The only reason it is the "nature of the beast" is because we allow it to be. There should be no "excuses"! Sorry, this comes down to the old .... "you want to do the job, then be ready and prepared to do it".... Albeit volunteer or paid. Let's quit pretending and stop covering up .... short and simply laziness! Simply that is all it is!
Your right, most of us in EMS would take the one out of the dumpster because we would know the difference by their actions and knowledge, but patients do not. I had an employee that was not the best medic as in knowledge base. Yet he always looked professional and his actions in public was always remarkable, holding doors open, calling patients Mr/Ms. etc... Trouble was medically he was poor and yet I received numerous thank you and letters of praise over even those that was a master of medical care. Again, the public perception is often skewed.
If those in your department cannot afford to have clean and pressed shirts available, then I worry about the caliber of their desire and ability to have a clean and well stocked unit. Things can represent and point to other parts. If one is sloppy in appearance and lack the motivation to even present themselves professionally, what degree of care will these people deliver if they care that little about themselves or the image of the profession?
I don't think you honestly can defend anyone not presenting themselves as a professional. Why would anyone even attempt to justify such behavior? What is next? Hygiene ... deodorant and baths optional?
If you can't afford to be in the business, then it's time to reconsider your options.
R/r 911