Paramedics want changes in day-to-day operations to shorten ambulance wait times

Ambulances in New Brunswick are over–utilized and under–resourced, according to Chris Hood, the executive director of the Paramedic Association of New Brunswick. 

"It's a simple mathematical equation with too many calls and too few resources to do those calls." 

Hood said his association is calling for changes on how paramedics do their jobs and the constraints they face on a daily basis. To them, policies and procedures within the system operated by Medavie isn't working. 

"So our beef is not with government. Our beef is not with the company, Ambulance New Brunswick. It's with the service delivery agent." 

Hood describes the ambulance system in the province as a long string that tightens as more ambulances are moved around to cover other areas. If ambulances in city centres move or get stuck at the hospital, the ambulance from the next closest community is moved in, and the string gets tighter. 

"The distance between the ambulances on the string keeps getting further and further apart," Hood said. 

As a result, the greatest impact is felt in the rural parts of the province. 

But he doesn't agree with Blackville Mayor Chris Hennessy's call for another ambulance to be stationed in his community. 

Hennessy told CBC last week there never seems to be an ambulance in the community when there is an emergency and the wait times are too long. He said he also had issues with how things were being managed and was growing frustrated after trying to get it resolved for five years. 

Time for changes

Hood said the paramedic association wants the way ambulances are moved around to cover off others to be changed. To him, that system is not working effectively.

But he said the real change has to be made with how paramedics are doing their job. At this point, paramedics treat a patient and transport them to hospital, unless the patient refuses to go. 

"Otherwise, the only other way that a patient doesn't get transported to a hospital is if they're deceased. The paramedics have no latitude, according to policy, to do anything other than take a patient to a hospital." 

Hood describes the emergency room at the hospital like a vortex of waiting for everyone. People are waiting to be seen by medical staff but there are no beds. There are no beds because those patients in them need to be transported to other hospitals, taken back to nursing homes or even taken home. But there are no ambulances to do it because they are waiting for the patient they've transported to be transferred to the care of the hospital. 

"You can't get patients in because you can't get patients out, or you can't get patients out because there are no ambulances to take people anywhere. So it becomes a real frustration for our paramedics and becomes a real frustration for the health care system." 

Hood said hospital's have no staff to look after the patient. "So rightfully, they can't take ownership or care of that patient because they don't have the physical capability to do it." 

Long waits 

Some paramedics have had to wait at hospitals up to 10 hours. Hood said that means that ambulance and paramedic crew isn't available, which then tightens the string again. 

"That's extreme, but, you know, those are the kinds of things that are happening."

Hood said he asked paramedics if they had ever seena manager from Medavie come to the hospital to see if they could help reduce a wait and the answer was no. 

"We need to get out [from] behind these desks and get out to the hospitals and, you know, use what expertise they have in negotiations and try and come up with solutions in real time at the bedside where this problem actually exists." 

Hood said his association made a recommendation two years ago to allow paramedics to make the decision on whether a patient needs to go to the hospital. 

"We should have the ability to be able to treat those people on scene, refer them to another health care professional, or release them to their home and follow up with them by phone or some other method using technology to be able to ascertain as to whether they're still doing well."  

Hood said this is done all over the world and isn't something new.