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Paramedic shortages still plague B.C. rural areas, but remedies may be in the works

Part-time staffing model, better on-call wages may help areas facing staffing gaps

Rochelle Baker, Local Journalism Initiative Reporter CANADAB次元官网网址橲 NATIONAL OBSERVER

Carol Woolsey had the misfortune to experience a medical emergency in her rural community last month after the last ferry had sailed for the night.

After developing searing pain in her lower abdomen, the 77-year-old resident of Quadra Island and her cousin called 911 at about 10 p.m. on April 2.

Disoriented by pain and vomiting constantly into her kitchen sink, it seemed to Woolsey it was taking forever for paramedics to arrive. She was relieved to see two people come through the door around 20 minutes later.

However, relief turned to alarm when she learned the two were local volunteer firefighters responding because there were no paramedics available on the island. Woolsey had to wait for a crew to come by water taxi from Campbell River.

It took at least an hour before paramedics came to provide medical care, and the trip to the hospital in Campbell River B次元官网网址 just three kilometres across the water on Vancouver Island B次元官网网址 took about another half-hour, Woolsey said.

B次元官网网址淲hen I heard that, I thought, `Oh, my God. How long am I going to have to wait?B次元官网网址滲次元官网网址 Woolsey said. B次元官网网址淚 was in the middle of real pain, and that was stressful.B次元官网网址

Quadra, like many small, ferry-dependent communities in coastal B.C., is facing a double whammy of acute paramedic shortages made worse because BC Ferries no longer guarantees off-hour sailings for medical evacuations at night.

The lack of local paramedics and ferries to get people off-island to hospital in a timely manner is a persistent worry, said Woolsey, especially in a community where nearly 40 per cent of the population is 65 or older.

An online petition started last summer has garnered more than 2,200 signatures and calls on Transportation Minister Rob Fleming, B.C. Emergency Health Services (BCEHS) and BC Ferries to rectify the islandB次元官网网址檚 barriers to emergency care.

B次元官网网址淧eople talk about what happens in the middle of the night,B次元官网网址 Woolsey said. B次元官网网址淲hat kind of help is available? ThatB次元官网网址檚 what I hear most people are concerned about.B次元官网网址

Three of the four scheduled on-call (SOC) staff positions at the Quadra paramedic station are vacant B次元官网网址 two since the fall of 2021 and the other since May 2022, a freedom-of-information request by CanadaB次元官网网址檚 National Observer shows.

The station currently relies on casual on-call staff or staff pulled from other locations to backfill scheduling gaps, and volunteer firefighters to drive the ambulance when only a single paramedic is available.

From May to early October, there were 11 occasions when no local paramedics were available for emergency medical calls on Quadra Island B次元官网网址 a community of 2,700 residents with a large seasonal tourist population. There were no complete gaps in paramedic coverage in the final three months of 2022.

However, during the first four months of this year, there were nine instances where no paramedics were on Quadra to respond to emergency calls, data from BCEHS and the paramedicsB次元官网网址 union shows.

While vacancies on Quadra Island have been acute, a new labour agreement is expected to improve staffing on Quadra and in rural communities provincewide, BCEHS told CanadaB次元官网网址檚 National Observer.

The February agreement includes a wage increase for casual on-call paramedics and does away with the unpopular part-time staff SOC positions used in small rural communities, said Glen Greenhill, BCEHS Comox-Strathcona patient care manager.

Formerly, on-call paramedics B次元官网网址 typically a pool of casual employees who let BCEHS know when they can cover shifts B次元官网网址 didnB次元官网网址檛 get full wages for being on call, but they will now receive $12 an hour, up from $2.

Additionally, any existing SOC positions, which made it difficult to attract paramedics to work in rural stations, will be phased out across B.C. and replaced with an alternative part-time staffing model by the end of March 2024, Greenhill said, and maybe sooner on Quadra.

Under the current SOC system, paramedics are scheduled to work an eight-hour shift but must remain on call for a further 16 hours B次元官网网址 for a total of 24 hours daily over a three-day rotation. This ties up staff for a full three days but potentially only pays them full wages for one, unless they respond to emergencies while on call.

A new staffing model hasnB次元官网网址檛 been fully determined for Quadra yet, but Greenhill said heB次元官网网址檚 confident future changes, along with transitional incentives, improved wages and ongoing recruiting efforts, will improve service in rural B.C. communities.

Paramedic coverage on Quadra is expected to improve moving forward because four new on-call paramedics have been recruited to the Quadra station to help cover shifts, for a total of six members currently available for scheduling to support the existing SOC paramedic position, according to union data.

There arenB次元官网网址檛 any scheduling gaps projected for May, Greenhill said.

The objective is to have employees scheduled to drive ambulances 24/7, he stressed.

B次元官网网址淨uite honestly, the crew on Quadra Island have been working miracles to do that,B次元官网网址 he said.

B次元官网网址淲eB次元官网网址檙e still not going to let our foot off the gas pedal and will continue with recruitment and retention strategies.B次元官网网址

Quadra IslandB次元官网网址檚 Volunteer Fire Department has agreed to provide drivers for ambulances on days when only one paramedic is available when possible, and pick up paramedic crews coming from Campbell River at night when no local paramedic is scheduled, Greenhill said.

Weather and availability permitting, a water taxi in Campbell River is called out on an ad hoc basis if a patient needs transport off-island at night since BC FerriesB次元官网网址 own staffing crisis means vessels canB次元官网网址檛 run outside of scheduled hours, Greenhill said.

Failing that, if a patientB次元官网网址檚 condition is serious, an air ambulance or Canadian Coast Guard vessel may be dispatched, he added.

Troy Clifford, president of the paramedicsB次元官网网址 union, said the added difficulties and travel time with evacuating patients from remote communities underscore the need for rural stations to be fully staffed.

And using volunteer firefighters as an ongoing stop-gap solution diverts the department from its primary purpose, he added.

B次元官网网址淚t puts pressure on those firefighter resources, and itB次元官网网址檚 absolutely not what they are there for,B次元官网网址 Clifford said.

But he is also cautiously optimistic rural paramedic positions will be easier to fill under the new contract.

There are approximately 60 rural stations operating under the SOC model in B.C., with up to half of them vacant, he said.

The union, BCEHS and the province are discussing shifting up to a third of those communities, often those with higher call volumes, away from any on-call model and staffing them with full-time, 24/7 ambulance crews, Clifford said.

Gabriola Island, Bella Coola and B.C. Interior communities such as Alexis Creek and Clinton are some of the communities being considered, he said.

In small communities with fewer calls, like Quadra, the SOC model will be shifted to a regularly scheduled part-time position B次元官网网址 involving 12-hour rather than 24-hour shifts and a limited on-call component that offers a better work-life balance and sustainable wages, he said.

While relying on water taxis may be a necessary short-term solution to not being able to roll an ambulance onto a ferry at night, the vessels arenB次元官网网址檛 designed to accommodate paramedics or complex patient care, Clifford said.

Woolsey is thankful the weather wasnB次元官网网址檛 miserable and she was still able to walk the ramps to the water taxi on the Quadra dock, which isnB次元官网网址檛 designed to accommodate wheeled stretchers. It would have been a struggle for paramedics to get her aboard the boat if she were unconscious on a stretcher or weighed a lot, she noted.

She has nothing but praise for the local firefighters and the paramedics who came from Campbell River, Woolsey stressed, noting they had to overcome difficulties and pull resources from their own community to respond to the 911 call.

At the hospital, it was determined Woolsey had a kidney stone, which is extremely painful but not typically life-threatening.

But that wasnB次元官网网址檛 something she knew during the anxious wait for paramedics in the company of the local firefighters.

B次元官网网址淚 think the firefighters felt badly,B次元官网网址 Woolsey said.

B次元官网网址淚t must feel helpless to see somebody in pain, but you canB次元官网网址檛 do anything to help.B次元官网网址

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