The province’s paramedics are burnt out and say higher wages, better working conditions and recruitment and retention top the list of what’s required to improve a system “nearing the point of failure.”
That was the message delivered by members of the union representing paramedics during the province’s Standing Committee on Public Accounts on Wednesday. Held via video conference, the meeting focused on Emergency Health Services contract and service delivery.
“We became paramedics to help Nova Scotians. When we see calls in the queue with no units available to respond, or we are dispatched from the CBRM to calls in Truro and Dartmouth like was reported to us on Dec. 30 of 2021, that takes a serious mental and emotional toll on our members and puts Nova Scotians at risk,” Kevin MacMullin, business manager of the International Union of Operating Engineers (IUEO) Local 727, told the committee.
“How many more news articles do we need to see of stories from Nova Scotians who waited and waited and waited for an ambulance while their loved ones suffered in front of them? Nova Scotians are struggling. It’s time that we all work together and put an end to it.”
‘Nearing the point of failure’
Describing working conditions for paramedics as continuing to deteriorate with “constant” missed meals, shift overruns, denied vacations, extended response times and more, MacMullin said paramedics in Nova Scotia are mentally, physically and emotionally exhausted.
“For years, we have been calling for change and ringing the alarm bells on a system in crisis…Today, the system is nearing the point of failure,” MacMullin told the committee.
In his opening remarks, MacMullin applauded the provincial government for what he described as a well-deserved 23% pay increase announced for continuing care assistants (CCAs) last week. He said a similar increase for paramedics would significantly alleviate staffing pressures and help improve working conditions.
“Our paramedics are some of the most highly skilled and trained in North America, and yet they’re some of the lowest paid,” MacMullin said.
“It’s easy to see why we are bleeding paramedics to other professions and other jurisdictions.”
While the issues facing paramedics existed before the pandemic, there was recognition they’ve been exacerbated by it. Omicron in particular has had an impact.
Charbel Daniel, executive director of provincial operations for Emergency Medical Care Inc. (EMC), described this latest COVID variant as “truly relentless.” He told the committee that at any given time, EMC had on average 40 to 50 team members either exposed to or testing positive for COVID-19.
“It’s definitely added further strain to the system and to the service delivery. It’s now starting to trend downwards, which we’re happy to see,” Daniel said.
“Our numbers of people that we see exposed or testing positive are down into the thirties and twenties, and we’re looking forward to that completely going away.”
Daniel described the challenges currently faced by EHS (Emergency Health Services) as “unprecedented” due to what he described as health system and human resource strains.
“We no longer have that same ability to flex and fill these gaps, and this has impacted our service delivery to the public and our employees,” Daniel told the committee.
“We know Nova Scotians and our team members are concerned about our ability to respond in a timely manner, and we’re listening.”
Stressing that the challenges aren’t unique to Nova Scotia or even Canada, Daniel expressed optimism about the steps taken by government to “improve communication, collaboration and accountability in the health care system.”
Several initiatives undertaken to help ease some of the pressures faced by paramedics were also highlighted by officials during Wednesday’s committee meeting. In addition to a graduated licensing system for new paramedicine graduates and the creation last year of a medical transport service, they pointed to the province’s announcement on Tuesday that will see every ambulance outfitted with power stretchers and power loaders by year’s end.
This was one of the recommendations for injury prevention outlined in the 2019 Fitch Report.
While pleased with these initiatives, MacMullin said more needs to be done, particularly when it comes to wages and working conditions. He pointed to recruitment, noting it’s impossible to recruit paramedics when you can’t retain the ones currently in the system.
“We need to step up to the plate and help them now. We’re helping them with some collaborative initiatives now, with new power load stretchers, that’s great,” MacMullin said.
“The fact that we’ve got a graduated license system with temporary license, that’s great. But we really do need help for our paramedics out there. They’re virtually hanging on by their fingertips.”
MacMullin said 21% of their members are currently on leaves of absence, short term disability, workman’s compensation, or long term disability.
Responding to a question from Halifax Atlantic Liberal MLA Brendan Maguire, he told the committee that if he could wave a magic wand, he’d have 250 more paramedics “at the minimum” brought into the system.
‘We’re at code disaster’
Middleton paramedic Samantha Hamilton also addressed the committee. With 24 years experience, she’s also president of the union’s executive board. She said she’s never seen paramedics “at the state they are right now.”
“I think right now we’re at a critical crossroads with the paramedics. We’ve been talking for years about all these fixes, but I think at the end of the day, our top priority right now needs to be on retention,” Hamilton said.
“If you don’t have paramedics on the ground, I’m not sure what it is that the contingency plan is going to be. We really need EMC and EHS to actually acknowledge that there’s a problem.”
Hamilton said paramedics can’t be expected to work non-stop for 16 hours, adding that it’s far too much for her and her colleagues to handle.
“If you’re in cardiac arrest and I’m supposed to be at my prime thinking right then on my 13th hour, my 14th hour, and I’m supposed to make all these decisions about your care, you want me at my prime,” Hamilton said. “Not absolutely exhausted.”
IUOE business agent Michael Nickerson told the committee that when paramedics have to call in sick when their shift ends so they can return to their home base, “there’s major problems and issues within the system.”
In February of 2018, IUOE Local 727 launched its #CodeCritical public campaign to alert Nova Scotians when ambulance availability is “critically low” in any of the province’s health zones and corresponding counties. Each report is followed by “We encourage everyone to call 911 in an emergency.”
Dartmouth North NDP MLA Susan Leblanc asked MacMullin to explain the criteria for calling a code critical and what it meant for paramedics and people waiting for an ambulance.
MacMullin described code critical as a situation where there are two (or fewer) ambulances available in a county. He said for the period from Jan. 1 to present, they’ve had 247 code critical incidents.
“That’s a lot, so we’re running short all the time,” he said.
Offering her final comments to the committee, Hamilton told members that paramedics “desperately” needed their help.
“All my colleagues, everybody has an exit strategy right now…If there’s no paramedics, I’m not sure what’s going to happen,” Hamilton said.
“And we’re beyond code critical. We’re at code disaster.”
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