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Government reorganizing B.C. Ambulance Service The B.C. government is reorganizing the B.C. Ambulance Service, Health Minister Kevin Falcon announced Thursday, saying the move will help address some of the issues that led to last year's paramedics' strike. By Vancouver Sun The B.C. government is reorganizing the B.C. Ambulance Service, Health Minister Kevin Falcon announced Thursday, saying the move will help address some of the issues that led to last year's paramedics' strike. But the paramedics say it could be used to attack their union. The government is removing oversight of the ambulance service from the independent Emergency Health Services Commission and handing it to the Provincial Health Services Authority, which looks after province-wide programs such as B.C. Children's Hospital and cardiac care throughout B.C. "What we are doing is more closely integrating [the ambulance service] with the health system," Falcon said. He said the transfer will mean more flexibility, which could be used to help rural paramedics who don't have enough work to make a living wage, and part-time workers who want more shifts. For example, he said, paramedics could be put to work in emergency rooms or health centres. The health ministry is also consolidating administrative services in other areas to eliminate duplication and cut costs. Moving the ambulance service into the PHSA could translate into an ability to find even more savings. Last year's strike by paramedics, which followed bitter contract negotiations, ended with the government legislating paramedics back to work. A spokesman for Canadian Union of Public Employees Local 873, which represents the province's 3,500 paramedics and dispatchers, criticized Thursday's announcement. "This is nothing short of retribution by a vindictive health minister," B.J. Chute said. Chute said he thinks the move could lead to privatization of some services now provided by the ambulance service and too dismantling of the service's bargaining unit.

Fair enough. I’m not for a couple of reasons. Firstly, such a switch is a serious blow to those of us who have worked very hard actively pursuing the career path currently necessary to obtain such a position. It’s a matter of saying “if you want this job you must do this,” then pulling the carpet out from under us as we near our goal and saying “just kidding. Now you have to do this”. It’s a cruel, unjust thing to do to dedicated hard-working people because another interest group, though potentially qualified to do the job, carries a bigger political stick. Most of the nurses I know are caring compassionate people who only want the best for patients. How the BCNU, which is currently black-balled by other Canadian unions due to recent actions, sprang forth from such an otherwise wonderful group is beyond me. I absolutely do not hate nurses. I hate the blatant attacks and take-over bids put forth by the BCNU. Being a “team player” is damn near impossible when your own team-mates are gunning for you. Secondly, and I think most importantly, a paramedics role in BC has always been defined as the provision of care on a scene coupled with the provision of care in transport. When selecting a profession to draw on to provide specialized care in transport it only makes sense to draw on a profession whose programs have been structured around the provision of transport from day one. You and me both. If BCAS deployed an appropriate number of ACPs and CCT endorsed staff many of these issues would disappear. Underfunding and poor communication between BCAS and the health authorities are the primary cause. I do have hopes that falling under the PHSA will help to knock down some of those barriers. My pessimism is a direct result of how paramedics in BC have been treated under the BC Liberal reign. I’m guessing you would prefer to continue seeing those experienced, relaxed, professional crews (in a timelier manner of course). Just one of many symptoms indicating current flight crews, though effective, are not available when needed. The limitations are in staffing and resource allocation not the quality of personnel. If you have been able to produce quality personnel capable of providing the required service it makes far more sense to me to step up production over moving to an entirely different product. It actually comes down to economics when you think about it. No worries. I’m not the type to flame someone for spurring good discussion. I know you speak with the best interests of patients at heart. That’s the thing. BC has a number of communities with low enough call volumes to make excellent use of Community Paramedic initiatives. I wouldn’t expect community paramedics to have a SOP rivalling that of a NP. I’m thinking more in terms of providing in home IV therapy or conducting fall hazard assessments on an elderly person’s home. It’s becoming less and less of a gap all the time. Most new grad ACP’s will have completed a minimum 3 years of university education. Some because of other past university programs, many because of the educational path they have chosen. I don’t think an additional 2 years of education to produce a Paramedic Practitioner is unreasonable. In fact I think it would be prudent to put paramedics with 5 or more years of education on the street serving the public. Fair enough. I’ll be the first to admit there is often more going on than meets the eye. Kind of like being told your hand-off report was painful by a triage nurse when you haven’t slept a wink in the last 30 hours and she stole your crew report leaving you nothing to reference as you muddle through. I’m sorry. I don’t necessarily get to go home after 12 hours like some people. But that’s another story . Dave you work in the Yukon correct? The majority of nurses working in a southern ED actually have next to nothing for standing orders. It’s bewildering actually. You have a 4 year RN with full ER certifications and she can do very little without physician’s orders. It’s not right and it’s certainly an area that needs to be addressed. Even working as a PCP I’ve stayed with an admitted patient on multiple occasions because by license I’m able to give another dose of nebulized ventolin etc. and the RN has to wait for orders (frequently there is no onsite physician). It’s absurd. A BSN RN is more than capable of making those type of decisions. Regards

Hello, Personally, I am indifferent as to who dose intra-facility critical care transport in BC. What I want is actual ground critical care transport resources available in a timely fashion. In reality, what happens now is the sending facility sends staff with the BLS crew. In fact, this week we have had three admission to the ICU all brought in via BCAS with accompaning hospital staff. This is wasteful. You tie up a ambulance crew AND hospital staff. As for flight. I find the BCAS flight temas older, relaxed and expereinced. Response times tend to be slow (from my point of view) due to limited numbers of crews and planes. The same for ITT. But, I would like to add that nurses are capable of filling this role. There are excellent systems that use nurses. But, in BC, the logical solution is to build on the system that is already functioning. Not intend for a 'flame war'. Just waving the flag that is all. =) The NP vs Community Paramedic. There is room for both. But, I think on the Paramdic side of the house doing two jobs (EMS & Primary Health Care) wouldn't work well unless the station is very slow. The example I like to cite is Long and Brie Island in Nova Scotia. Even there, their scope is limited when compared to NP. So, to sum up, Community Paramedics can work in a few selected areas. Also, considering the educational background for a NP is a Master Degree it would be hard to match this with suplamental training in addition to one PCP or ACP training. As for Paramedics doing Traige. Yes. Can they do it better and faster than a nurse? I say that that is an individual issues that transcends one profession. I have done triage. Sometimes, you need to wear two hats; being the charge nurse and triage. Trying to sort out bed issues. Trying to move a patient to ICU. Dealing lots of other crap....to put it bluntly. If all I had to do was triage was I would be moving a light speed! As for 'Dr orders'...... I think that beyond the typical standing orders (...CP, SOB, ect...) that one will find in any good ED (..that in many ways mirror EMS protocols..) Paramedics won't find a greater degree of freedom becasue at the end of the day the DR is the 'most responsible' provider. Cheers

Air and Ground CCT, ITT primarily. Though the number of such positions is relatively small there are two very important things to remember about them. Firstly they are highly desirable positions often seen by the public as prestigious. The BCNU would use the status of these positions as a public bargaining chip (believe me after some of their recent shenanigans nothing is below the BCNU). If you want to see tears of gratitude just watch the ITT come in to transport a sick infant to BC Children’s. Secondly, and frankly more importantly to me, the demand for CCT crews is set to rise dramatically in BC. Healthcare funding cuts have resulted in service centralization the likes of which no one has ever seen before. The more services are centralized the greater the demand for specialty transport teams. The push for Nurse Practitioners has also resulted in the squashing of Paramedic Practitioner movements by the BCNU. The two things can realistically be developed together and without one being at all detrimental to the other. NP’s working primarily in hospital and clinics. PP’s working primarily out of hospital and in public outreach. Kind of like a general surgeon vs. a cardiologist; different, but still related, specialties with similar levels of education. For whatever reason the BCNU has chosen to take paramedics on as a foes instead of as friends. It’s really quite unfortunate as the two professions could truly do wonders working together. I wholeheartedly agree Dave. In my experience Paramedics tend to triage patients more quickly than most RN’s. One of the determining factors seems to be that Paramedics are used to having to make their own decisions without direct physician orders. Also for whatever reason “drug-seeker” sensitivity tends to be a little higher with paramedics. Again, agreed. I’ve actually been very fortunate in having hospital staff accept my assistance wherever possible and they have become excellent learning opportunities. My current station is one of the few that is actually attached to the local hospital. As a result I end up spending much of my time between calls in the emergency and medical imaging departments. Being a true local who was actually born in the hospital my station is attached to, has afforded me opportunities not allotted the majority of paramedics. That’s exactly it. Specialist nurses like the ones who make up these groups are the ones that would have to be used to provide CCT and ITT transports. They don’t have enough of these nurses as it is. On what planet does it make sense to stretch a resource already near the breaking point even thinner?

To some thats what it means to me it means Cant Understand Paramedic Ever

Sad thing about this is the fact that alot of medics in remote area's were I live have full time jobs already and may have to choose. Well I would have to choose the one that pays the bills and my community will be at risk. The lucky thing about my day job is that I can leave to do a call and make up the hours, and I do about 106 to 140 hrs per pay period. I also know if they decided to have the health authorities take over the ambulance there will be alot of paramedics handing in their notice, Northern Health for one has a crappy track record for their employees. Good luck BCAS in finding dedicatated paramedics in the future. Oh ya and we are now not a CUPE union, we are free agents for now lol.

This is my take on it. This is not my run so I really don't care but...............EMT-b training does not teach these guys how sensitive a job they hold. Just the possession of Vicodin and Pot are out side the fence. It is still the south, so.....I will raise an eyebrow to the cousin issue. It have heard of several Sex Offenses in that area. Someone might ask what is going on. This type of issue is very complex and other EMS Providers passing judgment does not help. Remember this...... put a firefighter in a room with 2 steel balls, he will brake one and loose the other. I know I have done it myself. Guy should have asked for help before his addictions got out of hand. BUMMER FOR EVERYONE.