Staffing challenges add to struggles at beleaguered Thunder Bay Ambulance Service


The head of Superior North EMS says the Thunder Bay District Ambulance Service in Ontario is facing increasing pressure as the service grapples with the effects of an aging population, the coronavirus epidemic opioids, the COVID-19 pandemic, an overcrowded emergency room and now a staffing crisis.

Before the COVID-19 pandemic, black codes — times when there’s no free ambulance to answer a call — happened once or twice a week, Wayne Gates told CBC in March.

At the end of winter, they were daily. And since ?

“Unfortunately things haven’t improved,” Gates said Tuesday, speaking to CBC News about the current situation. “They probably got a little worse.”

Ambulance services under pressure across Canada

Ambulance services across the country have faced similar challenges as they struggle to keep up with demand.

The Ottawa Paramedic Service said this summer, it could lose 60,000 hours to unload city delays hospitals this year. A woman in the interior of British Columbia was told in July that she would have to wait half an hour for an ambulance while trying to revive a friend who had suffered a cardiac arrest. BC Emergency Health Services has also launched an investigation in the reported death of an infant at the end of August while waiting for an ambulance.

A recent study by researchers at McMaster University in Hamilton found that the number of patients transported by ambulance to Ontario emergency rooms increased by 38.3% between 2010 and 2019.

This is four times the province’s population growth of 9.6% over the same period.

Some of that demand growth was expected, based on an aging population, Gates said.

“But what we really haven’t seen is the pandemic, COVID, and the aftermath of COVID that is continuing…but we also have the drug situation, the addiction situation that has hit us as well .”

Not only has the pandemic led to more calls related to mental health issues, it’s also contributed to a staffing crisis, Gates said.

It now sometimes finds itself without enough paramedics to staff all the ambulances that might be operating at any given time, he said.

“It’s partly because we still have staff who end up sick with COVID, but a big challenge for us is the number of graduates who have come out this year,” Gates said.

Confederation College’s primary care paramedic program graduated just 11 students this year, according to Rob Plummer, its program coordinator.

It’s between 16 and 25 in a typical year.

Plummer blamed the shift to online learning at the start of the COVID-19 pandemic for a higher than usual dropout rate.

“We can’t deny that these weren’t ideal circumstances for our paramedic students to learn,” he said in an email.

The head of the union local representing Thunder Bay paramedics said the profession had also lost some of its appeal.

“Who really wants to take on a job that demands more and more [paramedics] with very little help from the province? said Rob Moquin, president of the Thunder Bay City Paramedics Union.

Rob Moquin is a paramedic with Superior North EMS and President of Thunder Bay City Paramedics. He said paramedics can be tied down for hours waiting to transfer patients to Thunder Bay Hospital. (Matt Prokopchuk/CBC)

Although the career is no less rewarding than it was 20 years ago, Moquin said paramedics face more pressure than before.

“Twenty years ago, speaking quite frankly, paramedics were often able to sit and think about difficult calls they answered throughout the day; they were able, sad as that was… lunch,” he said.

“Now… paramedics show up for work, they do ambulance work for 12 hours, 13, sometimes 14 hours, then go home without… having that break to eat or sit down or process what they have seen.”

Paying for paramedics in the city of Thunder Bay ranks in the top third of paramedic services in the province, Moquin said, though that’s still lower than other first responders, namely police officers and firefighters.

Gates said he is working with unions and the city of Thunder Bay to create more incentives to attract workers to northern Ontario and get them to work there.

Confederation College is also taking new steps to help retain its paramedic students, Plummer said, including creating a new paramedic student resilience training course slated for release in January.

He will also hold regular team debriefings and student check-ins and issue a weekly mental health check-in form, to monitor student mental health on a weekly basis – so he can intervene early if students are showing signs of signs of increasing stress.

Need to take patients away from hospital

Meanwhile, Gates, the EMS chief, hopes to launch a public education campaign aimed at discouraging people from calling 911 unnecessarily – although Moquin has warned that people shouldn’t hesitate to call 911. number if needed.

Gates and Moquin said the city needs alternate destinations for patients so EMS can get them somewhere other than the hospital.

St. Joseph’s Care Group submitted a proposal to the province last year for a 40-bed crisis center for the city, which would include 20 crisis beds and 20 mental health beds.

“It wouldn’t solve the problem. But it would definitely help us,” Moquin said.

An improved detox center could also help, he said, as the service handles a high number of alcohol-related calls for patients who are currently being taken to hospital simply because they have no nowhere to go.

Once at the hospital, paramedics may be held back from transferring patients to facility care, despite the presence of an offload nurse to help expedite the process, Moquin said.

“We had a crew last night, actually, who had done about half their shift with an unloading delay of just a little over five, just after one o’clock until about 6 o’clock in the morning this morning,” Moquin said. .

“It’s not uncommon for us to sit with patients for two, three, four, sometimes five hours.”

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