LAKELAND – Dropped shifts, downgrades and red alerts have become the norm for ambulance services across the province, and ambulance services in the Lakeland are no exception.
“Currently, in the province of Alberta we have thousands of unfilled shifts every month,” said Health Sciences Association of Alberta (HSAA) President Mike Parker.
HSAA is the union that represents paramedics, emergency communications officers, and thousands of other healthcare professionals in Alberta.
“We don't have paramedics, we don't have emergency communications officers to be available to serve the public. That affects Edmonton and Calgary, that affects suburban areas, and that affects distant and remote rural areas,” he continued.
Starting from Sept. 9, 2021, HSAA started tracking the number of service disruptions for ambulances in all regions of the province.
And while the data collected is comprehensive, it only highlights a portion of the ongoing disruptions to Emergency Medical Services (EMS) taking place across Alberta in both rural and urban settings.
"(People) need to know that our healthcare system is under immense pressure. Our paramedics are not able to respond to your 911 calls like they want to, like they have been trained to do, because there's just not enough of them anymore,” he said.
Ambulance disruptions in the Lakeland
Dropped shifts are the most common disruptions to Lakeland ambulance services. Between Sept. 9, 2021, and March 1, 2022, there were 92 EMS shifts dropped across Bonnyville, Cold Lake, Elk Point, Lac La Biche and St. Paul.
During that six-month period, Bonnyville had seven red alerts while Cold Lake had six. Lac La Biche EMS only had one reported. Elk Point and St. Paul had no red alerts reported during the period.
A red alert refers to when there are no ambulances available in the area to respond to an event.
When it came to disruptions caused by downgrades to ambulance services, St. Paul EMS was the greatest effected.
St. Paul ambulances were downgraded from “advanced life support” to “basic life support” for 27 shifts over the last six months, reports HSAA.
This summary, however, does not include the large number of instances ambulances responded to calls in different areas, such as when Elk Point paramedics responded to events in St. Paul or elsewhere.
When this occurs, wait times increase and EMS resources are pulled away from areas where they are based and may be needed.
The data also only contains instances that were reported by HSAA EMS members. This means that some shift statuses may have changed after a report had been logged, resulting in some red alerts, downgrades and dropped shifts likely going unreported, according to HSAA.
“Paramedics and emergency communications officers deal with non-stop calls during any given shift and are pressured into accepting excessive overtime,” described Parker.
“They don’t get breaks and are often denied vacations. The result is unacceptably high rates of burn out, physical and psychological injury, and people leaving the profession.”
Reaching a crisis point
Parker says the current staff shortages puts all Albertans at risk because there are not enough staffed ambulances to respond to all the calls received.
He notes that there are also times when communications officers are forced to enact an “urgent disconnect,” hanging up on a caller, to answer the next because call volumes are so high and there simply isn’t enough staff to answer incoming calls.
This is an issue that has been worsening for the last 20 years, according to Parker.
“We have less people working in the healthcare system today than we did back in the 90s,” he remarked.
Parker says there are two main factors that have led to today’s current EMS crisis.
The first relates to the industries struggle to recruit and retain paramedics and emergency responders.
“For every one (paramedic) that comes out of school, we lose one on the street and we have never been able to grow or to have members replacing those who are retiring or quitting.”
The second relates to a long-term trend of increasing call volumes and a more recent COVID-related spike.
“Annually, we’ve seen for the last 10 years, call volume increase by about six per cent. As reported by the employer, or AHS (Alberta Health Services). And in the last 12 months, we've seen an additional 30 per cent increase in call volume,” he said. “In the last year, that spike has not diminished.”
With 10 years of a sustained increase in workload with no increased numbers of staff – emergency medical services in the province are beginning to buckle under the strain.
“This is where we have come to. Our members can’t sustain this level of intensity, they can’t have a work-life balance with a workload that is this high, and they are not being retained – they don't stay.”
Self-fulfilling prophecy
While academic programs for emergency responders generally see full enrollment, Parker acknowledges that the industry lacks the capacity to provide enough practicum training for students.
“The problem is our members on the street are running back to calls for 12-14 hours a day. It is an exhaustive job that is a high stress job, and when you bring on a mentee or a student it requires additional resources,” he explained.
“You need to spend time with that student to ensure that they can be in a learning environment. When you are just running back-to-back trips all day long there is no opportunity to train these folks.”
This has become a self-fulfilling prophecy he says, “We are not taking on students, which means that we don't have students graduating to take over in a resource-strained industry.”
The situation is complex, there are countless variables and there are no easy fixes, he says.
But for now, ensuring staff can take meal breaks and leave work after a 12-hour shift is the first step in improving working conditions for EMS staff.
Strained relations
An ongoing lack of intervention to improve the working conditions for medical first responders by government and employers has created a strained relationship between leadership and EMS workers.
Parker said, “this is fully political.”
“The Government of Alberta knows darn well what is going on here and chooses not to move forward in a fashion to address this,” he stated. “AHS treats our EMS members as expendable rather than the highly valuable professionals they are.”
Parker says that while recent funding for EMS has been increased slightly, it is still not enough to address the critical strain being experienced in the industry.
“If you do look back in the last six years, there was a one time that there was an uptick in funding until recently. There was an uptick in funding that was cut, which was brought in by the former (NDP) government, and then it was cut out by the current government (UCP), only to be re-announced again, by the current government as a new idea, but just a lot less,” he said.
Provincial EMS funding
The Government of Alberta’s 2022 Budget included an increase in spending of $64 million in additional funding for EMS with the intent of responding to the high demands on staff.
The 2022 budget earmarked $28 million for ground and helicopter air ambulance services, and $22 million to be put towards “increasing capacity, extend ground ambulance contracts, and support integrated operations centres and inter-facility transport projects,” according to the Alberta government.
The total operating budget for EMS for the upcoming year is $587 million, a 12.2 per cent increase from the 2021 budget.
On March 10, the province also announced that Edmonton and Calgary will both receive five 24-7 ambulances in each of the next two fiscal years. Both Lethbridge and Red Deer will see ambulance hours increase by 12 hours per day in each of the next two fiscal years, according to the Alberta government.
“The steps announced to address the crisis in EMS by Jason Kenney show he doesn’t understand what needs to be done to ensure people who need care, get it,” said Parker, following the provincial announcement.
“New ambulances with no one to crew them just sit empty.”
The response the current government is taking can one be described as only one thing he says – “negligent.”
“We have got challenges and AHS doesn't want to look at it. We continue to raise this alarm with them and hopefully people hear us – that the citizens of this province, the rural communities in Alberta hear us,” he emphasized.
“We are in trouble, and we need their help, we need people to contact MLAs and say, ‘Support our paramedics, support our healthcare system’.”
Parker says that while it is a bleak conversation, the truth is the industry is at a crisis point.
“There are no spare paramedics out there. You can add the money, you can have good intentions, but we are in a crisis that needs a more rapid solution.”
Steps requiring immediate action
HSAA would like to see the province and AHS address three current needs in the industry immediately.
1. A plan to retain paramedics and emergency communications officers that are currently employed.
2. A plan to train and recruit more paramedics and emergency communications officers.
3. A move to reinstate harm reduction programs to ease the burden on EMS.
“We've been in an opioid crisis for years. Hundreds and hundreds of people have passed away, which means thousands and thousands of people have been treated by paramedics,” stated Parker.
“This government has chosen to close down these harm-reduction facilities leaving folks who have addictions and they're winding up in critical conditions and paramedics are their only way into the (healthcare) system.”
The need for harm reduction sites is not just limited to inner cities, he says.
“To think that the opioid crisis is only an issue in municipalities such as Calgary would be a mistake for anyone. This is not just an inner-city issue, this is a community issue,” Parker emphasized.
“So, this cycle just keeps going.”
