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Sea to Sky paramedics say current staffing levels ‘dangerous’

With few solutions in sight, morale is ‘in the toilet’
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A Whistler ambulance prepares to head out after responding to an emergency call in Whistler’s Function Junction in early July.

Paramedics in the Sea to Sky are raising the alarm about changes to deployment models, and what they see as a “dangerous” staffing shortage in the corridor.

According to one paramedic, there are no ambulances staffed in Pemberton for Saturday or Sunday for the remainder of July.

“The staffing levels for the corridor have dropped to dangerous levels. Squamish is short 34 ambulances for July, Whistler is short 14, Pemberton is short 73 ambulances and has 140 unstaffed shifts. This would not be a problem if the B.C. Government would finally admit that no one wants to work for $2/hr (what rural paramedics are paid when not on a call),” they said.

“The public needs to know that Pemberton is without ambulances overnight for 17 days in the month of July. For many of those days, crews will be extending themselves to work the 16 hours maximally allowed under labour law to provide as much coverage as possible for the public. We do this because we are the Band-Aids holding together a very broken system.”

Pique heard from six paramedics after an article on deployment models was published in the June 24 issue, speaking directly with three of them.

Pique has agreed to keep the paramedics anonymous as they can be reprimanded by their employer, BC Emergency Health Services (BCEHS), for speaking out publicly, and potentially lose their jobs.

A job that's impossible 

Morale among paramedics is “as low as I’ve ever seen it,” one paramedic said.

“It’s not even just frustration anymore, although obviously we’re frustrated. It’s despair,” they said.

“There is this feeling of, it’s never going to get better, and when you put that on top of the psychological stress that is continuing to happen—our job is difficult at the best of times—we are feeling unsupported in a job that’s impossible.”

Another paramedic described morale as “completely in the toilet.”

Frontline staff has “lost all faith in management,” they said. “The staffing levels are so low that the crews that are remaining have to work extra hard to cover for the gaps in the schedule, and it’s impossible to find coverage when you want a day off.”

On top of feeling unsupported, paramedics have been dealing with the dual crises of COVID-19 and the opioid epidemic, another paramedic said.

“During the worst weeks of COVID there, right after the mountain shut down, Whistler was the hotspot of Western Canada … We were transporting multiple sick people a day out of the Sea to Sky,” they said. “It leads to, quite often, burnout and stress, and work leaves, because you’re in a metal box for two-and-a-half hours going down the highway with a critically-ill patient.”

At least three to four times a week, a Whistler ambulance will have to respond with lights and sirens to a call in Squamish, a response time of almost 45 minutes, the paramedic said.

“This is not a new problem but has gotten much, much worse over the past few months. This problem directly impacts residents of the Sea to Sky, and it has gotten to a point where I am unable to tolerate it any longer,” they said.

“There [are] typically six cars located throughout the corridor and lately staffing issues and deployment models have caused there to be no emergency medical services in our communities for hours at a time.”

Compounding the issue is a deployment model known as cross coverage, where if an ambulance in one community has to attend a call, one from a neighbouring town will take its place.

The method can lead to a “cascading effect,” said MLA Jordan Sturdy, who worked as a community callout paramedic in Pemberton from 1990 to 2015.

If Bowen Island with its one ambulance has a call, for example, paramedics from Lions Bay or Squamish have to cross-cover. If resources are thin, that means an ambulance in Whistler will have to cover Squamish, while Pemberton has to cover Whistler.

“Only in the most bizarre organization would a call on Bowen Island activate a paramedic in Pemberton,” Sturdy said.

“That doesn’t make a lot of sense, does it? But that is exactly what happens.”

Resource decisions

Since he started as a paramedic more than 30 years ago, “there has been no increase in ambulances or staffing in the Sea to Sky. So I think that probably is the bottom line in many respects,” Sturdy said, pointing out that in 1990, Pemberton had a population of about 350.

“Obviously the region has grown, the visits have increased, and the ambulance service has not adapted.”

Staffing and resource decisions are often based on call volume statistics and average response times—but one paramedic Pique spoke with said BCEHS “grossly underrepresents” the volume of work done by Pemberton paramedics.

While BCEHS said Pemberton had 711 calls in 2019 and 636 in 2020, the paramedic’s stats showed 1,700 and 1,470, respectively.

Sturdy said the discrepancy might be in how BCEHS tallies its calls, noting that a Pemberton ambulance “crossing over” to Whistler is not considered a call, because paramedics don’t have a patient contact.

“If Pemberton is going to cross-over Whistler two or three times a day, that does make up the 1,700 calls, but by [BCEHS’] definition it’s not a call, so all those cross covers don’t count,” he said.

“And I don’t even know if transfers counted.”

Transfers—a Whistler paramedic transporting a patient to Vancouver—are a problem in their own right, as Sea to Sky paramedics end up stuck in the city responding to emergency calls, often until their shift ends.

Sturdy said he has been advocating for a dedicated transfer car out of the Sea to Sky for the last five years.

Even an agreement to send ambulances back to their home communities immediately post-transfer “would go a long way to making sure that we have better response times,” he said.

Yet another paramedic noted that a full roster for all the stations in the corridor is 120 shifts per month (two day crews and two night crews, times 30 days).

“Squamish, Whistler and Pemberton have all had months recently where they have been unable to staff more than 20 of those shifts [per station],” they said. 

“This is a significant reduction in coverage for an emergency service, which should be operating with lots of redundancy in the bag.”

Government seeks solutions

Interview requests to BCEHS were deferred to the provincial Ministry of Health, which sent an emailed statement, blaming “a decade of underinvestment” by the previous government for the longstanding challenges.

The government has increased total investment in ambulances to almost $560 million this year, compared to $424 million in 2017, a ministry of health spokesperson said in the statement.

“This has meant more paramedics, more dispatchers, and more ambulances,” they said.

“Between 2017 and 2019, B.C. added 115 paramedic positions to support direct patient care, improve service and response times, and modernize dispatch operations. More recently, since January 2021, 271 paramedics have been hired by BCEHS, and 322 more job postings were issued July 2, 2021.”

But there is more work to do, the spokesperson said.

“The government’s focus now is solutions. We are working together with BCEHS and the union to find solutions, and we will have more to say soon,” they said.

But paramedics say stats from BCEHS and the government can be misleading.

One method of increasing the number of full-time positions is to convert standby cars into full-time cars, one paramedic said.

“This will be a big positive for the people who snag a full-time spot, but those who don’t get a spot will no longer be able to make a living, and the net increase in coverage is zero,” they said.

“Put another way, the total amount of boots on the street is remaining the same; but fewer people will be filling those boots, and the organization is trying to present it as all of those people being new hires, which they are certainly not.”

The most obvious way to make things better, they added, would be for every station to have fully paid shifts for every car.

“The long and short of it is that the service has been subsisting on borderline volunteer employees for basically decades, and it’s finally caught up with them,” they said.

“The only solution is to pay people.”

Sturdy believes there needs to be an accurate assessment of call volumes in the Sea to Sky, and “the ambulance services should reflect the growth in population and visits, and I don’t think that has been considered,” he said.

“And I think that we need scheduling and personnel solutions that are region-specific. The circumstances in the Sea to Sky are quite different than in the Fraser Valley or on Vancouver Island or in the Okanagan, and we just we need some creativity, and I think chiefly we need an advocate for the region to try and create those solutions.”