25 Investigates: “Crippling” ambulance worker shortage impacting care and response times

Patients are enduring long wait times at emergency rooms across Massachusetts. Now they’re also facing challenges getting to the hospital.

As 25 Investigates uncovered, a “crippling” Emergency Medical Service (EMS) worker shortage could be impacting care and response times in life and death situations.

Investigative reporter Ted Daniel found new EMS hires may not be getting enough training because they are needed on the road.

A 71-page report, obtained through a public record request at the state’s Department of Public Health (DPH), shows Brewster Ambulance - the state’s largest private medical transport company - sent two brand new Emergency Medical Technicians (EMT) in an ambulance they were not familiar with. The pair received only one day of field training each before being sent on their first 9-1-1 emergency call, the document shows. Both had requested more “third-ride” or observation time before they were paired, according to the documents.

That first call – a seemingly ordinary one of a person complaining of body pain - almost turned fatal for the patient, a 69-year-old man from Plymouth. After walking onto the ambulance on his own, Steve Brenner’s heart stopped suddenly and, according to the report, the novice EMTs became overwhelmed in a situation they were not properly trained for.

In an audio file, part of the DPH report, one of the EMTs can be heard asking for assistance.

“We need ALS (advance life support) please. I don’t know how to get on to Plymouth Fire,” she said describing her lack of training on the emergency radio. An (AED) or automatic external defibrillator was never used on the patient. The review blamed that on the “cognitive overload of the situation,” the EMT’s found themselves in.

Unsure of how to get to Beth Israel Plymouth hospital, the EMT driving the ambulance used a “GPS mapping app on her phone” while her partner performed CPR. She told DPH investigators “I did not have the experience to handle this,” says the report. That EMT quit soon after the June incident.

25 Investigates tracked down Brenner and asked to discuss his experience that day. He did not wish to speak on camera but by phone told us he was not aware of any issues on the ambulance until our call.

Heidi Kummer, MD, president of the Patient Advocate Certification Board to review the DPH report for us.

“All she wanted to do was help people and she’s lost to the EMT profession,” Kummer said. “Can you imagine the stress that these two must have been under? Despite that, they managed to get the patient to the hospital and save his life.”

Other EMS systems are also stretched thin. Scanner traffic audio from Chelsea EMS reveals just how overwhelmed ambulance services have become.

In one call a dispatcher is heard saying “they have no ambulance in sight. We don’t know when we can get one.” In another instance, the dispatcher warns of long waits for ambulances. “It’s going to be an extended ETA. They’re sitting on a couple of calls.” In a third call, an ambulance is cancelled when the patient decides to no longer wait.

According to the Massachusetts Ambulance Association, the EMT shortage coupled with fewer available ambulances are crippling ambulance systems around the state. The number of ambulances statewide are down as much as 30 percent compared to two years ago, Dennis Cataldo, President of the Bay State Ambulance Association, said.

“We have to find a way of doing more with less,” Plymouth fire chief Ed Bradley told 25 Investigates, adding that pandemic burnout, skyrocketing call volumes and low pay have made it harder to attract and keep EMS workers, especially at private ambulance companies.

“Everybody gets into this field and into this profession to help people and when you get those situations where you couldn’t you feel guilty and you feel bad about it,” said Chief Bradley.

Brewster provides 911 emergency ambulance services in Plymouth, Middleborough, Braintree, Brockton, Quincy, Taunton, and Framingham.

We contacted Brewster to discuss the DPH report and the incident involving the two new EMTs. The company’s Clinical Care Director Chris DiBona agreed to an on-camera interview. When our crew arrived at their Weymouth headquarters, DiBona told us he was unable to comment on the DPH investigation but would explain how Brewster trains its workers and tell us about a new program the company is launching with Plymouth Fire. He offered to send us a written statement about the incident instead. 25 Investigates did not receive a statement despite repeated requests.

Under the partnership with Plymouth, highly trained paramedics drive their own “chase vehicle” instead of being tied to ambulances that may get stuck waiting at a hospital. DiBona says this will allow his team more flexibility.

“In every business, there’s a challenge for staffing,” said DiBona. “Fortunately for us, we’re in a good position. We’ve also introduced a number of initiatives – infusing money into the payroll, paying for free healthcare, also owning our own EMT and paramedic program to internally train staff.”

As for Brenner, the patient the two EMTs treated, he says he’s making a good recovery from the massive heart attack he suffered and is grateful for the work the paramedics performed on him.

“I’m perfectly normal now. I do my yard work. I still walk everywhere,” he says, adding that despite the challenges they faced, he believes the EMTs who treated him saved his life.

“I would like to thank them. Thank them a million times over for saving me, for not stopping and not giving up on me.”

DPH issued Brewster a notice of serious deficiency for the lack of training and the lack of help their new EMT’s received that day.

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