Paramedics and 911 dispatchers are used to working in emergencies, but years of ongoing ambulance shortages have been made worse by the pandemic, and now the pressures have reached a “boiling point”, according to their union in the City of Ottawa.
“Over the last number of weeks we’ve been receiving many emails … from our rank and file of pure desperation for action to be taken,” said Carrie Lynn Poole-Cotnam, treasurer of the Canadian Union of Public Employees (CUPE) Local 503.
That union took the rare step of sending a survey last week to 333 of its 600 paramedic members for whom it has personal email addresses. Just over 204 responded.
Ninety-eight per cent said the paramedic service did not have enough staff. Two-thirds reported that workplace stress was so high their co-workers were in distress.
Meanwhile, 90 percent said they were not getting enough daily support from senior management to do their duties.
“Our members do not feel like they are heard,” said Poole-Cotnam, adding the survey’s findings provide a “relationship-building moment” for the relatively new paramedic chief and management.
750 instances of ‘level zero’ in 2021
For many years, Ottawa has struggled with having no ambulances free to send to a call, mainly because paramedics are tied up at hospital emergency rooms waiting to transfer patients to hospital staff.
It’s not the exception, but the norm. A letter Mayor Jim Watson sent to the provincial health minister in mid-January, seeking a permanent fix, said 750 “level zero” incidents took place in 2021.
Poole-Cotnam says “level zero” is not an accurate term, because “the number is actually usually a negative” given the queue of calls waiting for an ambulance.
Morale has plummeted as those ambulance shortages drag on and worsen, the union reports. The level zero figures have a human impact, she explained.
Paramedics waiting many hours to transfer a patient at a hospital are always thinking of the emergency calls they’re unable to take.
“While they’re sitting there, they’re listening to the radio, and the radio is indicating serious calls … that require response,” said Poole-Cotnam.
After particularly difficult 911 calls, many do not pause to use the service’s peer support program, CBC has been told, because they do not want to put extra psychological burden on fellow paramedics. They also know if they’m not back on the road, that’s more pressure on colleagues.
Dispatchers, meanwhile, speak with distressed families on the phone trying to sort out which paramedics they can send. The city has begun to have a retention problem with its dispatch staff, the union said.
Paramedics work overtime hours regularly at the end of their shifts, Poole-Cotnam added, and are often not being given the meal breaks they’re due.
They have only 15 minutes in which to write notes after a call and clean their ambulances, before telling dispatch they are free again, she said.
Others felt frustrated over the holidays by the negative comments following an annual paramedic holiday party when dozens contracted COVID-19. The Omicron situation was only just developing then, and gathering limits allowed the event at the time, Poole-Cotnam noted.
“I think workers who are working this pandemic on the front line put a lot of pressure on themselves,” said Poole-Cotnam. “Any messages that they receive from management where it’s being implied that they’re not doing enough is a very difficult message to hear when you feel like you’re giving it your all.”
Extra hiring not the solution
The chair of the city committee that oversees the paramedic service had not yet seen the survey or its results, but was not surprised if morale is low. Coun. Matt Luloff said Ottawa in general probably does not praise paramedics enough for the critical job they do.
As a veteran of the Canadian Armed Forces who has had post-traumatic stress disorder, he says he understands the strain and the city needs to support its employees.
Yet, Luloff says the city should not hire more than its typical 14 paramedics per year to fill a gap in a provincial health care system he says is chronically underfunded.
“We have the right amount of paramedics, but we do not have the right amount of nurses that are offloading these patients so that our paramedic service can be effective,” said Luloff.
Instead, he wants the province to address ambulance shortages – he and the mayor have yet to hear about a letter they sent to the health minister more than a week ago – and he wants it to become an election issue this spring.
Neither paramedic chief Pierre Poirier nor emergency services general manager Kim Ayotte was available for an interview.
In a statement, Poirier spoke of high call volumes and efforts to maintain established response times. Ayotte, however, addressed morale and fatigue among paramedics.
“We will continue to listen and adjust our operations where possible to foster the best workplace environment we possibly can,” wrote Ayotte.