Changes are coming to Squamish's British Columbia Ambulance Service station starting on Nov. 30.
Currently, during the day, Squamish has one ambulance staffed with full-time paramedics, plus one ambulance staffed by standby paramedics. At night, currently, Squamish has one ambulance with paramedics on standby and a second ‘kilo” unit.
Standby paramedics are paid minimum wage to be at the station and ready to go at a moment’s notice.
Kilo staffing is when paramedics are available and are paid $2 an hour to carry a pager in their home or community, ready to respond to the station in case they are needed for a callout or an emergency.
It is converting at the end of the month to “Alpha” shifts, which is full-time 24-hour coverage with paramedics being paid full wages, according to a spokesperson for BC Emergency Health Services (BCEHS).
The BC Ambulance Service works under the authority of BC Emergency Health Services.
That nighttime standby paramedic is being converted to full-time and the day-time standby paramedic is being shifted to on-call.
Put another way, there will now be a day full-time crew and a night full-time crew and a daytime on-call kilo crew and nighttime on-call kilo crew.
The standby model is being eliminated in the province,
For Squamish, the change means the hiring of four permanent full-time positions, BCEHS says.
These changes are part of a suite of changes occurring across the province .
“The changes to regular, full-time paramedics is also expected to improve paramedic recruitment and retention in individual communities — as employees have regular shift work with full paramedic pay."
Ambulance stations in Pemberton, Whistler and Lions Bay are also increasing their staffing.
The Pemberton Ambulance Station converted earlier this month and has already seen improved staffing levels, according to BC Emergency Health Services.
Three additional ambulances have been added to the Sea to Sky Corridor to respond to patients needing to be transferred to higher levels of care, usually in Vancouver, from Squamish Hospital or care facilities. These transfer ambulances are based in Squamish, Whistler and Pemberton, the spokesperson said.
"This eases the demand on local community ambulances being called out of their communities on long transfers."
In 2020, there were 1,588 medical responses in Squamish. So far, in 2021, there have been 1,574, according to data from BCEHS.
Response times
Two Sea to Sky paramedics, who The Chief has agreed not to name because they could lose their jobs for speaking out, say that the changes are a “downgrade” in terms of ambulance response times, not an improvement for Squamish.
“For certain employees, it is an improvement,” said one paramedic, adding the public likely doesn’t care about the pay scale of paramedics. What they care about are response times: how long it takes to get the ambulance to them.
The on-the-ground reality is that it may take longer during the day after these changes, both paramedics say.
“And that is where we are seeing a decline,” a paramedic said. “Currently, the model is a full-time crew during the day and one ambulance is a stand-by. So they are staffed by the on-call crew and they are paid minimum wage to be at the station.”
Right now, the second ambulance is available with the same response time as the first, the paramedics said.
Their response times are the same because they are both in the station, ready to go, their “shoot times” are 60 to 90 seconds from when the paramedics receive the page to driving away from the station, both paramedics said.
If there is a big accident, both units, or ambulances, can respond at the same time, they said.
What is more common is that if one ambulance is at the hospital “clearing a call,” which usually takes about 60 to 90 minutes, the standby ambulance is available.
“That leaves a lot of time in the community where that other second ambulance — that is your ambulance…. Now that ambulance is available with the same response times as the first.
“Starting in a few days, that second ambulance is only going to be on-call. That means not on-call at the station, but a casual crew, [with a] pager, they take it home and can be anywhere in the community.”
After the paramedic receives the page, they have two minutes to respond by calling into dispatch.
“And then there is no actual requirement for how long it takes to get to the station and be driving out the door. Whereas [on standby] the 60 to 90 seconds, that is what your contractual obligation is or you get in trouble. On-call, [kilo] they set a goal of 10 minutes shoot time, but realistically, it is hard to receive a page, call into dispatch, get changed into your uniform, drive into the station, grab your stuff, load it into the ambulance and drive away. Ten minutes is kind of rare,” the paramedic said.
It could take approximately 20 minutes to even get out the bay doors during the day, the paramedics both say.
With the nighttime paramedic shifting to full-time pay, that is a positive in that everyone should get fair wages, said one of the paramedics, but the changes don’t improve or hurt the quality of service at night and they decrease the level of service during the day.
“As a person who wants my neighbours, my family and my friends to have ambulance service and everybody in the community … to have an ambulance there sometime near to the time that they call it — when you are waiting for 20 minutes for an ambulance, it is a long time,” the paramedic said. “That 20 minutes on scene waiting for an ambulance feels like an eternity...We needed better service. We don’t need worse service.”
“They had the opportunity, when they switched over, to turn our fox — day-night standby car — into an Alpha car, but they cheaped out and only wanted to switch one of the units, so instead… They had an opportunity to at least keep the service levels the same, but they went the opposite way.”BCEHS responds
Asked to address these concerns, the BCEHS spokesperson said that it is aware not all paramedics are on board with the changes, but they are meant to improve patient care.
The spokesperson stressed the conversion of all “fox shifts” — those are the shifts referred to as “standby” where paramedics are on standby at a station, making minimum wage unless they receive a call-out — are being eliminated across the province on Nov. 30. Squamish is one of many stations making this shift conversion.
Further, this conversion away from standby shifts is mandated as part of the collective agreement, or contract, with the paramedics union.
Asked about the possibility of response times being impacted, the spokesperson said response times are often based on available resources.
“The Sea to Sky Corridor has increased both paramedic staffing and the number of ambulances. The increased number of ambulances includes Squamish where there is an additional ‘transfer’ ambulance to take patients to higher levels of care outside the community. This allows local ambulances to stay in their community to respond to medical emergency calls.”
Union supports changes
Troy Clifford, president of Ambulance Paramedics and Dispatchers of B.C. (CUPE 873), told The Squamish Chief that while there is still work to do, these changes are ones the union has been calling for.
"The conversion to an Alpha car — 24-7 — is an improvement on service in Squamish, Whistler, Pemberton and Lions Bay," he said.
"That hired two locals and two provincials. Same in Whistler. Pemberton went from a one-person station to a full-time 24-hour ambulance and the same with Lions Bay. They went from a day ambulance to a full-time 24-hour ambulance. So those are all significant improvements in full-time, immediate coverage in Howe Sound."
He said the response times stay the same with these changes.
Putting full-time ambulances into each of the communities should alleviate some of the cross-coverage and delays that are needed that have been seen in the corridor because of not enough staff, he added.
He noted Squamish is a growing community that may warrant another 24-hour ambulance and he said the on-call kilo system where paramedics make $2 an hour until their pager goes off is not sustainable.
"The concerns that the members are raising and others are very real, and they are things we are working with BCEHS to do. But overall, the changes in the Sea to Sky Corridor have been improvements. The government put a significant investment into them,” he said.
How are paramedics doing overall?
"I am proud of our paramedics and dispatchers. They have been through so much and they just keep working hard and trying to do their best," Clifford said.
Almost two years into a pandemic, as an opioid crisis rages in its sixth year, and with the impact of wildfires and weather events like the heat dome making people sick, paramedics are weary, he said.
"It has been tough. We are still seeing a lot of injuries and people booking off because of psychological injury," he said, noting that it isn't just paramedics who are worn out. Everyone is.
"Society is tired," he said. "It is a lot, what we have all been through."
He said the heat dome was one of the worst experiences most paramedics have lived through in their careers.
With the opioid crisis, he said, it has sadly become a reality of paramedics' shifts in every community.
"It is what we deal with every day now; it is not getting better," he said, adding that mental health calls are also "really challenging."
"It has taken its toll on paramedics and dispatchers," he said, adding while there are robust programs available to his members, more mental health support for them is needed.
"We need to really enhance them because we can't keep this pace," he said.
"But I think we see through some of these changes that there is hope," he said.
