Dartmouth woman's painful struggle highlights N.S. paramedic shortage

As she suffered through over a day's worth of intense abdominal pains, vomiting and diarrhea last week, Liz LeClair said she thought she would die in her bed at home.

"I've had a chronic bone infection, I've had appendicitis where my appendix ruptured, I've had all kinds of things happen," the Dartmouth resident told Information Morning this week. "I have never been so scared in my entire life."

LeClair said increasingly worsening stomach pains led her to call 811 for virtual care to avoid "clogging up the system." She was told that there was a nine-hour wait to speak to a nurse and that her next move should be to call 911.

An hour after calling emergency services with no ambulance in sight, she called back and was told that there was no estimated arrival time for the ambulance.

"They could continue to have me in the pipeline, but they couldn't guarantee anyone was going to show up any time soon," she said.

36 hours

LeClair's mother, a retired nurse, was with her. They worried about the long wait they would face once they actually arrived at the emergency room.

So LeClair stayed home. She dealt with about 36 hours of pain before her symptoms began to subside.

LeClair's mother monitored her, giving her fluids to keep her hydrated.

"We opted to do that because it was the less stressful of the two situations and thankfully everything resolved itself," LeClair said.

"I'm just really fortunate that I have a parent who is here with me who knew the signs and symptoms of what was going on and could help me manage it."

She hasn't been able to determine what was wrong with her during that time, though her mother believes she had a partially obstructed bowel, LeClair added.

Increased demand

LeClair's case highlights the struggles of the province's Emergency Health Services. 

Jeff Fraser, the executive director of the EHS, told Information Morning on Thursday offered "condolences" for the situation LeClair was in and stressed the problems weren't just limited to Nova Scotia — emergency services across North America are under the same pressure.

Fraser added that demand for ambulance services has been up 10 per cent over the past year.

"We've got a lot of challenges in our emergency departments that are partners in getting our ambulances back on the road," Fraser said. "We're working really hard to try to change the way that we deliver the service so we can be there in Nova Scotia."

Some of those challenges include long offload waiting times, which force paramedics to stay with patients at hospitals until they can be taken in by hospital staff, sometimes for several hours. Paramedics also have to contend with ER closures, often having to drive around to find an open emergency room to drop patients off.

Kevin MacMullin, the business manager of International Union of Operating Engineers Local 727, echoed the sentiment, and added an increasing number of paramedics leaving Nova Scotia has also played a part in the strain on the health-care system.

The union represents ground and LifeFlight paramedics and LifeFlight nurses and air transport in Nova Scotia.

In an interview, MacMullin said it's been a difficult time on the ground for paramedics in the province. The summer months bring more tourism and as the province grows in population, the system is under higher pressure.

Ongoing staff shortages are also a problem, MacMullin added. 

"[The hospitals are] facing staff shortages with their physicians, their nurses, everybody," he said. "We're also facing staff shortages as paramedics. In any given 12-hour shift, we may have up to 25 per cent of our units not able to be staffed because we just don't have the staff."

The province has lost more than 70 paramedics in the last few months, and the ones that have remained are often overworked, he added.

"This has been building over several years. Our paramedics in the province, Nova Scotia, are undervalued by their employer," he said.

MacMullin said the union has asked to discuss the issues with the provincial government and employers of paramedics, but Premier Tim Houston has not responded.

A spokesperson for the Nova Scotia government said in an email they are aware of the union's request to meet with the province "however we do not have an update on the status of the request at this time."

Easing pressure

Fraser spoke to some of the solutions the government has started to put in place, including improving the transfer service capacity, which takes the load off paramedics to transfer non-urgent patients between health-care facilities.

He said more than 80 per cent of patient transfers between facilities were done by emergency ambulances a year ago. That number was at 26 per cent four weeks ago.

In an emailed statement, EHS spokesperson Remo Zaccagna wrote that 22 transport operators have been hired since the expansion of the patient transfer services earlier this summer.

"Many of them recently completed orientation and will be supporting patient transfers starting Monday, August 22. There are an additional 13 transport operators who will begin orientation on Monday," Zaccagna wrote.

"Our selection processes continue to evaluate the over 600 applications we've received since the expansion announcement in an effort to hire 100 transport operators as we open positions for them."