MARSHALL - The operations of emergency management services in Madison County has changed a lot over the last 30-plus years as the county has experienced a developmental and residential boom.
Since July 2020, the county's EMS operations have been carried out by Madison Medics after the county contracted with Ashe-Watauga Medics for a five-year contract totaling $8.4 million.
The contract is set to expire in July 2025. Prior to that, since 1990, the county's EMS operations were controlled by Mission Health, which ran ambulance services in Marshall, Mars Hill and Hot Springs. Mission took over operations in 1990 from Madison County EMS, which was founded in 1977.
Mark Snelson, Madison Medics' director, has been with the county throughout these transitions, as he began working for the county EMS in 1990.
The News-Record & Sentinel spoke with Snelson and other Madison Medics staff May 15 ahead of National EMS Appreciation Week, which takes place May 19-25.
As Snelson approaches his 35th year working in Madison County EMS operations, he looked back on how much change he's witnessed.
"I started this job in 1990. I was making $3.65 an hour," Snelson said. "We're still making good money. It's $18 or $19 to $25 an hour, and you work 96 days a year. You work two 24s a week. So, a lot of people have second jobs."
Snelson said Madison Medics responds to 3,800 to 4,000 calls a year. Snelson said that figure has nearly tripled since he started in 1990, when the figure was closer to 1,400 calls a year.
According to Snelson, Madison Medics has 33 employees, 22 of whom are full-time employees. Full-time employees work two 24-hour days a week.
Of the 33 employees, nearly half are not Madison County residents, as 15 of the 33 employees commute from out of the county.
Staffing concerns are a problem throughout the industry, according to Snelson and his staff.
"The burnout rate up there is like four or five years, and they're starting pay at $90,000. But you get dogged," Snelson said of Buncombe County EMS. "You're a number up there, you're not a person. It's just the culture up there. It's better than what it used to be."
Of Snelson's 33-person crew, 21 employees are full-time employees.
Paramedic Rachel Perez is one of the full-time employees at Madison Medics.
Perez and her husband, who live in Arden, lived and worked in Qatar from 2013 to 2021.
"It was insane," Perez said. "Neither one of us have military experience, so it was kind of hard for us to get jobs abroad, because most of the time if you get EMS or fire jobs abroad, they want military experience."
Perez said the call volume in Qatar was roughly 1,000 calls per day, and referred to her experience over there as "being in a different world."
But Perez said she's found peace working in the family-like atmosphere at Madison Medics.
"Mark knows what he's doing over here. He actually takes care of his people," Perez said. "You can come to him and be like, 'I have an issue,' and he takes care of you. I used to work at Mission, and I went to my boss there and said, 'I'm stressed out from a call,' and they were like, 'Get on the truck or go home. We don't care.'
"Mark would be like, 'What's going on, Rach? Sit down."
The family-like atmosphere goes a long way in combatting attrition and burnout, as well as trauma and PTSD from the job, according to Perez.
"Not only do we work 24-hour shifts and you see people who are dead, also in the small town, we get to know everybody," Perez said. "The next call we go on could be somebody that they went to school with that's now dead.
"I see stuff. And it's not just seeing people, it's forgiving ourselves when we make mistakes and we don't catch it, because we feel like we kill people if we don't save them. That's what it is. It's not that they die or that we see them dead. It's, 'If I would have known to give this medicine quicker, then they wouldn't have died.'"
Perez said she has done EMDR therapy to help work through her trauma, including an incident in 2013 when she was shot at while on a call.
"I had to rewrite the story and reword it," Perez said. "I love EMDR, it's amazing. I'm good. I'm happy, I'm working. Now, I can take what I learned and not only share it with everybody in Qatar, but share it with people here."
Perez said the mental health resources available to paramedics and nurses and first responders are limited compared to doctors, which also contributes to burnout.
"Whereas the doctors and the nurses have a little more network of a hospital, they don't necessarily feel as responsible," Perez said. "When you close the door, it's just you and the patient. You know it's just you.
"We bear witness. Our real job is just bearing witness to the tragedies that happen. There's not much we actually can do. We hold hands. We give hugs. We bear witness."
More: Madison Medics receives AEDsMadison County's 9 fire departments receive automated emergency defibrillators
More: Mission moves out of MadisonMission to move out of Madison after commissioners approve new EMS provider
Community initiatives
Throughout the uptick in emergency calls, Madison Medics has been engaged in a number of different projects throughout the community.
Since 2004, Snelson has worked with North Carolina State Highway Patrol to teach more than 4,000 youths through the CARES 2000 program.
"Every kid that's come through driver's ed since 2004 has came through that," Snelson said.
In April, the county announced it had received a number of automated external defibrillators. Madison Medics provided the 27 AEDs and dispersed them to fire departments and other first response agencies throughout the county as part of a partnership with RACE-CARS, a seven-year trial led by a team of researchers at the Duke Clinical Research Institute in partnership with participating EMS agencies, hospitals, 911-dispatch, fire, rescue, law enforcement agencies, and communities throughout North Carolina.
That collaboration with the local fire/rescue, law enforcement officers and 911 dispatch has been crucial Madison Medics and its mission, Snelson said.
"We couldn't do our jobs without the fire departments, I'll be honest with you," Snelson said. "No three paramedics can do the whole job. You get mad patients in the back, and the fire department guys are sometimes back there helping us."
Johnny Casey has covered Madison County for The Citizen Times and The News-Record & Sentinel for three years. He earned a first-place award in beat news reporting in the 2023 North Carolina Press Association awards. He can be reached at 828-210-6074 or jcasey@citizentimes.com.
Most Popular
Comments / 0