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Rural ambulance crisis old news to YTG

When Carol Tyrrell started talking about problems within Yukon’s rural ambulance service five years ago, she was threatened.
dawson-ambulance

When Carol Tyrrell started talking about problems within Yukon’s rural ambulance service five years ago, she was threatened.

The volunteer ambulance supervisor was employed by the Yukon government as a home-care nurse.

“When I started making waves I was called by the (deputy minister of Health),” said Tyrrell.

“They basically told me to shut up or I could lose my job.”

During her five years as Dawson’s ambulance supervisor, Tyrrell’s crew faced many of the same frustrations as today’s rural ambulance attendants.

So in 2003, Tyrrell, her husband John and supervisors from other communities formed a negotiating committee.

They wanted to see a wage scale that reflected individual training, compensation for training, plug-in pay for having cars on standby all winter and uniforms that were practical.

Carol’s group also asked for improved training that met the national standards and, most importantly, volunteer recognition.

In January 2004, Health’s deputy minister said he was prepared to look at wages and plug-in pay, work out a clothing budget, do media recognition and long-service awards, a PR campaign and improve training.

But it didn’t happen, said Carol.

“We negotiated a whole bunch of stuff in good faith, and it didn’t come about,” added John.

“Really it just fell back to dictatorial changes and stonewalling.

“The minister announced he was graciously giving us two of the five things we negotiated with the deputy minister.”

There was a wage increase and new training was implemented through Yukon College.

Volunteers still weren’t recognized for their services, said Carol.

Four years later, after rural ambulance attendants walked off the job in both Watson Lake and Dawson, Carol is starting to see a pattern.

Again, rural supervisors have formed a negotiating committee to work with the Health department.

Neale Wortley, who is employed by the Yukon government in Haines Junction, heads the committee.

He could not be reached for comment.

“If you’re employed by YTG, you can’t criticize YTG,” said Carol.

“The government has been saying they’re going to do something about the problem, but nobody is telling anybody anything — they’re not telling the nursing station or the ambulance people anything.”

“The amazing thing is, while the government is not co-operating to solve the problem, it’s spending a bundle by sending fulltime attendants up here on per diems, staying up here, travel expenses and the whole bit,” said John.

“They’ll be pulling in a fortune because they’re also on call, for which they get paid and we don’t.

“At some point they’re going to realize they’ve spent far more than it would have cost to actually hire one fulltime paid person in this community.”

Volunteer supervisors in Dawson and Watson Lake end up doing a “hell of a lot of work,” said Carol.

“If you’re in Pelly Crossing and get seven calls a year, OK fine, you can handle that,” she said.

“But when you start looking at 300 calls a year, it’s a whole different ballgame.”

Demand has grown and grown, particularly in Watson Lake and Dawson, said Carol.

“And the reality is, it’s gone beyond a volunteer service.”

Watson had even fewer volunteers than Dawson, but gets more calls, she said.

“And they’re in terrible shape because they have to leave their job, if they can get a job, once or twice a day, everyday.”

The number of volunteers continues to drop because of frustration and lack of support, she said.

During her years of service, Carol remembers one day in particular.

“We had seven Code Threes,” she said.

“It was like something out of a textbook.”

Every attendant was called in.

There was an attempted suicide, a vehicle roll-over that involved four victims, one of whom was diabetic, some firefighters were hit by falling trees and an allergic person was stung by bees.

Planes couldn’t land in Dawson because of the smoke from the fires and Carol’s crew was tapped.

“We called it Mayhem Monday,” she said.

“We handled it, and we handled it because we had well-trained ambulance attendants.”

The Dawson crew didn’t even get a thank you.

Three weeks later, there was another day when the whole crew was called in. “And we like doing it, otherwise we wouldn’t be doing it,” said Carol.

“But the fact of the matter is that if you get knocked down often enough, you’re not going to get up.”

Currently the government has one causal ambulance attendant stationed in Dawson.

“God help us if we have another Mayhem Monday while we only have one ambulance attendant,” said Carol.

Having only one attendant makes it difficult on the local nursing staff, added John.

“Because they’re pulling them out to do ambulance calls.”

Nurses shouldn’t be going on ambulance calls, added Carol.

Ambulance attendants are trained in pre-hospital care, and while nurses are excellent at what they do, they are not trained to go on 911 calls.

“Ask a nurse out at the side of a highway in the pouring rain with someone lying in the gravel, ‘OK, how do you get them safely into the ambulance?’ and they don’t have any training in that, that’s what the ambulance people do,” she said.

But over the years, that ambulance attendant training has deteriorated, said John.

Ten years ago, attendants in the territory received training from the Justice Institute of BC.

It was accredited professional training, he said.

“But we are so far from that now — it has totally fallen apart.”

Whitehorse crews are currently getting their primary care paramedic training, said Health spokesperson Pat Living.

But it is not offered to attendants in the communities, she said.

“Previous governments and health ministers felt communities should have better training than Whitehorse,” said John.

“We don’t have the resources, we do longer calls, and we do them without backup. Whitehorse has several teams, plus fire and police — it’s called layered response — we don’t have that here.”

Now there’s a hodgepodge of training for the people in Whitehorse and nothing for the communities except for a basic course offered at Yukon College, said John.

The college course was created after Carol and the committee of rural supervisors asked for better training in 2003.

“The supervisors really went after them about recognized training, but the application of it was total and absolute chaos,” she said.

The college course was more basic than the training most attendants already had, and it didn’t meet the national standard, said John.

But it was mandatory.

“So, someone who’d been working here and had been on 72 calls in the past year was suddenly told they needed to take the 80-hour course,” said Carol.

“While somebody else who had been an ambulance attendant five years previously and had taken the Yukon College course then and had been on only two calls in the previous year was told all they needed to do was take a test.”

It was a government cash cow, said John, noting that volunteers weren’t reimbursed for time spent taking the course.

“It made no sense whatsoever,” said Carol.

The old Dawson crew has moved on, she added.

One past attendant is now training to be a doctor, three are training to be nurses and two others have advanced their education and gone on to work as ambulance attendants in other jurisdictions.

“So we must have been doing something right up here,” she said.

“We have to get back to where we were 10 years ago,” said John.

The government plans to “modernize its entire emergency services system to provide the best possible co-ordinated response for ambulance, fire and other emergencies in the territory,” according to a recent press release.

But this is not the best approach, said John.

“The government, in its arrogance, now intends to pull in the poor fire people and everybody else,” he said.

“And they talk about a comprehensive program for the Yukon for all the volunteers, but this is going to be a nightmare.

“Now you’re pulling the territorial ambulance in with the municipal fire department and the EMO and they can’t organize themselves anyway — so is this going to be better?

“They’re just ignoring the big problem that they’ve got.”

Premier Dennis Fentie and Health Minister Brad Cathers refused comment.