N.B. paramedics waiting for offload delays to improve, as health officials promise solutions

The offload delays plaguing New Brunswick paramedics and their patients do not appear to be getting any better, according to the Paramedic Association of N.B.

The delays mean ambulances are waiting longer outside hospitals, or in hallways, to drop off patients, they say, because there are not enough workers inside to staff a bed.

On Friday, Horizon Health CEO Dr. John Dornan admitted it’s an “embarrassing phenomenon,” but something each region is working on.

“So what we are looking at doing, for example, if people are very ill, they get put on a hospital bed immediately," said Dornan. "If people are not that unwell, what we call the four’s and five’s, they could be moved to a waiting room area and don’t necessarily need to occupy an ambulance, stretcher and personnel.”

“For those people who are in between that …we assess them when they come in so that we know they haven’t gotten worse on the ambulance ride, that they meet the same criteria that we use in our emergency departments and we are putting into place measures to get those people on to a bed sooner than later."

That system has already started. He says a solution for Saint John may be different for another city hospital, so each region has a local group working on the problem and trying to find a fix that meets their needs.

Executive director of the Paramedic Association of N.B., Chris Hood, says patients considered ‘four’s and five’s,’ are already being triaged by paramedics in the field using the new ‘treat and release’ model – where paramedics use their clinical judgment to determine whether transport to the hospital is necessary or if there are better health care options available.

“We’re hearing specifically from our practitioners in the Saint John area that the offload delays in Saint John are not different than they have been,” Hood said.

“They’re telling us that it’s essentially the same as it’s been prior to the implementation of any changes. And frankly, across the rest of the province, we’re not necessarily seeing, on the ground, any significant improvement even as a result of the implementation of the treat and release process.”

Hood says paramedics are expressing concern over their responsibility to the patient – and if the patient is getting the best care possible under these circumstances.

“The system is exhausted, the system is fragile, it’s on the verge of I would say a complete collapse,” he said. “And COVID and offload delays and all of those other issues is simply the symptoms of the bigger disease.”

Health Minister Dorothy Shephard said last week the issue doesn’t have to do with Ambulance New Brunswick, rather a shortage of healthcare workers that was an issue before the pandemic. As of December, there were about 1,300 nurse vacancies across the system.

But her department has made a number of announcements in recent weeks, trying to recruit and train more nurses. On Monday, she announced 80 internationally trained nurses have joined the system since 2020, and they’re aiming to recruit 150 more before the end of the year.

Ambulance N.B. did not respond to a request for comment.