'Extremely dangerous': N.B. paramedics warn about long waits and staffing shortages

An Extra-Mural Ambulance New Brunswick garage in an undated file photo.

New Brunswick’s health minister says Horizon and Vitalite Health networks, Medavie Health Services, and the Department of Health met Thursday to discuss the situation with ambulance offload delays.

Dorothy Shephard said she was hoping for an immediate, temporary solution to a problem that could get worse as the latest wave of COVID-19 impacts the health-care system.

“We’ve got to put a solution in place to help them, to help everyone get through this, and I think there are a few considerations on the table that EMANB (Extra-Mural Ambulance New Brunswick) can help us with. But right now we need all of them to come to the table and I need urgent action,” she said.

As of Tuesday, 633 health-care workers across the province were off work due to COVID-19. Shephard says a lack of staff and discharges are, in part, causing the delays.

It’s become common to see lineups of ambulances sitting outside hospitals --  particularly The Moncton Hospital -- with patients inside. Paramedics say they’re unable to offload the patients, either because there are no beds, or not enough health-care workers to staff those beds.

“It’s getting really bad and extremely dangerous. People just don’t know the true severity of the situation,” one paramedic told CTV Atlantic.

CTV News is not identifying the paramedics because they’re fearful of repercussions for speaking out.

They said one patient in particular waited 27 hours before being transferred to the hospital.

The offload delays, they say, are keeping those ambulances off the roads and out of communities -- forcing others to respond to calls, sometimes an hour or more away.

“Moncton had 10-plus ambulances on offload delay this morning (March 30), some of those trucks were from Miramichi that responded to Moncton for calls and then got stuck at the hospital for the duration of their shift,” the paramedic said.

“This morning at shift change those paramedics were still stuck on offload delay, past their off-duty times, and still hadn’t received relief yet. There was also a truck being sent from the Kingston Peninsula to the Moncton Hospital to relieve a Sussex crew that had been there all night.”

They say it’s frustrating, but they’re worried most about their patients, for whom they feel responsible.

“It’s not all just stubbed toes and belly pain, we have people that are complaining of chest discomfort, broken bones, chronic pain, overdoses and hypoglycemia calls and are still having to wait!” said another paramedic.

“The fear of Paramedics is that we are responding to calls nowhere near where we are, these calls are sometimes life-threatening and very critical, putting more stress on the paramedics, who are arriving from an hour away.”

They say burnout is becoming more and more difficult to handle -- but understand this isn’t only impacting their field of care.

“The ER is depleted, the nurses are also burnt out! This is with the help of paramedics watching their patients; imagine if paramedics would just drop patients off to them and go back out into the city for the next 911 call!” they said. “Paramedics feel vulnerable, they want to make sure each patient matters, we want to be advocates for our patients, but we are being worn thin.”

Offload data shows the situation is worsening

Both Horizon Health and Medavie Health Services -- which oversee Ambulance New Brunswick -- acknowledge the issue is becoming more of a challenge.

"We are working hard to free up as much bed capacity on our inpatient units as possible in order to alleviate strain in the ED. However, this situation remains challenging with high numbers of staff off work due to COVID-19, in addition to pre-existing staffing shortages. We would urge the public to reserve the Emergency Department for medical emergencies only, and to explore alternative options for non-urgent cases, such as walk-in clinics, Telecare 811, virtual appointments through eVisit NB or consulting with a pharmacist.” said Christa Wheeler-Thorne, executive director of The Moncton Hospital.

Medavie says Ambulance New Brunswick uses a "dynamic deployment system that moves ambulances strategically around the province" and will relocate a unit if there’s a need.

Once an ambulance is experiencing an offload delay, that unit is considered out of service until the transfer can be made.

“Once our paramedics arrive at a hospital with a patient, they have a duty of care to remain with the patient until the Emergency Department staff have completed the official transfer of care from Ambulance New Brunswick to that of the hospital,” a spokesperson said in a statement.

There were several complaints about ambulances having to be redeployed in other areas on Tuesday, with Medavie confirming a number of units were experiencing offload delays in the Moncton area.

A graph of monthly offload delays at Hospitals. (Courtesy: Medavie Health Services N.B.)

“This, combined with an exceptionally high volume of 911 calls in the area, resulted in ambulances as far away as Sussex and Miramichi responding to calls in the Moncton area. An ambulance from Jemseg was also temporarily assigned to a call in the Moncton area, but was reassigned as other units closer to the call became available,” a spokesperson said.

Medavie did provide data. Between March 15 and March 29 the average number of hours spent on offload delays, per day, at the Moncton Hospital was 34.45.

The worst day in that time period was 71.47 hours.

And while there were spikes of long offload times in January, the situation was worse in March.

Shephard told reporters on Thursday she was hoping to have more information on a temporary solution Friday.