool to get the best compensation.”

He encourages everyone who is not involved in their local union to unlock the power of the union difference.

AFSCME launched Staff the Front Lines, a massive retention, recruitment and outreach initiative to address public service worker shortages, including in the EMS sector. AFSCME members across the country are organizing to recruit qualified and passionate professionals to fill these vacancies, bringing relief to front-line workers and ensuring their communities continue to receive the quality public services they need and deserve.