Staff shortages at Outer Cape fire departments and rescue squads are increasing pressure on the first responder teams who answer emergency calls. Local fire chiefs point to a dearth of affordable housing and training backlogs as major hurdles, while emergency medical technicians say that mental and physical fatigue are the prime reasons why workers resign.
Everyone interviewed for this story emphasized that the need for new hires is critical.
“I don’t want to be an alarmist,” said Wellfleet Fire Chief Richard Pauley Jr., “but I am a realist. Ten years ago, for any one job there were 20 to 30 applicants. But for the last six to eight years, we get maybe one or two qualified applicants.”
Chief Pauley and Eastham Fire Chief Dan Keane both praised their town select boards for supporting the hiring of more first-responder staff. But with entry-level salaries at about $50,000, they both say, the shortage of affordable housing is an almost insurmountable problem.
“What paramedic can afford a house?” asked Chief Pauley. “The money is not bad, and there’s always overtime, but even if a firefighter or paramedic has a partner and together they’re making $100,000 a year, how are they going to come up with a 20-percent down payment?”
Chief Pauley said that, while Wellfleet currently has people in every position, it’s still not enough. “We send one or two ambulances out the door, and the building is empty,” he said.
Both chiefs pointed to the need for cross-training firefighters and EMTs as a significant obstacle. Outer Cape firefighters are trained as EMTs or paramedics, and anyone hired as an EMT will be sent to one of the fire academies to complete a 10-week course; the nearest fire academies, however, have substantial backlogs.
A fire training facility in Barnstable was closed in 2019 because of issues of chemical pollution in groundwater. PFAS, also called “forever chemicals,” in several nearby wells were linked to the fire-suppressing foam used at the academy. These chemicals have been linked to numerous health hazards, including cancer. A new Barnstable County Fire and Rescue Training Academy has opened but has not yet had a significant effect on the backlog, according to Chief Keane.
The wait for training is now 9 to 18 months. Meanwhile, the academies themselves are experiencing staff shortages, as many of the instructors are firefighters and EMTs volunteering as teachers on their days off.
“So, for the last couple of years, no one is being trained,” said Keane.
Exhaustion and Compassion Fatigue
Kyle Morse, a Wellfleet native and paramedic who has served Cape Cod for 30 years, recently handed in his resignation from the Eastham Fire Dept. He cites exhaustion as his main reason for quitting. Although his last shift is still three months away, Morse is ready to stop.
“It’s kind of abusive to your health, both mentally and physically,” said Morse. He described the toll of working nights, weekends, and holidays, often in 24-hour shifts. Frequently being called to work extra shifts because of staff shortages, according to Morse, is especially difficult.
And there are less immediately recognizable stress factors, such as often having to choose between sleeping after a shift that ends during the day and doing the sort of things that allow you to maintain a sense of normalcy. That can lead to chronic sleep deprivation.
“Your body says you need to sleep,” said Morse. “But spending time with friends and family doing regular stuff is what I want to do, so I miss a lot of sleep.”
Compassion fatigue, according to the International Journal of Environmental Research and Public Health, is a problem that affects many first responders. It’s defined as a diminished capacity for empathy caused by repeated exposure to other people’s stress combined with burnout, which is a state of physical and mental exhaustion often leading to depression, anxiety, and increased risk of suicide.
A 2021 study from the U.S. Surgeon General’s office titled “Call to Action to Implement the National Strategy for Suicide Prevention” highlighted suicide among first responders as a particular concern. The study found that law enforcement officers and firefighters are more likely to die by suicide than in the line of duty.
A 2021 review by the National Institute for Occupational Safety and Health (NIOSH) stated that the number of suicide attempts and fatalities among first responders is likely underreported. First responders often have multiple jobs or work as volunteers. In 2020, the National Fire Protection Association estimated that there were 1,041,200 firefighters in the U.S., and that 676,900 (65 percent) were volunteers. The NIOSH study suggested that many suicides by volunteers may not be reported as a first responder suicide.
Morse pointed out that employee assistance programs are readily available to first responder teams, although some level of stigma — less now than 30 years ago — exists among responders who don’t want to be seen as weak by the other members of their teams.
“Eliminating stigma is a leadership issue,” said Steve Hirsch, CEO of the National Volunteer Fire Council (NVFC). This year on Oct. 10, World Mental Health Day, Hirsch oversaw the launch of the NVFC First Responder Helpline to help address this issue.
This new resource provides both immediate assistance in a crisis as well as confidential counseling, resources, and referrals for a range of issues including stress management, family conflict, financial or legal concerns, addiction, and grief. The need for more preemptive care to help responders process the trauma they inevitably will suffer has also become a higher priority.
“We can’t wait until after an incident to address trauma,” said Hirsch. “We have to get in there and have ongoing education — educate family members as well to recognize signs of when there is a problem. Family members will see it first.”
“The help is there if you want it,” said Morse, who credits his 12-step program and a therapist with keeping him mentally fit. But he added that help is effective only if the person needing it is willing to invest in it and do the necessary work.
For now, Morse is keeping himself going by envisioning his life after retirement. He recently adopted a dog after connecting with a local dog-rescue worker while working a four-car pileup at the Orleans Rotary. The dog rescuer was involved in the crash; cards and information were exchanged, and Grubbie, an emaciated and battered dog, found his way into Morse’s heart. Grubbie has since blossomed into a happy and healthy best friend.
“I’d like to do something with dogs,” said Morse. “I’m going to go back into construction and carpentry. I’m going to travel. I’m going to have freedom.”