In more than 1,100 instances since February of this year, people who called for an ambulance were told none was available and in more than half of those instances, those calls were in rural communities. A shortage of paramedics, crowded hospitals, and increasing call volumes are all combining to make things difficult all around. Crowded hospitals are part of the problem. While the average wait time is three hours, an eight-hour wait is not uncommon, and for rural paramedics that can turn into an exceedingly long day once the drive time to and from the hospital is factored in. When crews are waiting with patients on stretchers in back hallways, they are obviously unable to respond to other emergency calls. Paramedics cannot drop off a patient and leave until there is an available space in the hospital and they sometimes wait hours for that to happen, said Steve Skoworodko, president of the Paramedic Chiefs of Saskatchewan and owner of Wakaw and District EMS. “It’s not a great situation for the patients or the paramedics. They’re trying their best to get there, but that happens.” 

Call volumes are also increasing. The increase in call volume can likely be partially attributed to a growing and aging population. However, whether the increase is due to aging baby boomers, health consequences of COVID, complications due to delayed surgeries, chronic health conditions that did not receive timely treatment during the pandemic, addictions, or mental health issues, the result is the same. More professionals are needed for the short-staffed profession. While there is a severe shortage of paramedics across the country, in Saskatchewan, Skoworodko said, there are 150 vacant paramedic EMS positions alone, a number which does not include paramedic positions within fire services or private companies.

The healthcare system, as a whole, in Canada is struggling to keep afloat, but Saskatchewan seems to be hooked up to a life-support system that is outdated and in imminent danger of failing. Compounding the problems that are causing delays in ambulance service are the congestion and overcrowding at hospitals and overworked staff. “We acknowledge that current hospital capacity pressures create a difficult environment for patients who are seeking care in our emergency departments, and for staff and paramedics who have continued to provide excellent care,” said Andrew Will, CEO of the Saskatchewan Health Authority.

In response to the overcrowding and ‘hallway medicine’ that led to the fire code violations at St. Paul’s hospital in Saskatoon, the Saskatchewan Health Authority released an action plan eloquently named the Saskatoon Capacity Pressure Action Plan. Actions currently being implemented include: 

* Addition of thirty-two transitional beds by the end of November to facilitate discharge and care transitions for patients from acute care to appropriate care settings. 

* Deployment of primary health care staff to support the Emergency Department and inpatient units to identify patients that could be cared for at home or in community to avoid admission to hospital. 

* Additional staffing to support forty-three additional beds at Royal University Hospital, including twenty-one temporary inpatient beds; twenty-two temporary flex beds, and EMS transition beds.

These measures all require more staff. Temporary deployment of staff to acute care units; enhancing weekend staffing; adding temporary Emergency Department staffing… again, where are these staff coming from? Is it more scheduled overtime? Or more agency nurses? The Saskatchewan Union of Nurses states that nurses in Saskatchewan have clocked more than a million hours of overtime already this year. Those overtime hours, SUN president Tracy Zambory said, would pay for 720 full-time equivalent nurses. Zambory went on to say that the out-of-province agency nurses currently working at St. Paul’s hospital are being paid $120 an hour, a fact that not only overtaxes healthcare budgets but is demoralizing for staff nurses and those who sounded the alarm years ago about impending shortfalls in the profession. Staffing is the most persistent issue in the whole of the system and the deficits in one area aggravate the deficits in another. Without enough long-term care beds or community supports to facilitate a return to the community, individuals wait in hospital beds for transfer to an appropriate space. Without enough beds open in hospitals to admit patients from Emergency Rooms or from ambulance transfers, paramedics are stuck waiting at hospitals instead of responding to calls for service. Without enough primary care physicians, more people are presenting at Emergency Rooms and needing ambulance service because chronic and acute medical conditions are not being managed or prevented. 

Minister of Health, Everett Hindley, said of the paramedic shortage that the utmost priority is training people and keeping them here in Saskatchewan, and the same could be said about the rest of the staffing shortfalls in the province. In order to ‘keep them here,’ however, there needs to be an understanding and acknowledgment of why they are leaving. No number of bandages will make a wound heal if the infection itself is never treated.

Tami Fehr who worked as an RN in the Saskatoon region for 35 years was quoted by Global News reporter Brody Langager as saying that during her employment, head nurses and managers were not afraid to speak up for their wards, but that is not the case now. “The staff are afraid of reprimand and of losing their jobs. They are muzzled,” Fehr said. “I tried to give them an outlet, left contacts to the media, and guaranteed anonymity.” The letter she left for the nurses in the hospital containing media contacts, she said, had been taken down. 

Statements made by the SHA claim it has engaged with staff to hear their ideas and address their concerns, but the former nurse as well as the Saskatchewan Union of Nurses say there is a policy in place that prevents nurses from approaching media with their concerns. It causes one to wonder how wide-reaching the ‘policy’ is since the most vocal of Saskatchewan doctors throughout the pandemic, left the province once the worst of it was over. As for the media, all inquiries, no matter how big or small, must go through the SHA Media Relations.

Although Saskatchewan nurses are not personally speaking out, other nurses across the country are. Quebec nurse, John Dela Cruz took to the social media platform TikTok to show what he experienced working in healthcare. Speaking for nurses he says, “We love this job. We love helping people. We love helping our community, but the conditions we are put in, is unsafe for us nurses and other professionals, and [also] unsafe for our patients.”

By Carol Baldwin, Local Journalism Initiative Reporter

Original Published on Nov 23, 2023 at 20:28

This item reprinted with permission from   Wakaw Recorder   Wakaw, Saskatchewan
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