As of November 1, The Tumbler Ridge Ambulance Station—station 868—will be converting from an Kilo station to a Scheduled on Call (SOC) station.
This means that as of next month, there will be four permanent, scheduled paramedic positions in town (including our current community paramedic), with two new SOC positions.
Previously, the station operated as a Kilo station, which means paramedics would carry a pager, and get paid $2/hour for their time, until a call came in. Once a call came in, they would get paid at regular wages for a minimum of four hours.
This made it hard to find people who were willing to work as paramedics in town, as most paramedics needed to work a second job, flexible enough to allow them to run off at a moment’s notice.
But that is changing.
In a Scheduled on-call system, paramedics are scheduled for a certain number of hours per day—say, eight or ten—and for three days. During that time, they are at the station or with the ambulance, always ready to go during the time they are scheduled. During the off hours, they carry the pager and are ready to respond to calls during that time.
Over the last five years, Tumbler Ridge has seen between 207 call outs a year and 543 call outs a year, for an average of 406 calls a year, or a little more than one a day, on average.
Province-wide, BC Emergency Health Services (BCEHS) has been working to create a more stable ambulance system.
In Chetwynd, for instance, they will be converting from an on-call station to a 24/7 Alpha station on October 24.
In order to support that move, BCEHS will be hiring eight full-time staff to work out of Chetwynd.
There is some worry in town that will draw some people away from Tumbler Ridge to Chetwynd.
“This is the start of something not good for Tumbler Ridge,” says Councillor Howe. “Chetwynd is going to full-time, but at the end of the day, paramedics from Tumbler Ridge are going to be more willing to go to Chetwynd and work a full shift. We had no input, and no idea this was coming. We claim that health is the number one priority for this council, and these [attendants] do a tonne for us in Tumbler Ridge. We cannot lose people like this. I talked to a long term resident, who is likely going to leave Tumbler Ridge where he has a job with BC Ambulance and go to Chetwynd, because it’s a better opportunity. Why can’t he have the same opportunity in Tumbler Ridge?”
Councillor Krakowka points out that it’s not just Chetwynd, but a number of other locations that are going to full-time which will also offer better options for paramedics than Tumbler Ridge does. “You’re going to lose more and more man-power from the smaller stations,” he predicts.
The question becomes even more interesting when you look at the number of calls for Ambulance service in Chetwynd. Over the last five years, the Ambulance service in Chetwynd has received between 226 and 259 calls per year, for an average of 247 calls per year.
The transition to this new staffing model is being implemented in phases during 2021, which began on Vancouver Island. According to BCEHS the Scheduled On-Call model will be creating 220 regular positions in the province’s rural and remote communities.
Other communities are worried because their stations are being downgraded to a SOC facility.
In Revelstoke and Burns Lake, for instance, the Ambulance station was staffed around the clock, with a response time of 90 seconds. Now paramedics there are worried that the response time will climb to 20 minutes during the time the station is not staffed.
Revelstoke receives about 700 calls on average, while Burns Lake sees 589 calls per year.
According to a BCEHS document on the new system, “all of the staffing changes throughout the province are based on in-depth analysis of 911 and hospital transfer call volumes as well as current BCEHS resources in ambulance stations that serve these communities. To ensure resources are best allocated to serve patients, and to ensure that paramedic workloads support employee well-being, we will monitor and adjust the changes as needed.”
Historically, BCEHS has relied on ‘on-call’ staffing to maintain ambulance service in Tumbler Ridge. The on-call model relies on the availability of paramedics to work around other commitments, without a guarantee of regular pay. Without a regular, predictable income it is difficult to retain and attract paramedics in smaller communities, and in Tumbler Ridge, we’re down to three attendants.
Scheduled On-Call is a model developed to provide regular, sustainable paramedic work where 911 call volumes are low. According to BCEHS, “Paramedics will be provided eight hours per day of pay and assigned work which may include community paramedicine work, 911 emergency response or other duties. On their workdays, the paramedics will respond to patients with medical emergencies during scheduled work hours and will also be scheduled to be ‘on call’ for emergency response in their community for the remainder of their shift.”
This is another place where Krakowka has issues with the set up. He says that a community paramedic will set up appointments for the next day. “What happens if they get a call out at four in the morning?” he says. “They aren’t able to do any more work for at least eight hours, so they’ll have to cancel their morning appointments.”
And even if they don’t have any appointments says Krakowka, there will be no ambulance coverage for eight hours, meaning more gaps in the system.
The changes are part of major reorganization across the system, which will see 85 new paramedics hired in large call volume centres like Vancouver and Prince George, 177 new positions, starting October 29, for 24 new 24/7 Alpha stations in places like Fort Nelson and Chetwynd, and close to 90 new SOC stations from Atlin to Zeballos, and, of course, Tumbler Ridge, which will see 220 new SOC positions.
In total, more than 500 new positions are being created by these changes, including attendants and 911 operators.
Trent is the publisher of Tumbler RidgeLines.