It’s Emergency Medical Services Week! The Northern Michigan Center for Rural Health with Andrea Abbas, Programs Manager for the Michigan Center for Rural Health, to get her input on the current state of EMS in rural Michigan. Here is her #MiEMSstory.
When Michigan native Andrea Abbas began her college career, she had intentions of attending medical school. As she began conquering pre-med courses, she also enrolled in business courses. The pull between two passions, medicine and business, led her to enroll in an Emergency Medical Technician (EMT) course...and the rest is history.
“(Before taking the course) I didn’t know what an EMT was,” Abbas said. “I had never really paid attention to ambulances and ambulance work. I didn’t understand what that was...so I checked it out, enrolled in a course, and just loved it.”
Abbas went on to take a paramedic course. With a Master’s of Science in molecular biology, she began teaching at the collegiate level while also working in EMS. She then made the decision to follow her initial dueled passions and pursue the business side of EMS. After fulfilling roles in quality assurance & compliance, EMS supervision and directorship, she landed at the Michigan Center for Rural Health, which serves as the MI State office of rural health. As EMS Programs Manager, Abbas is responsible for the center’s rural EMS programming, which includes but is not limited to continuing education, workshops, and operational sustainability.
In every position she’s held since that initial EMT course, she has continued to work in an ambulance.
“I still work in the ambulance to this day, and plan to continue until physically I can’t anymore,” she said. “I find the work deeply fulfilling –– there’s nothing like it. I feel privileged to work in this industry in my current role.”
Abbas adds that her work as an EMT directly assists in her work as EMS Programs Manager.
"When you are on the street, you’re physically writing the reports, taking patients, and seeing from the frontline how things change. Having that inside knowledge is important and taking care of patients is what it’s all about."
Read on for more of Andrea’s first-hand account of working in rural EMS!
Q&A
In your experience, what are some common misconceptions or lack of information about the EMS system and EMS agencies?
I think it’s important for communities to understand the varying levels of EMS and scope of practice, how EMS personnel are integrated in their communities, and how agencies are funded.
There are four levels of education with training requirements for each level: 1) emergency medical responder, 2) emergency medical technician, 3) advanced/specialist, and 4) paramedic. Additionally, there is a scope of practice within each level. A paramedic spends roughly 14-16 months in school completing academic requirements and clinical rotations. Whether someone is working at an EMT license level or a more advanced level such as a paramedic, there is a necessary level of clinical care and scope of practice followed and demonstrated as a provider.
With EMS there’s a common misperception. A community member may see a crew sitting in an ambulance at a grocery store in a parking lot, and oftentimes I’ve heard people say “why are they sitting there? Why aren’t they working?” What isn’t commonly understood is that we’re “holding post”. If someone in that area of the city, town, or township has a medical emergency, we are close enough to get to them. During that time, we are completing paperwork and handling other work-related duties while we prepare for the next medical call.
For rural areas especially, geography can be a challenge. The landscape, long and winding roads and extreme winter weather impacts transportation in general. The distance and time it takes to arrive on scene can vary pending on these circumstances. It’s important that community members understand that a response time in rural Keweenaw county versus a response time in the city of Lansing could be vastly different.
What do you think is one of the most crucial issues affecting EMS systems in rural Michigan communities? What are some steps that can be taken to improve this issue?
I think that we need to look at how we can better fund EMS, because it really does fill two niches: public service and healthcare.
If we improve the funding structure, it creates better equipment as well as the ability to recruit and retain folks for career long or community volunteer work. Whether someone is employed in EMS full-time or part-time, they’re still wanting to put food on the table and pay their mortgage. Funding drives many aspects of the industry including clinical care. Without adequate funding you can’t have updated equipment and may struggle to provide paid training, which is important on the clinical side. Also, funding drives leadership. If leadership teams become stretched for time because there is not enough funding to staff trucks and onboard employees, it can become Ferris wheel of dysfunction; leadership is pulled in multiple directions and they don’t have time to lead which can cause dysfunction at all levels.
When it comes to recruitment and retention of EMS professionals in rural areas, what are steps that can be taken to improve the current situation?
Community engagement is huge. Not just in small, rural EMS communities –– a large corporate entity needs to be engaged with their community as well. The community needs to understand more about EMS agencies such as the scope of practice and level of education that’s associated with the various levels of EMS certification. When you’re engaged in the community, they understand the service you provide, and then you can easily advocate and story tell for your service to get stakeholders involved.
Coming back to funding, a good financial model is crucial so you can recruit at a good wage and have funds to retain your talent. The last thing is leadership and making sure there is a healthy work environment so employees don’t enter a toxic situation and leave –– that’s going to really affect the overall retention.
How has the current pandemic affected the EMS situation in rural Michigan?
EMS providers have been at the forefront of this pandemic. There’s been a heavy reliance on EMS during the pandemic and seeing EMS systems struggle, we have started to realize how important it is for ambulances to be available. There have been legislative movements with treat in-place and legislative movements with telehealth medicine. The health systems knew before, but this past year has highlighted how important EMS agencies are and when we’re not available how taxing that can be on a health system. I’m hoping the light has been shined on our EMS systems and a realization has been made that we are an integral part of the health system.
Continuing education has been a huge focus of the Michigan Center for Rural Health EMS programming. Why is this so important?
The Michigan Center for Rural Health advocates for education and for lifelong learning. Our office does a really great job of delivering quality continuing education to our EMS providers that offers what they need. We are constantly striving to put on continuing education credits that our providers are asking for. As an office we are proud of the education we offer and of our relationship with the Michigan Department of Health and Human Services Bureau of EMS, Trauma and Preparedness. Our working relationship and collaborative effort to make free continuing education available to EMS providers is working well for the state of Michigan.
Describe your connection with the Northern Michigan Center for Rural Health. How does this partnership benefit your center?
Northern Michigan University approached the Michigan Center for Rural Health about establishing a collaborative model to bring resources to the Upper Peninsula, and vice versa. Elise Bur was hired by NMU as the Northern Michigan Center for Rural Health director and it’s working out marvelously. I assist her with needs when it is an EMS question or project. When her schedule allows, she attends our Michigan Center for Rural Health staff meetings and has been involved in our strategic planning. We expect the partnership we have with the Northern Michigan Center for Rural Health to grow and prosper.
The Northern Michigan Center for Rural Health seeks to improve the health and well-being of Upper Peninsula residents and communities by developing collaborative partnerships that enhance the access and availability of affordable, quality healthcare services. For questions or comments related to this story, contact ruralhealth@nmu.edu.