Home Care In Volunteer, NC

: Xavier Martin – News-Topic, Lenoir, N.C.

From fighting fires to fighting for patients’ lives, the new Caldwell County Emergency Medical Services Manager has done it all.

Nathan Elliot, 40, started his emergency services career when he was 17 years old, volunteering with the Linville Volunteer Fire Department.

“I just made some friends when I was about 17 who kind of introduced me to the fire service, and really just fell in love with it, and started there as a volunteer. I ended up working about 10 years in the fire service, and then wanted a little bit of a change, and transitioned to EMS,” Elliot said. “From that first day of getting your feet wet and meeting people, I just kind of fell in love with it. It’s all I’ve ever done.”

He was later promoted to captain at the fire department.

Before working with Caldwell County, Elliot spent six years with Watauga County Medics, where he began as a part-time Emergency Medical Technician.

“I started in EMS as part part-time EMT, and then just literally transitioned through pretty much every step as a part-time paramedic, and then a full-time paramedic,” Elliot said. “Then I was an assistant supervisor, and then a shift supervisor, and then I started handling a lot of logistics for them, supply stuff.”

Elliot started as a part-time paramedic for Caldwell County EMS in 2019. A few years later, he left Watagua to work full-time in Caldwell County.

“From the first time I came here, I fell in love with the area and just the agency and the culture here,” Elliot said. “Then I left there and came here full-time. Best thing I ever did, by far. I tell people my only regret about it was that I didn’t come here a whole lot sooner.”

The 22-year emergency services veteran moved through the ranks, promoting to sergeant while working with the county community paramedic program. Before assuming his new role, he served as a captain while acting as the agency’s training coordinator.

Education and Training

Elliot holds a bachelor’s degree in emergency and disaster management from Western Carolina University and an associate’s degree in emergency management from Caldwell Community College & Technical Institute. He graduated from UNC-Charlotte’s School of Professional Studies EMS Management Institute and will complete his master’s degree in public administration, with a concentration in emergency management, from Columbia Southern University next summer.

In addition to his studies, Elliot is certified in a plethora of fire, rescue and EMS certifications. These include earning his national registry paramedic certification, level 2 EMS instructor, level 3 fire instructor, fire officer 2, rescue officer and rescue technician, with specialties in agriculture, ropes, wilderness and vehicle and machinery.

Elliot’s diverse background and skills have prepared him to excel in his new role. His diverse background and training have prepared him to not only lead EMS but also to coordinate with agency partners.

“I truly like emergency services as a whole, being able to see every aspect of it. And so from spending time in the fire service, my degree path was emergency management, and then as much time as I’ve spent in EMS, being able to really see the whole picture,” Elliot said. “I tell people, it’s like that 10,000-foot view, so I understand the perspective of the patient, of the fire department, of all of our partners.”

Agency Goals

In his new role, Elliot hopes to continue to focus on finding ways to improve work-life balance, reduce burnout and focus on the mental health of his staff.

“I’m not interested in just making decisions and then being like, ‘Here, here’s what we’re going to do.’ I’m huge on surveys and really take input from the staff to understand what helps,” Elliot said. “Trying to find ways outside of the normal job that we do, to interact together, those types of things. We try to be very diligent about checking on mental health. We have options available to them for that. But constantly just asking, ‘Are we good? What can we do to help you?’ And I think a lot of that comes from the culture here, where it’s really family.”

As EMS Manager, Elliot aims to improve recruitment in the short term and continue to keep Caldwell County EMS well-equipped in the long term, always looking to incorporate more innovative and effective ways to treat patients.

“We’re constantly trying to figure out new ways, new techniques, new things that we can do. And I think that’s a huge part of our recruitment tool that we use here,” Elliot said. “I’m a little biased, but I think in the state, you’re not going to find another agency that has anything better than we do when it comes to equipment.”

ASHEVILLE, NC – It's been one year since Helene devastated parts of the region in Western North Carolina and some of the first eyes-in-the-sky are reflecting on the devastation that followed.

Without cell service and washed-out roads, hundreds of people were left stranded in the mountains.

Al Mattress, a helicopter pilot with a commercial flight company, Total Flight Solutions, said he received an early morning call from one of the company's clients. The client asked them to check on a family member in western North Carolina.

Mattress says he got up in the air as quickly as he could. He was one of the first to see what was actually going on in the region.

"Watching it unfold, ya know, this water was still rising," Mattress tells FOX. "I had gotten there personally, literally, right after the storm left."

Mattress did a couple missions checking on loved ones and realized the destruction was worse than anyone thought. Back on the ground was Total Flight Solutions helicopter pilot, Tim Grant. Grant laid out the logistics for dozens of pilots in the coming weeks as missions switched from rescues to donation drops.

With support from the United Cajun Navy, Grant says they brought in nearly every helicopter they could. Everyone donated their time, effort and resources to immediately rescue people, or drop off essentials like medicine.

Mattress talked to FOX about the reactions and conversations he had with some of the people he rescued.

"No phones, ya know the phone they have, it's till the battery goes dead. They don’t know. They can’t call, they don’t know anybody is coming for them."

"When they [the pilots] would get done with their mission, they would climb high enough to find a cell phone tower that was outside, make a radio call and say, ‘hey, this is where I am, I picked up these people, and they’re OK,’" says Grant.

Grant's team of volunteer pilots did 25 rescues the first day and 30 the second day after Helene. "But we did well over 100 missions, just dropping off food and supplies," he says.

Volunteer pilots were working from sunup to sundown. Grant says pilots would debrief at the end of the day for about an hour before they called it a night.

One story stood out to Grant the most: "He [a pilot doing a rescue] went to go pick up some people, and he could see arms sticking out from the mudslides that had gone over."

Also doing missions, but just dropping off supplies — was South Carolinian, Austin Lane. He heard about a group on Facebook, Carolina Aviators Network, putting together a group of pilot volunteers to get donations closer to the mountains.

Lane flies a 1960s Baron twin-engine plane with a 1,000-pound load capacity, allowing him to fly a little further than other planes volunteering.

"Delivered diapers for people with newborn babies or delivered canned goods or dietary restrictions and insulin," Lane says.

Looking back, Lane is amazed at the organization of the donation sites he landed on. He says it only took minutes for volunteers at local airports to load his plane with supplies.

"It was one of the very few that could get further out. So we were doing 6 to 8 trips a day," he says.

Grant reflects on the overall experience, "The people that donated their supplies, their people, their helicopters, whatever it was…that was the best part."

Roads began to clear with help from the North Carolina National Guard and other volunteers. This allowed more volunteers and nonprofit organizations to get further into the hardest hit regions.

The NCNG tells FOX there were 869 air rescues, with 165 of them being complex hoist rescues. In an email to FOX, "A complex hoist rescue is when a helicopter crew uses a hoist to lift people from dangerous or hard-to-reach places during a disaster or emergency, and the situation is harder than a normal rescue."

Overall, the NCNG says South Carolina, Maryland, Oklahoma, Georgia, Florida, Connecticut, Minnesota, Iowa, New York, and Pennsylvania provided aircraft. The Army Helicopters used 21 CH-47 Chinooks, 7 UH-60 Blackhawks, 4 UH-72 Lakotas for a total of 32 helicopters.

The NCNG also rescued 226 pets, dropped off 3,638 food pallets and brought in 1,877 tons of cargo by air.

Small rural fire departments across North Carolina are struggling to recruit volunteer firefighters and pay for the rising cost of equipment. That’s prompting the state legislature to look more closely at the future of firefighting.

More than 70% of the state’s fire departments are staffed primarily by volunteers. But with newcomers moving in without close community ties, and long commutes for work in rural communities, fewer people are signing up.

"Volunteerism in general has changed so much over the years," said Barry Overman, executive director of the State Firefighters Association and a longtime member of the Weeksville Volunteer Fire Department in Pasquotank County. "Trying to keep volunteers on a roster and keep them active is becoming more and more of a crisis for communities across the state."

When departments don’t have enough firefighters to respond to calls, dispatchers will send a crew from a more distant station, which can lead to longer response times. Longer average response times, in turn, can affect insurance ratings that determine how much homeowners pay in their premiums.

Some short-staffed rural departments are merging or shutting down completely. State Fire Marshal Brian Taylor says county governments are then responsible for making sure every community has coverage.

"I think everybody needs to be assured that no one is ever going to go unprotected," he said.

Taylor says many departments have had to hire paid firefighters to answer calls during daytime hours when their volunteers are stuck at work.

"We don't have that local service station owner or local farmer in town, but they're able to pay someone to stay at that fire station, and it'll still be a volunteer fire department," he said.

Cost increases are also a problem for small volunteer departments. Overman says the price of a standard fire truck has increased dramatically since 2018.

"You could get one between $375,000 to $500,000 and now, seven years later, that same exact truck is just under a million dollars," Overman said.

The Office of State Fire Marshal provides grants to help, but Taylor says its funding isn’t enough to cover all the needs.

"Generally, we have about $13 million in requests, and anywhere from $9 to $10 million is what we are able to fund," he said. The state legislature has also included direct grants to some departments in recent years' budget bills, but not every department has been able to get a share.

The state House unanimously passed a bill earlier this year to launch a study of rural firefighting issues. The study would look at strategies to recruit more volunteers, funding for trucks and equipment, as well as the toll of firefighting on physical and mental health. It calls for the state fire marshal to "suggest funding and other legislative actions needed to keep those fire departments fiscally sound and mission effective."

Rep. Reece Pyrtle, R-Rockingham, sponsored the bill. "What we hope to find out is, what does firefighting look like in 2030, in 2035?" he told WUNC. "What does it look like in rural North Carolina?"

One strategy is to work with kids and teens to get them interested in firefighting. Taylor says some departments now host summer camps.

"Unless they had a father or grandfather in it, or mother, there's not a lot of interest, unless you get them early," he said. "I was drawn to it at age 12. I knew from that point on, going to the volunteer fire department in my area, that I wanted to become a fireman."

He says the training requirements can make the work less appealing for volunteers.

"To truly have a certified firefighter, it would take over 400 hours and probably two years to complete, so it's very time consuming," he said.

Rural fire departments are also busier than they used to be. Overman says his small department in Pasquotank County responds to four times the number of incidents as it did when he started in the 1980s.

"You see an uptick in calls, whether it be wrecks, fire alarm activations, just so many calls now that they respond to," he said.

If rural departments aren’t able to recruit more volunteers, Taylor says county governments could end up with the bill for paid firefighters.

"I think within eight to 10 years, that counties are going to take over these services, and it's going to be a burden to the taxpayer," he said.

Pyrtle says he’s hopeful that the state Senate will soon sign off on the bill to create the study. "I hope the solution comes from this study, and we can evaluate what we can do and when we can do it," he added.

RALEIGH, N.C. — Volunteer firefighters make up 65% of the U.S. Fire Service, according to the National Volunteer Fire Council.

In North Carolina, a number of communities rely on volunteers to respond to all types of emergencies.

What You Need To Know

A majority of fire departments in the United States are volunteer departments.

From structure and wildland fires to vehicle crashes, medical emergencies and natural disasters, these men and women show up and get to work.

Durham Highway Fire Department volunteer Craig Dunkley said after he’s done saving lives with the fire department, he heads to his job as a full-time marketing expert.

“If I have to stay late from a shift, and because of a fire or some situation like that, and I start work late, I’ll just work later in the evening to sort of cover the hours,” Dunkley said.

Many volunteers work 12 to 16 hours a month depending on the department’s needs. They receive small stipends and benefits, such as a state pension plan.

Luckily for Dunkley, he doesn’t volunteer for the money. He said he does the job for the community, camaraderie and commitment.

“My kids always thought it was pretty cool. My wife took a little bit of convincing, because I’d had a busy job beforehand. And then when I started adding this on, she was like, 'when are you going to be home?' But we all worked it out,” Dunkley said.

The National Volunteer Fire Council said a community’s population determines whether it gets a volunteer fire department.

The agency said large communities with over 100,000 people are protected by departments that consist of primarily paid staff.

Assistant Chief Mac Schultz said with the growing population in the Triangle, many volunteer departments need more people.

Dunkley, who began volunteering six years ago, encourages volunteering.

“You have to make time not only for being here at the station to run calls and do your duty, but also for training, because we all train to a pretty high standard. There's a lot of hours that go into that. And also, you have to make time to maintain your own physical fitness,” Dunkley said.

Durham Highway Fire Department is actively seeking volunteer firefighters.

All training and certifications will be provided free of charge. Prior training is not needed.

In addition, the NVFC launched the national junior firefighter program in 2007, and it's still active.

The goal is to get more youth interested in the fire service.