Thérèse Perdiac, 91, died in Montreal on July 9 after waiting for the ambulance for 7 hours. A few weeks earlier, Myron Cybriwski, 65, had waited for her for 11 hours. She arrived too late for him too.
Posted at 5:00 a.m.
When you’re waiting for an ambulance, every second lasts forever.
But lately, seconds have tended to turn into minutes and then hours. Emergency room overcrowding and labor shortages have a direct impact on the quality of work of paramedics.
The response time has increased in major centers as well as in the regions, where service interruptions are more and more frequent. People are worried, with good reason.
This situation is not unique to Quebec. All Canadian provinces face the same problem. From British Columbia to Nova Scotia, ambulance response times are on the rise.
Since the start of the COVID-19 pandemic, the already fragile Canadian healthcare system has been cracking up everywhere. And ambulance technicians are on the front line of this crisis accentuated by the aging of the population and the multiplication of mental health cases, two clienteles that tend to over-request ambulance transport.
That said, there are solutions to optimize interventions.
An often-cited example is the Renfrew County ambulance service, west of Ottawa, whose reputation extends beyond our borders. In addition to the usual tasks, their technicians make home visits, can do basic follow-ups such as pressure taking and remote monitoring, thanks to state-of-the-art equipment. In remote areas, they can also deliver medical equipment by drone, thus saving valuable time.
This approach, which grants more autonomy to those who are also called “paramedics”, seems to be gaining ground in our country. In his Government policy on the pre-hospital emergency system which he unveiled in mid-June, the Minister of Health and Social Services, Christian Dubé, has proposed several measures which, according to him, will transform the interventions of paramedics in depth.
Between now and the tabling of the action plan, scheduled for 2023, we have launched several pilot projects that rely on the ability of paramedics to assess a case and refer it to the right service, what we call in the government jargon “regulatory paramedicine”.
It’s a great thing.
The ambulance is not a taxi nor a pass to enter the emergency room more quickly.
For example, since July 25, Urgences-santé technicians can leave a patient deemed stable alone in the emergency room, whereas before, they had to wait for their care. A clinical coordination unit also helps them, by hiring nurses, to better direct calls. We will see in a few months whether this new approach produces results.
The Ministry of Health and Social Services is also closely monitoring a community preambulatory medicine pilot project in Montérégie-Centre. This project, launched in January 2020, allows ambulance technicians to work as a team with nurses who accompany them on the phone to assess the condition of patients aged 65 and over who have dialed 911. If it is deemed that the transfer to the emergency room n is not necessary, the patient will be visited in the following hours or redirected to the right department. It is estimated so far that out of 2,900 calls, 1,500 ambulance transports have been avoided. Ultimately, this approach could be exported to other regions of Quebec, and used with other clienteles.
These necessary changes in approach should help reduce the response time of paramedics. But they won’t fix everything. They do not respond, at least in the short term, to the glaring problem of staff shortages.
On Monday, on its Twitter account, Urgences-santé presented its 17 new recruits. It would have taken a hundred to cover the territory of Montreal and Laval.
Staff retention is also difficult. Training, good as it is, does not prepare recruits for the harsh reality that awaits them. Much has been said about the pressure tactics of paramedics who would like to be able to take their 30-minute break to eat their lunch. But we don’t talk enough about the accident scenes, suicides and human distress that make up their daily lives…
It is not said enough how physically and psychologically demanding the work of our paramedics, who run on adrenaline, is.
And the measures put in place so far do not seem sufficient to help them decant the strong emotions that can turn into post-traumatic shock if they are not adequately treated. Hence the high number of departures.
The ambulance technicians, who have just reached a tentative agreement with their employers, will start bargaining again soon, with their collective agreement already expiring in 2023. It is high time to recognize their needs and the importance of their work. in the large chain of the health system.
Everyone’s safety depends on it.