Private ambulance services often favour profit over patients, says EMS employee

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As someone actively involved in the emergency services industry, I find myself continually frustrated with many private ambulance services’ lack of focus on patient care in order to satisfy their desire for profit.

Editor;

I have personally witnessed events, which have greatly hindered many patients’ care and have possibly caused others to lose their lives.

Firstly, many of the private ambulance services in this (Conception Bay North) area are run out of a funeral home. Conflict of interest?

It would seem that way the company would stand to make a profit whether a patient lives or dies. I’ve spoken with families who have been mortified to witness a hearse appear at the scene of a loved one’s emergency, before the patient has even passed away!

Oftentimes, emergency personnel who are dispatched to the scene of an emergency battle exhaustion as they have been on the clock for 24 hours straight or longer. According to labour board, employees are entitled to an eight-hour break every 24 hours.

Those employed in the emergency field are somehow exempt. Wouldn’t it make sense to ensure those engaged in such high-stress situations are well rested, in order to properly perform their job?

I’ve witnessed ambulances dispatched to calls without oxygen tanks, stair chairs and reliable diagnostic equipment. Some private services cannot justify spending the money in order to maintain sterile equipment.

A colleague of mine recounted a story in which the employer mandated the oxygen masks be washed and reused after they had come in contact with bodily fluids. Some services do not have stretchers for overweight patients but instead rely on stretchers not designed to hold them. This increases the risk of injury to both the EMS worker and patient.

Some EMS workers will find themselves forced to dispatch calls, a practice which likely falls outside of their realm of experience. In one such instance, while trying to send an emergency crew to the scene of a seriously injured patient, the untrained dispatcher accidentally gave them the wrong address. This delay resulted in the patient succumbing to his injuries.

On top of this, dispatchers are only required to complete the most basic of duties. For example, when an emergency call is made dispatchers rarely collect more than the location and the reason for the call.

This is a wasted opportunity to improve patient care as dispatchers can help console the person while guiding them through basic First Aid and CPR practices.

If back up is needed while you are on scene, a paramedic may be unable to get it. Private services are not paid to send additional ambulances to help even though several neighbouring services may be available.

In order to cut costs, large areas are regularly serviced by one ambulance. If two emergencies were to happen at once there would be inadequate ambulances available to respond to them.

Services compete for calls, as they are paid on a per call basis. This means if a call is made to the service farthest away from where the emergency is taking place, then that service will respond to the emergency instead of appropriately redirecting the call to the closest service.

The move towards a government-run EMS field would greatly improve patient care and response time in the province and set Newfoundland on par with the other provinces.

Crystal Sparkes,

Bay Roberts

Crystal Sparkes is a native of Toronto, Ontario, but is currently residing in Bay Roberts. She is a paramedic working in Conception Bay North and plans to move back to Ontario in 2013.

Organizations: EMS

Geographic location: Bay Roberts, Ontario, Newfoundland Toronto

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Recent comments

  • DaveW
    January 15, 2013 - 09:32

    Hold on a second now. If your ambulance is not properly stocked, it is your responsibility to ensure you have the supplies in your ambulance based on your protocols and if you do not then you are responsible based on your liscence to remove the unit from service or get the stock. These are checks before you start your shift. If my defib is not working then that unit sits. O2, well you will have 4 tanks aboard. You cannot tell me you have no O2 on your ambulance. If so then what the hell are you doing when not on calls? I know I for one bypass the office and usually go straight to the garage. When the unit is not fit, I say I need an ambulance this one is not fit. It is up to the manager to get me a working unit and if not I will sit. Finally the government decides how many ambulances are in an area, not the company. I am sorry but if you are not going to take any responsibility for your ambulance or your inventory then we do not need you might as well return to Ontario because we are looking for real changes and as long as you want babysat you are working against the rest of us. Yes some changes should occur, I will not deny that but if you are not taking responsibility for your side how can you expect the owner/operators to take responsibility for theirs?

  • t-s-p
    December 21, 2012 - 20:38

    Im assuming we all work for the same company... Its appalling what goes on and what they can get away with- in regards to patient care and treatment of employees!!! I can very well relate to never being thanked or told 'job well done'!!!!! I can go on and on but the above comments sum it up quite well!!!!

  • MB
    September 18, 2012 - 15:18

    The way in which these Private Ambulance companies operate and treat their employees is appalling. Wages are laughable considering the work that these employees do on a daily basis and very few of these companies offer any benefits (medical/dental plans, retirement pension, sick leave benefits, etc). They expect employees to give their all, yet offer nothing in return. The employees of Private Ambulance services have dedicated their lives to helping the sick and injured residents of our Province. Sadly, it often comes at the expense of their own health. They miss meals, rarely get breaks, and often lack proper sleep. Most are expected to work beyond what is humanly reasonable...48 or 72 hours straight and even then are often "asked" work overtime. Some will often miss holidays and spend many hours away from their families. Very likely they will all deal with some very sad and tragic situations during their careers....and for what? Little money, few benefits, and certainly no appreciation from their employers. It is certainly time that the Province of Newfoundland and it's residents stand up for these dedicated men and women and advocate for better working conditions. Not only do they deserve the recognition and appreciation, but any improvements to the EMS field will most certainly benefit all those that it serves. The Goverment of Newfoundland needs to look long and hard at the way the Private Ambulance companies are operating and take some responsibility for this very important and much needed service.

    • CJ
      October 19, 2012 - 22:02

      I totally agree with the above comment. I am currently working for a Private Ambulance Service in the province of Newfoundland and the patient care standards are well below any other province in Canada. In the way of health and patient care, we are currently ten years or more behind! There is absolutely no reason for it. Like Crystal, I have also personally witnessed situations where patient's lives have been put at risk, because the company's main concern is to make more money. These companies must ensure that there is adequate coverage for their area, in regards to the number of ambulances available. Instead of having enough ambulances available in their area, they will send most of them on long transfers across the island and keep ONE ambulance to cover an extremely large area, in order to make more money. Because they make most of their money on the transfers. There is absolutely no concern for the community and for patient care. Some ambulance services have no Paramedics and run only with EMR's. No offense to all the EMR's out there. Many of them are great, do their jobs very well and have helped and/or saved lives at one point or another but standard of care should be at the level of a paramedic, bare minimum. This alone would greatly improve patient care. We are one of the only provinces that even allow an EMR to be on an ambulance. I have also seen ambulances that are not properly stocked and have been missing vital equipment. I have witnessed crews being sent to calls with ambulances that are not in proper working condition (blowing out black smoke, barely enough power to move it). As stated above, the dispatchers are not trained properly and do not assist with patient care at all. They literally answer the phone, get a name and number and hang up. There is no assistance with basic first aid measures such as stopping major bleeding, no direction in regards to beginning CPR, checking an airway or a pulse, or assisting someone who is choking. Assisting with these things would also greatly improve patient care. Again, no offense to all the dispatchers out there. This is based totally on what I've witnessed within the Private Ambulance sector. In regards to the lack of appreciation, you're right. There is absolutely no appreciation at all. In the two years I've worked as a Paramedic in this province I have not been thanked once. I've never received a "good job". Instead, I'm looked down on because I don't do overtime shifts. For all of you who don't know how it works. We work 24 hours shifts and get paid for 12 hours of that 24. So this means you could potentially be working 24 hours straight and get paid for 12. And yes, some days we only do one or two calls. But, being woken up at 2am after working 10 hours straight through the day, and having to: #1 - drive an ambulance and #2 - calculate the medication you might have to give to a 2 day old baby and actually do it in a calm and professional fashion..this can get to be exhausting. Not only physically, but also mentally. I have personally witnessed patient's die in front of me and have been offered no debriefing, or asked if I was ok. Instead, they call me to let me know that I have an early morning transfer at 7am sharp. I receive no benefits, no overtime pay, no sick or personal days. I am around sickness and contagious diseases all the time but I cannot afford to take a sick day if I get sick. There is something wrong with this system and there is so much more that the public is unaware of. Something needs to be done to improve it. The Private Services need to be more regulated and the public sector needs to step in and ensure that this is happening.

    • CJ
      October 19, 2012 - 22:05

      I totally agree with the above comment. I am currently working for a Private Ambulance Service in the province of Newfoundland and the patient care standards are well below any other province in Canada. In the way of health and patient care, we are currently ten years or more behind! There is absolutely no reason for it. Like Crystal, I have also personally witnessed situations where patient's lives have been put at risk, because the company's main concern is to make more money. These companies must ensure that there is adequate coverage for their area, in regards to the number of ambulances available. Instead of having enough ambulances available in their area, they will send most of them on long transfers across the island and keep ONE ambulance to cover an extremely large area, in order to make more money. Because they make most of their money on the transfers. There is absolutely no concern for the community and for patient care. Some ambulance services have no Paramedics and run only with EMR's. No offense to all the EMR's out there. Many of them are great, do their jobs very well and have helped and/or saved lives at one point or another but standard of care should be at the level of a paramedic, bare minimum. This alone would greatly improve patient care. We are one of the only provinces that even allow an EMR to be on an ambulance. I have also seen ambulances that are not properly stocked and have been missing vital equipment. I have witnessed crews being sent to calls with ambulances that are not in proper working condition (blowing out black smoke, barely enough power to move it). As stated above, the dispatchers are not trained properly and do not assist with patient care at all. They literally answer the phone, get a name and number and hang up. There is no assistance with basic first aid measures such as stopping major bleeding, no direction in regards to beginning CPR, checking an airway or a pulse, or assisting someone who is choking. Assisting with these things would also greatly improve patient care. Again, no offense to all the dispatchers out there. This is based totally on what I've witnessed within the Private Ambulance sector. In regards to the lack of appreciation, you're right. There is absolutely no appreciation at all. In the two years I've worked as a Paramedic in this province I have not been thanked once. I've never received a "good job". Instead, I'm looked down on because I don't do overtime shifts. For all of you who don't know how it works. We work 24 hours shifts and get paid for 12 hours of that 24. So this means you could potentially be working 24 hours straight and get paid for 12. And yes, some days we only do one or two calls. But, being woken up at 2am after working 10 hours straight through the day, and having to: #1 - drive an ambulance and #2 - calculate the medication you might have to give to a 2 day old baby and actually do it in a calm and professional fashion..this can get to be exhausting. Not only physically, but also mentally. I have personally witnessed patient's die in front of me and have been offered no debriefing, or asked if I was ok. Instead, they call me to let me know that I have an early morning transfer at 7am sharp. I receive no benefits, no overtime pay, no sick or personal days. I am around sickness and contagious diseases all the time but I cannot afford to take a sick day if I get sick. There is something wrong with this system and there is so much more that the public is unaware of. Something needs to be done to improve it. The Private Services need to be more regulated and the public sector needs to step in and ensure that this is happening.