Out-of-town medical transfers forcing overtime for EMS workers

Tim Peterson left Clovis at 11 p.m. on Friday alongside a man having heart problems. This was the back end of his shift that began 16 hours earlier.

The Clovis Fire Department lieutenant was destined for Lubbock on a patient transfer. He monitored the man’s chest pains as a second person drove the ambulance.

Following paperwork in Lubbock and vehicle cleaning, Peterson and his partner arrived back in Clovis at 3 a.m.

Then, another ambulance call.

“That night you just didn’t get any rest, you’re up until 7 in the morning,” Peterson said.

Out-of-town medical transfers, mainly to Lubbock, Amarillo and Albuquerque, have increased by 50 percent this year. As a result, the fire department’s overtime hours have skyrocketed and an already bare-bones staff is left scrambling to find personnel to man all five fire stations, fire officials say.

Sending a patient away for care is more than jumping in the ambulance for a cruise. In a normal transfer, an emergency-trained staffer cares for the patient as another person drives. Peterson said a page is then sent out to off-duty personnel who, by choice, fill in to keep the fire station open — and collect overtime.

Other times emergency staff are interrupted during training.

“There is no way for us to know when they are going to come and we may be in the middle of taking a class,” Peterson said. “If it is our time to go we have to go and we will have to make up that class at a later date.”

In 20 years, out-of-town transfers have more than doubled, according to figures from the fire department. Personnel on shift have increased by one person in that same time span.

The city recorded 558 transfers through September this year, Emergency Medical Services Director Karen Burns said. It totaled 296 transfers in 1989, Burns said.

Brian Bentley, administrator at Plains Regional Medical Center, said one reason for the increase in transfers is that doctors are more concerned with liability than in the past. He said Clovis doctors are more likely to send a patient to a larger hospital with specialists if they’re unsure about a diagnosis.

Bentley also said Clovis is receiving more patients in recent months, especially from the hospital in Tucumcari. More patients means more potential transfers. And he said some patients that Clovis used to send to Lubbock or Amarillo by helicopter are now receiving initial treatment in Clovis, then being transferred by ground ambulance the next day.

Clovis Fire Chief Ray Westerman said his department averages about 500 hours of overtime every two weeks with 90 percent a result of transfers. He has 63 shift personnel on staff. He said he must keep 18 working at any given time to keep all stations open.

“There have been times even while our personnel are working overtime that we can’t get enough personnel and have had to close a station,” he said. “The financial impact that it has on the overtime budget is tremendous.”

PRMC has at times requested four or five transfers at once, and Westerman said his department has to deny some requests.

“I feel like they are in a bad situation themselves because there are some procedures and some needs that they can’t provide for some of the patients and that is why we have transfers,” Westerman said.

Westerman said he plans to petition the city commission in December to allow for three new staff members. He will ask for three more next year.

“I reminded them the night they approved the pay increase for police to keep our expansion needs in mind,” he said.

City Manager Ray Mondragon said he has worked with hospital administration to cut down on late-night transfers except during emergencies. He said he will support adding staff to the fire department.

Mayor Pro-tem Kevin Duncan serves on the city’s public safety committee. He said he has heard the concerns but is waiting on figures to decide what action to recommend.

“If you can take into account our hospital is growing, our town is growing and with a growing community you are going to be hit and confronted with these things,” Duncan said. “You’ve got to look at what the priorities are and how we can address them.”