Two crews of EMTs prepare to make separate runs less than an hour after returning to the station. Both were responding to non-emergency calls, which account for more than 80% of their runs.
Low pay, grueling hours, and worker shortage are putting a strain on EMS and hospital facilities. The issue is being felt across county lines and the country.
What began to peak during the start of the pandemic has yet to begin to recover and few people are applying for jobs with high risk and fewer benefits.
“There just really isn’t a drive to get into this job,” said Nate Hornback, an EMT with the Nelson County EMS. “That’s kind of what’s hindering being able to retain people.”
Shift Leader Brendon Patten, one of the staff who worked Christmas Day with a small crew, said nearly the entirety of their shift was spent making runs.
“We found ourselves on the road pretty much the entire 24-hour shift,” he said. “Pretty much just call after call after call.”
With snow and ice-covered roads, EMS was only responding to emergency calls. The switch was made to reduce some of the stress brought on by non-emergency calls, which make up the majority of their runs.
An increase in non-emergency calls — which make up more than 80% of what they respond to — in the last few years adds stress to already limited resources.
“One of the biggest issues is that EMS has gotten to where it’s just abused,” said Hornback. “People have that mindset of ‘oh, my insurance will cover it,’ even if it’s just an upset stomach.”
He added others don’t have insurance and EMS doesn’t get compensated for those runs.
Once a fully staffed department, Nelson County EMS now is having trouble with retention as employees have made lateral moves to other areas offering higher wages and better benefits, Patten said.
Each ambulance has to be staffed with two people to make runs and the county has to have at least three on call around the clock to provide coverage for the more than 48,000 residents in the county.
“The way we have been running is three trucks and a supervisor in a car,” said Patten. “We are supposed to have four trucks (eight staff members on shift) every day, but we are down two to three part-time (staff).”
The decline in staff became noticeable around the start of the pandemic, Hornback said, adding that as things have begun to change back to pre-covid states, area staffing has not returned.
“You have people that leave for medical reasons because this is a high exposure job to covid, so those immuno-compromised people, (it’s) not a good position for them to be working in,” he said. “We had a few people who retired recently so you lose those, but there is no drive really to get into this job anymore.”
That drive Hornback and Patten said has been affected by a slew of issues surrounding the medical field.
For an EMT to become a certified paramedic, it requires a two-year degree. In the same amount of time, they said, a person can become a nurse and make twice the amount of money.
The risk of burning out is a real fear for staff, as well as the concern that while responding to a non-emergency call, they may not be able to arrive on the scene of a person who is facing a critical issue.
“With people using EMS, sometimes as taxis basically, that’s leaving the serious emergencies left unattended,” EMT Tonya Lutz said.
The staff typically works in 24-hour shifts, which are often fast-paced with little to no downtime between calls and transports.
“Here lately it’s been like, if you can get three hours of sleep or more that’s a good shift for you,” Patten said.
Nelson County is not the only one feeling the effects. Other counties and areas across the country are feeling stress from a lack of staffing and resources.
EMT Nick West, the only new applicant for EMS in months, is a part-time hire from Hardin County who said they are seeing the same thing.
“We run nine trucks every day and it’s still not enough,” he said.
This creates another problem for areas that share mutual aid because sending help across county lines also ties up trucks and staff for hours if they are even available to help.
“Let’s say there is an accident on the Bluegrass Parkway right on the Nelson-Hardin county line,” Hornback said giving an example. “Hardin County is tied up, all of our trucks are tied up, your next closest county is going to take 30 to 45 minutes to get to that run.”
Lutz said a lot of people who call for minor issues could be seen by staff at an urgent care facility or by their family doctor, but whereas those require appointments, people believe they will be seen instantly if they arrive in an ambulance, which isn’t the case and causes congestion in the hospital as well.
Tabatha Yates, interim Emergency Room Director at Flaget Hospital, said for a small rural hospital their staff sees as many patients a month as their larger sister facility St. Joseph East in Lexington.
Around 98% of people who are admitted to the hospital come in through the ER she said.
Last month the hospital saw 1,546 patients, with more than 330 of those being brought in by ambulance. The majority of those go into triage to determine which are the more critical cases.
As of Jan. 10 she said the ER has already seen 105 patients.
To determine who gets beds first, Yates said they use the Emergency Severity Index or the ESI level. Similarly to EMS, Flaget saw a drop in staff at the start of covid that has not returned and the hospital itself is small with limited beds, 52 rooms in total, 16 of which are in the ER.
“We are trying to do the best that we can with the staff that we have,” She said. “We might not be running to capacity on our units, so that means that if we have three patients that are down in the ER and one needs an ICU bed, one needs a TCU bed and another needs a (medical surgery) bed we might be holding those patients down in the ER. Sometimes (it’s) for just a couple of hours and sometimes it’s till the next shift, 12 to 24 hours.”
A plan Yates said they have for the spring is to hold a health fair to give people a chance to come in and get better educated on when an issue is critical enough to call EMS and when it can be treated at home or by a health care provider.
“We want to get in the community and remind them, ‘Hey, this is the parameters for high blood pressure, and what an actual temperature is,’ ” she said.
She added all cases are different and some people have underlining health conditions, but that is why they want to work on educating the public on what to recognize.
Director of Emergency Management Services Joe Prewitt said the issues his staff and others face is one that will have to be addressed at some point, and he hopes a way to separate non-emergency calls from emergency ones can be established in the near future.
“Where do we go? I think that’s the question,” Prewitt said. “What happens when this level of use, level of required service continues, and the person calls 911 and there is no ambulance to send. What do you do?”
Following heavy rainfall and flooding, Simpson Creek Road in Bloomfield was left in disrepair. However, crews were able to make the road passable after water levels dropped.
The now-repaired portion of Simpson Creek Road has the shoulder of the road littered with safety cones to alert drivers to the low shoulders.
Following heavy rainfall and flooding last Tuesday, many roads throughout the county are in need of repair. After a week of repairs, many of the roads have received a facelift after the damage caused by the flood.
For one road in particular in Bloomfield, they saw an immediate need for repairs following heavy rainfall on Jan. 3. Simpson Creek Road was in need of desperate repairs after nearly “30 to 40 feet” of road was destroyed. Asphalt was cracked in many places with portions of the road being washed away by the rushing water.
“There’s a waterfall right there on Simpson Creek that just whenever the water gets high like that, especially when we get a little over four inches,” said Bloomfield Public Works Director Scott Thompson. “It’s just more than the road drainage tubes can handle. It just washed the road out.”
Thompson said the asphalt on the road was buckled and destroyed the roadway in front of the waterfall. However, as soon as the floodwaters receded on Tuesday, Simpson Creek Road was repaired to allow for travel.
“We dug it all out yesterday and put gravel back in it,” he said. “We’ll pave it later on. … The rock we put in it, it’ll have to settle in and then we’ll have to work improving it.”
Currently Simpson Creek Road is passable, with tightly compacted gravel to fix the large chunk of pavement that was destroyed by the water flow. Thompson said although they have a temporary solution with the gravel, they will have to wait before the road will be paved and the shoulders repaired.
“After everything, after the ground we put in settles, I’m gonna meet with the county road engineers next week,” Thompson said. “We’re gonna look and come up with a plan for the shoulder of the roadway because that’ll have to be improved. So, for right now it is passable. We got it all back together for the time being.”
While Simpson Creek Road received some of the largest amount of damage due to flooding, according to Nelson County Engineer Brad Spalding many roads only experienced shouldering, or a loss of the gravel on the sides of the road.
“We had a lot of roads that the water got over,” he said. “It just happens sometimes, you know, ‘welcome to rural Nelson County’ is what I tell them. It could have been that workers put up temporary closed signs, because water was going over the road at that time. And then we have since taken them back up, because there were no damages reported to me with the exception of what we call shouldering. … We’ll just have to go back and redo that. It’s not a major safety concern. It’s just something that we will have to go and address at some point.”
Spalding said over the next few months the county road department will be going around and addressing any shouldering issues where the water washed away the rock. He said he wanted to emphasize that they will only be repairing county roads and not gravel washed away from driveways and private property, as he has gotten those requests in the past.
“And then, like I said, we’ve got multiple places all throughout the county, not only in the Bloomfield and Chaplin area, but the south and the east and west,” he said. “And the road department is one road at a time going through as we get reports, clearing trees out, opening culverts back up and then creating a project list to address each issue that came up. So now it will take us a month or so to fix everything we need to fix.”
In addition to the shouldering on various roads throughout the county, there are a few more areas of interest he noted. On Eggen Road, Spalding said an abutment that holds up the bridge has the gravel and rock around it washed out and in need of replacement. Spalding also listed the bridge at the end of Russell Road as in need of repair.
“There’s a bridge there, you notice how it’s always these bridges,” Spalding said. “It actually did wash out the concrete on the approach, the approaches are how you approach the bridge, it did wash some of that away. We put rock down for now, temporarily, and we’ll go back in a couple of weeks and fix it properly with probably concrete and pour concrete back in that area.”
Spalding said moving forward they are addressing all road concerns one at a time and encourage residents to contact the department to alert them to issues. He said following the flooding they received more than 100 calls to bring debris and road damage to their attention.
“It’s that way everywhere you know and that’s part of what we do,” he said. “We see this under real hard rain conditions. And we’ll address them one at a time. We tell the public, they’re more than welcome to call in to the road department, county road department. I only deal with county roads, not state roads. Any county road that people want to report an issue on they call (502) 348-1880.”
EDITOR'S NOTE: Lillian Smothers' parents posted on Facebook as of Tuesday night that the teenager had been located and was back with her family.
The Nelson County Sheriff’s Office has issued an attempt to locate notice for a teenage Nelson County girl, and is investigating leads into her disappearance.
Lillian Smothers, 14, has been missing since Sunday, according to a post on the NCSO Facebook page.
“We don’t have a whole lot of information,” Det. Brandon Teater told The Standard Tuesday afternoon.
“If any friends know where she’s at, contact local authorities,” Sheriff Ramon Pineiroa said.
Teater said it is believed that Smothers left her home some time Sunday evening, and “she may be in the company of some other juveniles” who are missing, and it appears she may have run away from home.
Teater said they are continuing their investigation and welcome anyone with leads about Smothers’ location to call (502) 348-1840 or (502) 348-1868.
“We just want to locate her as quickly as we can to make sure she’s safe,” Teater said.
This is a developing story and will be updated as more information becomes available. Go to kystandard.com for additional updates.
Group Commander Neven St. Clair stands at attention during one the many ceremonies the ROTC put on last November.
Thomas Nelson senior Neven St. Clair leads a group of enthusiastic cadets as the Group Commander for the Air Force ROTC organization.
Neven St. Clair wanted to fly planes when he began his first year at Thomas Nelson High School. In his final year at TNHS, St. Clair has had his dream fulfilled through his time as Group Commander in the Air Force JROTC program.
For the Thomas Nelson senior, he said his whole life has changed since beginning his time in JROTC four years ago. However, the values instilled in him and the sense of duty to his cadets and his community is what drives him to continue to move forward each day. St. Clair said through ROTC he has found his raison d’être.
“I’d say that my purpose is to serve the community and help others become better citizens,” he said. “They’re serving community, because now I have 40-some cadets that I have to teach and make sure that you know when they go out in the community that they leave the program with something that they learned.”
However, St. Clair said he wasn’t always the most confident stepping into the program. For the last four years, he had other senior cadets and Group Commanders to lead by example and follow their best practices. With him in their role now, he said he feels pride in how far he has come and in the role he can play in the cadets’ lives.
“The three years that I’ve been in the program before, I’ve been learning,” St. Clair said. “Now it’s my turn to turn around and teach that to the folks who are coming after me and instill the values that were instilled in me and show them how to lead. Especially now, when I’m going to be leaving here in a couple months. I’m really trying to hammer in there, out of preparing them for next year, how to lead and go forward.”
The Nelson County School’s ROTC instructor, Sgt. Craig Davis, said although he has only known St. Clair for a year, he knew immediately the type of person he was. Davis said he saw St. Clair as a person who had dedicated his life to looking forward and following the tenets of the Air Force.
“He’s very driven as a young student, he is very involved in this program,” Davis said. “It wasn’t just, this is another class or anything like that. He fully embodied what the mission of the program is … if not for him taking the leadership role that he has, this program would not be rebuilding as well as we are.”
In addition to his instructors and former Group Commanders, St. Clair said another huge advocate and support system for him was David Mudd, who passed away early last year. St. Clair said Mudd was the person who has initially helped him add the program to his class schedule, which was a memorable way to begin his journey.
“He was the one who originally got me an ROTC,” St. Clair said. “They didn’t put it on my schedule, and I was like, ‘Oh, I kind of wanted that Mr. Mudd.’ He was like, ‘Well, you know, if you really wanted that, you should talk to them about it.’ He got me into it, and all along the way, you know, always guided me say, ‘Well, you got some options. Show me all the options.’ He’d sit down and talk about things and Mr. Mudd was always a really big cheerleader for me.”
Looking forward to the future for the Group Commander, he said he is close to finally achieving his dreams of being a pilot, just 20 hours away from obtaining his private license. Next fall, he plans to attend Eastern Kentucky University. He will also be attending the Air Force ROTC program at University of Kentucky through the Crosstown program.
St. Clair said he plans to obtain his degree in national security and after four years of post-secondary education he will be commissioned as an officer in the Air Force.
“I do feel (proud),” he said. “I feel that right now, how our unit is contributing (to the) community, how it’s structured right now, I feel I played a big role in it, especially with our instructors retiring … I’m proud of the way the unit is looking right now.”
The Nelson County Clerk’s Office is looking to have 32 new voting machines in service by the May primary race for the governer’s office.
The clerk’s office is looking to have one election of training under its belt before handling the presidential election in 2024, which will have a larger turnout.
“We have been talking with Fiscal Court over the last several months on getting the new machines so we could get a few elections under our belt before they are mandated,” said Nelson County Clerk Jeanette Sidebottom. “Hopefully we’ll get this, we have the bids sent out and hopefully will get them back and get with the Fiscal Court.”
Nelson County Fiscal Court approved taking bids on the first round of voting machines last week and the goal for the clerk’s office, Sidebottom said, is to have 32 of them by May. The county is looking to purchase the equipment from Harp, a vendor based out of Lexington.
The benefit of working with a company so close to home, Sidebottom said, is the easy access to qualified tech support in the event a machine was to go down or any other problems were to arise.
“I can make a phone call and if I need one of those techs to come down, they are here, on election day especially,” Sidebottom said.
Another benefit, said Cathy Marks, Election Team Leader in the clerk’s office, was should they run out of ballots, they can call to have more printed off and pick them up the same day as well.
The new machine mandates are because of legislation passed last year which says all voting machines must use paper ballots, which most of the older machines use with the exception of handicapped-accessible machines, which were all digital.
“The reason why these machines are mandated is the machines we are using are at least 15 years old,” Marks said. “They were bought sometime between 2005 and 2009.”
A thing to remember about the old machines, she said, is they actually have two types. The one most often used takes and tabulates paper ballots. The second is all electronic and Americans With Disabilities Act (ADA) compliant, and will not be recertified by the state because it is all digital and cannot be audited in the event of a recount.
“When we get the new machines, every machine will have a paper ballot that you can scan,” Marks said, which will include a new ADA-compliant machine to ensure every person who wants to vote can do so on their own.
By 2024 the clerk’s office hopes to have 36 to 37 voting machines in total, as well as three to four printers certified for printing off ballots.
The county has 14 polling places plus the office for absentee, mail-in, and early voting. Each polling place will require one regular machine as well as an ADA one.
“What Fiscal Court is asking us to do is just get what is necessary right now and then maybe we can order the rest at a later date,” Sidebottom said.
Once the clerk’s office has the machines, they will still need to train around 100 staff members who work election day on how to get their reports at the end of the night, how to pull a ballot, and how to test them the morning of the election.
“There is a lot of training that goes on that the public doesn’t see,” Marks said.
They said voters will not see much of a change in how they cast their ballots.
Once the county has the new machines it will be up to the Fiscal Court to decide what to do with the old ones, whether they pay to let Harp pick them up and destroy them or if the clerk’s office will have to find a way to destroy them.
The clerk’s office is currently waiting on bids to present to fiscal court before moving forward.
