Union says overworked paramedics becoming public safety issue in N.S.
HALIFAX -- Nova Scotia paramedics are being so overworked it's become a public safety issue for the province, their union told a legislature committee Thursday.
Mike Nickerson, business agent for union local 727, told the health committee that paramedics are logging one to six overtime hours a shift, which he said "is just not safe."
"Paramedics are tired, they're hungry and they are feeling the pressure of a busier system," said Nickerson. "Something needs to be done and it needs to be done now."
While the situation is complex, Nickerson said the biggest problem is the offload delays at many overcrowded hospital emergency departments, due to a lack of acute care beds.
"If we can fix the offload delays somewhat, then a lot of these other issues that our members are facing will fix themselves," he said.
The union also told the committee that bottlenecks created by the offload problem and the use of ambulances for non-emergency calls have cut into response times.
Union CEO Terry Chapman said the standard response set in 1997 was eight minutes and 59 seconds, and now many call responses are much longer. Those standard times can vary from 15 minutes outside the city to 30 minutes in rural areas.
"One case that I actually witnessed in this city (Halifax) was 58 minutes," said Chapman, who called that unacceptable.
NDP committee member Tammy Martin got a dramatic response when she asked Chapman what happens on busy days when the nearest ambulances are long distances away.
"You wait," said Chapman.
"So my loved one has just had a cardiac arrest," stated Martin.
"You wait with a person who will probably be non-living when they (paramedics) arrive," Chapman said.
Chapman said 30 more ambulances would help, but 210 more paramedics would be needed to staff them.
He said something has to change.
"Historically there has always been random occurrences where there has been offload delays and crews were delayed at hospitals. But never to this degree and never where 60 or 70 per cent of our staff are tied up at any one time," he said.
Jeff Fraser, director of provincial operations for Emergency Health Services (EHS), said he believes patient handoff times are gradually beginning to improve.
"I expect within the next three months we will begin to really feel some marked improvements," said Fraser.
However, Fraser said none of the province's largest emergency departments are currently meeting the standard patient handover time of 20 minutes.
Tim Guest, vice-president of health services with the Nova Scotia Health Authority, said under a pilot project at the Dartmouth General Hospital, a two-nurse handover team looks after patients until they are seen by doctors, freeing up paramedics.
Guest said that project has been expanded to the hospital in Kentville, N.S.
However, he said it requires space to house patients, which not every hospital ER has.
"So we are looking at different strategies in different units in order to enable us to do that," Guest said.
Guest said a Health Department directive means handover policies have to be in place by mid-April, with some additional time to implement them.
Meanwhile, a U.S.-based consulting firm is expected to present its review of the current EHS model to the Health Department this spring.
The province hired Fitch and Associates to look at ways to provide an "efficient, effective and sustainable" emergency medical system for the next 10 to 15 years.
Fraser said there would be "no way" the offload issue wouldn't be raised as a challenge by the review.
"The good news is, by the time that report comes we should be well into some of these changes that are really beginning to happen," he said.