Will Kincaid  /  AP
Dorreen Beaver, a single mother, nursing student and bait shop owner, stands by the ambulance she drives in Binford, N.D. Beaver says she has no problem handling the occasional ambulance call.
updated 5/18/2006 11:17:33 AM ET 2006-05-18T15:17:33

Dorreen Beaver is a medical assistant, a junior nursing student at Jamestown College, a single mother of a 13-year-old boy, and a bait shop operator.

Still, even with her busy schedule, she has no problem handling the occasional ambulance call.

“Binford is really small,” she said. “Once you’re an EMT (emergency medical technician), you just go on calls and do about two hours a month for continuing education.”

Rural ambulance services would like to find more people like Beaver, as busy lifestyles, an exodus of young people from small towns, and burnout threaten the existence of volunteer ambulance squads.

In the past year, three ambulance services have shuttered in a state where about 90 percent of EMTs are volunteers, said Tim Meyer, director of the state Division of Emergency Services.

About one-third of the state’s 141 ambulance services are at risk of the same fate, he said. EMTs and officials worry the shortage could hurt the quality of health care, forcing people to wait longer before an ambulance arrives.

“Science will tell you the longer you have to wait when you’re having an acute event, the less likely you’ll have a positive outcome,” Meyer said.

North Dakota is not alone. Volunteer shortages are found in most states, said Jerry Johnston, president-elect of the National Association of EMTs.

“There’s been some ... debate about what the issue is with volunteerism,” Johnston said. “But a lot of it has to do with the generation of people right now.”

'Rekindle the spirit'
Earlier generations had strong feelings of volunteerism and being part of a bigger world, said Mark Haugen, past president of the North Dakota Emergency Medical Services Association.

“We need to rekindle that spirit,” Haugen said.

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The average age of an EMT in North Dakota is 46, said Dean Lampe, executive director of the North Dakota EMS Association. About 20 percent of volunteer EMTs in North Dakota are older than 60, Meyer said.

“They can’t do it forever,” Meyer said.

Small towns, however, are often short on young people, who are more fit for a job that may include heavy lifting, 2 a.m. phone calls and uncomfortable situations. They take jobs in larger cities and leave behind an aging population in need of medical assistance.

“When these kids graduate, they just leave” Binford and its population of less then 200, Beaver said. “There’s just not enough to keep them here.”

Many who remain in small towns head to cities during the day for school or work. Members of Binford’s five-EMT staff aren’t always available to respond when state radio dispatchers call, Beaver said. “We don’t always have day coverage,” she said.

The North Dakota EMS Association has no formal state recruiting effort, Lampe said. The burden falls largely on the rural squads to find new members, he said.

Steve Fugelstad, the association’s vice president and an EMT, said his squad tries to recruit high school juniors, because they know they’ll stick around for at least one year. Even if they leave town, hopefully they’ll join a squad somewhere else, he said.

Other tactics include consolidating ambulance squads into countywide services, then using local squads as first responders, Johnston said. North Dakota counties have been encouraged to follow suit, Meyer said.

'No quick fixes'
Some towns and counties pay EMTs a small sum when they go on a run. Binford EMTs get $15 per call — not enough for those who would have to leave better-paying jobs to respond, Beaver said.

“You could pay these people $100 a call and I’m still not sure they’d volunteer for that,” he said. “It’s a really challenging issue. There are no quick fixes.”

Money isn’t what brought in the existing EMTs. Many have busy lives and good jobs, but they feel the need to sound their sirens when someone needs help.

“You do it for your community,” Fugelstad said. “It’s a feeling of giving back.”

Beaver expects to graduate with a nursing degree from Jamestown College in May 2008. But even when she’s a registered nurse, she plans to continue volunteering as an EMT.

“It’s stuck with me for life,” Beaver said. “I do it because of that little old lady that you transport to the hospital ... who says, 'You’re like my guardian angel.' "

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