Ambulance shift demands causing worker burnout

By Sharon McLeay Times Contributor

Wheatland regional partners are taking steps to get Alberta Health Services (AHS) to eliminate paramedic job burnout due to “core/flex” work schedules at Wheatland and Adjacent Districts Emergency Medical Services Association (WADEMSA, also known as Wheatland and District EMS).
They want to discuss the issue with AHS, contact the local MLA on the issue and write a letter to the new provincial health minister. They say there is a need for AHS to fund the changes that eliminate the core/flex shift schedules and replace it with shifts that have more humane hours.
“These staff members are very busy and the staff on these shifts rarely get a proper night’s rest, and often have to book off duty for fatigue and safety measures,” said Darcy Burke, a member of WADEMSA. “When management is advised that a staff member needs to book off, they have to take the unit off the road to give those members an eight-hour rest period. This reduces the resource capability to respond to emergencies.”
Rob Witty, WADEMSA’s operations director, has repeatedly brought the issue to the AHS coordination meetings, but no changes have occurred. Letters were written to the previous Alberta labour minister and health minister, but there was no action taken on the issue. In spite of the pleas for change, the previous Alberta labour minister allowed variances to labour regulations, so some services could keep using the core/flex method.
“This doesn’t even meet current labour standards,” said Burke.
The core/flex schedule requires basic life support medics to work a 24-hour shift for four days straight, followed by four days off. Each shift day has core hours, shift floating core hours and shift standby hours. Staff is paid for 12 hours, and get overtime only on calls responded to after the 12-hour allotment. Critics state the practicality of the core/flex shift is flawed, because it doesn’t take into consideration how many hours the employee has remained awake.
Witty said 10 years ago, when there were less calls, it generally worked. But today, with the current call volume, this method does not allow staff proper rest or family time. The shift endangers patients and worker safety, he said. WADEMSA responded to 3,877 calls last year.
“I am seeing, for the first time in 30 years, burnout and health problems in young medics,” said Witty.
Witty said core/flex is not only affecting staff, but fatigue management for ambulances is required in order to book them off to get proper rest, which means an ambulance is out of circulation during recuperation time. It means there are fewer ambulances to respond to Wheatland and Calgary area emergencies.
The Alberta Paramedic Association commissioned a study in 2018 by Jennifer Short, PhD: The Impacts of Extended On-Call Hours on the Functioning of Paramedics. The study concluded that interrupted or insufficient sleep causes sleep inertia that impaired performance and reduced the medic’s concentration on the tasks at hand. The study stated sleep deprivation and sleep fragmentation cause cognitive shifts and impacts paramedics’ delivery of service, client care and public safety. A BioMed Central article, posted online on Aug. 20, 2018, outlined a German study on EMS workers’ burnout that applied to working regular shifts. It found a 40 per cent burnout rate for paramedics working a 48-hour shift. The University of Regina’s Canadian Institute for Public Safety Research and Treatment did a study on Canadian emergency and RCMP member’s suicide risk and found paramedics had a 9.8 per cent increased suicide rate over the general population. This does not account for all the other job hazards paramedics experience on a daily basis, such as a vehicle accident while responding, infection risks from patients, lifting and fall injuries, and dealing with workplace violence. Those are factors that can’t be controlled, but changing core/flex to a regular 12-hour rotation is one avenue AHS could use to reduce burnout for local medics, said WADEMSA.
In regular 48-hour shifts and core/flex shifts, medics are paid for a 12-hour period. There are only three locations in AHS Calgary region, and the other two locations have fewer call outs.
Burke said he wonders if WADEMSA is being treated differently because it contracts AHS ambulance delivery.
“The biggest part for me as a municipal leader is I always try to work on the pretense of fairness for everybody. When we compare WADEMSA to AHS… fairness is not there. If this shifting is all right, why is it not in place for AHS employees? Why is core/flex not being used there? Obviously, they have seen that it was not productive to have staff work on core/flex shifting and they have moved away from it,” said Burke.
Burke and Witty said the fallout of core/flex is making employees think about leaving WADEMSA.
“Now we are getting in a pickle. Our staff has had it. They are tired and they are being overworked and over tasked. This needs to be fixed and it needs to be fixed now,” said Burke. “We have a very low turnover of staff. We have lots of long term employees. They are some of the finest employees you could have. They are community people and we see them out and about in our community. They are excellent people and we don’t want to lose any one of them because of this.”
Wheatland County gave their support for letters and discussions with government officials and AHS. There is a request for an AHS representative to attend the July 15 regional municipal meeting.