SANBORN, Iowa — When she was 16, Kaitlin Kribell decided she wanted to become a volunteer emergency medical technician for Sanborn Ambulance.
At the time, Kribell’s parents were serving as EMTs and her grandmother as a driver for the rural ambulance service in Sanborn, a city of nearly 1,400 people in O’Brien County.
“I kind of just wanted to follow in their footsteps. I saw what they were doing and how they were making a difference in the community,” said Kribell, who has been volunteering as an EMT for around six years. “I wanted to help out people at their worst times. That just kind of became my passion.”
Today, Kribell is the ambulance service’s director and, for the last couple of weeks, its only EMT. Before the previous director resigned, Kribell said Sanborn Ambulance had been operating with just two EMTs for a few years.
Kribell doesn’t know how long she’ll be able to continue to shoulder the rural ambulance service on her own. Sanborn Ambulance, which has been serving the community since 1975, responds to roughly 120 calls a year and its service area extends a couple miles outside of the city limits.
“It is very stressful just kind of knowing that everything falls on you,” Kribell told the Sioux City Journal. “Kind of having that guilty feeling when you’re not in town and the residents have to wait up to 20 minutes for a different agency to respond, it’s been hard, but we’ve been working through it.”
A majority of rural ambulance services nationwide are dependent on volunteers.
The National Rural Health Association (NRHA) reports that 53% of rural EMS units are staffed by volunteers-only, versus 14% in urban areas. A 2019 Iowa Department of Public Health publication states that 75% of Iowa’s emergency medical services are entirely volunteer-based and respond to approximately 10% of all EMS calls in the state.
According to a NRHA policy brief, nearly 70% of rural EMS providers report having difficulty recruiting volunteers to meet staffing needs.
“We’re not the only agency that’s struggling,” Kribell said. “I think we’re all kind of getting into that same issue where we used to have a bunch of members and, as the years passed, they got older and were just uncomfortable doing it anymore, so we just slowly started losing people, but not gaining any, either.”
Dejay Langel, Whiting’s rescue captain, said finding volunteers for the ambulance service has always been difficult. Langel said he doesn’t think many people are fond of committing to upwards of 200 hours’ worth of class time in order to volunteer, even though they gain a skillset they can use to help people wherever they go.
“I think it’s a mixture of people being so caught up in everything else going on in their lives. There’s so many extracurricular activities nowadays with school and sports and other academic activities,” he said. “I think a lot of it has to do with the education of the general public, too. People might be under the assumption of EMS being funded via tax dollars and, up until July of last year, EMS was not an essential service. I think people just assume, ‘My taxes pay for that. I don’t have to worry about that.’ That’s not necessarily the case.”
Jeff Nohava, who directs Hawarden and Alcester’s ambulance squads, also thinks the amount of EMT training volunteers are required to complete deters some. Nohava, who has grown both squads to more than 30 volunteers, has a class that currently meets two nights a week and one Saturday a month. He said volunteers started the training in January and won’t complete it until May.
“In my opinion, it’s the constant demands the state and federal government keep putting on volunteers,” he said. “I understand that we’ve got to have rules and regulations, but most of our rules and regulations that I have seen are catered to the big cities and they forget about the rural people.”
After completing EMT training, Nohava said volunteers have to take a National Registry of EMTs exam, which he described as “tough.” He said he thinks rural volunteer EMTs should be allowed to be certified at the state level.
“Seventy-five to 80% of the calls we go on in the rural area, we just need to basically get there, package the patient and get them to the hospital,” Nohava said. “We don’t want to be nurses. We don’t want to be doctors. We just don’t want to cause anymore harm to that person and get them safely to the nearest facility. We need to get back to the basics.”
Kribell is on call from 6 a.m. to 6 p.m. Monday through Friday.
“That’s the time that I can guarantee that I will have a driver to respond,” she said.
Since she works at Sanborn City Hall as an administrative assistant from 8 a.m. to 4 p.m., Kribell said she’s able to respond to calls within three minutes, during that timeframe. In the evening, she said the response time is closer to seven minutes. Sanborn’s volunteer firefighters and Kribell’s husband, Kolton, a machinist, pitch in driving the ambulance. When Kribell isn’t available on weekends and other hours, EMS crews from nearby Primghar and Sheldon cover the calls.
“It does get hard when you have multiple-vehicle accidents. If we’re not really sure if we’re going to need extra help, extra drivers, those are the worst ones, as well as any of our pages that go into cardiac arrest. It’s really hard to take care of everything by yourself. There’s a lot of steps involved,” Kribell said. “I haven’t had to deal with that as of yet.”
The small town of Archer, just southwest of Sanborn, lost its ambulance service a few years ago. Sanborn Ambulance extended its coverage area a bit to share that territory with Primghar and Sheldon.
Kribell said Sanborn Ambulance is in danger of shuttering, too, if more volunteer EMTs can’t be found. She said drivers and emergency medical responders are also needed. EMRs are trained to provide life-saving care, but they are unable to transfer patients without an EMT present.
“At the end of the day, I am a human. I’m not going to be able to juggle all of this for the long-term,” Kribell said. “If we continue not having people, that is a very real possibility for the future.”
Kribell said the city is offering a sign-on incentive for anyone wanting to take EMT or EMR classes. She said volunteers also receive an annual payment, which could range from a couple hundred to a couple thousand dollars, depending on the number of calls taken, the length or those calls and other factors.
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