Nova Scotia orders EHS review as paramedics' work concerns continue

The Nova Scotia government is preparing to do a system-design review of EHS as the union representing paramedics continues to sound the alarm about understaffed ambulances and service shortages around the province.

The union released data this week collected during July that shows increasing numbers of ambulances are either out of service or not fully staffed. The data, from three of the four health authority zones, suggests as many as 34 ambulances were completely out of service between July 4 and 23.

Terry Chapman, the business manager for theInternational Union of Operating Engineers Local 727, said they collected the data to draw attention to the problem of paramedics not getting enough rest between shifts to be able to answer backfill requests,or feeling burned out and not wantingextra shifts.

Chapman said the data is connected to other problems already highlighted by the union, including long waits ambulance crews face releasing patients athospital, which delaystheir return to the field. Simply adding more crews isn't the answer, he said.

"They'll just end up tied up like everything else is," he said. "This is a systemic breakdown of the system and every system needs to be evaluated."

Chapman said paramedics need to be involved in conversations about trying to find solutions.

"Then when we identify them, there has to be a mandate to fix them."

Health Minister Randy Delorey said he knows the system needs improving and he believes his government is taking steps in that direction.

Last week the government issued a tender for a system-design review of Emergency Health Services. The minister said after 25 years in its current form he thought it was time for a review to ensure the system continues to follow best practices.

"We want to know, with an outside set of eyes, to [be able to] say, 'These are the things that are working really well, these are opportunities to possibly change, tweak, make [things] better.'"

Delorey said the call for a review isn't directly connected to the concerns recently voiced by the union, but he does believe it will help address some of the pressures paramedics are facing.

He also thinks changes to other parts of the system, such as improved management of beds in hospitals, better access to primary care and paramedic visits to long-term care homes, should help ease system pressures.

The minister has met with the union and paramedics in the field to get a sense of their concerns and what can help. Delorey pointed to a program at the Dartmouth General Hospital where a paramedic works with a nurse to receive and monitor patients when they arrive at the emergency department so ambulances can return to the field sooner.

"Things like what they've done at Dartmouth General, I think, also provide a lot of optimism for where we can tweak services and actually get much better outcomes."

Chapman said the system review seems like a good thing to do, but likely won't get at all the concerns. That's why it's so important they be included in discussions about overall system improvements, he said.

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