rock_shoes

Now this is where things really get interesting in a communist do as I say not as I do sort of way. Until the BC Labour Relations Board issues the reasons behind their essential service order the order can not be legally challenged. Thus far the LRB has blatantly refused to issue any such declaration. We have requested that the LRB member responsible for the ESO recuse himself from any further issues between CUPE 873 (the union) and BCAS. In response we received an eight page proclamation outlining why he would not recuse himself following our request. Oh and it gets even better. Now the BC government in its wisdom has amended the Emergency Medical Assistant legislation (this legislation governs practise in BC) such that the employer can force our licensing board to issue temporary licenses to essentially anyone they chose. This includes students who have yet to finish their programs, managers who no longer hold a valid license (and may not have for a number of years), and people from other jurisdictions. "What you used to have a first aid ticket and drive a taxi? Here are the keys to that shiny new ambulance we bought for the Olympics and an EMR (EMT-B equivalent) license." Just a little scary eh? We are not just fighting for wages here. We are fighting for the profession as a whole in Canada. The precedents set in Toronto and BC will have repercussions that extend for many years for better or for worse.

I'm going to have to disagree with you on this one Dust. When a group is in a position where they must show up for work regardless of job-action (due to both ethical and legal causes), this is one of the only methods deployable. It does not affect a medic's ability to care for their patients in any way shape or form while it continues to inform the public that they are engaged in a labour dispute. You need to remember that TEMS and BCAS medics are public servants. The public has a right to know when these people are in a labour dispute and the public has a right to know why. On another quick note. The "Essential Service Order" in BC has actually set our service levels beyond 100%. The ESO has gone so far as to demand that people continue to work overtime shifts or risk being found in contempt of court. For the younger people such as myself it is possible to license in another province and jump ship. For the older people it's much more difficult. Our current licensing board has held the state of practise 10 years behind what it should be so the older medics who went through older programs are unable to meet the competencies required to re-license in another province without doing some major, very expensive, upgrading. It's much more difficult to change employers when your current employer is the sole EMS provider for an entire province.

This isn't always the case. In Canada the few (and I mean very few at this point) PA's that we have come from the Canadian Armed Forces paramedic ranks. Long term I think the best solution is going to be the development of a Paramedic Practitioner program. In Canada obtaining Advanced Care Paramedic certification requires the equivalent of 3 years full-time university education (some provinces front load with longer Primary Care programs while others backload with longer Advanced Care programs). Add an additional 2 years of targeted education to create a paramedic practitioner program and a new rural gold standard will be born. You make an excellent point. Extensive transport times in austere environments requires the best of the best if you want to provide proper patient care.

I use the "Skyscape" emergency med constellation on my iPod touch and so far it has been excellent. The menu system is very simple and the layout of "Davie's Drug Guide" is the most user friendly I've ever worked with. The applications are not cheap but I also have a knee high stack of medical reference material at my fingertips at all times. It's extremely rare that I use this kind of reference material on a call to be honest. I usually reference the "Emergency Medicine" manual, and "Davie's Drug Guide" post-call to reinforce the proper management of that particular patient. This also gives me the opportunity to review any new patient management practices that may improve my patient care.

There's something extremely satisfying about being able to thank another crew like that. Being on the other end of the stick and having another crew live up to the same expectations you place on yourself is one of those things you can never forget. Kudos to the responding crews, and best of luck to your grandfather during his continuing recovery. Ed

Does this only apply for scene to hospital trips or is this also the case for scene response? Scene to hospital is entirely at the paramedic crew's discretion for us. Scene responses can be downgraded at the crew's discretion if continuing to run L/S is ill advised for safety reasons (weather, road conditions, traffic etc.).

The whole "Everyone is equal. Some are just more equal than others." is really rearing its ugly head around here. I can't share what the next step on CUPE 873's part will be just yet. Know there is more to come and things are going to get even more interesting. King Gordo needs to think long and hard about who he wants to show up at his door if he ever needs EMS. Does he want Primary and or Advanced Care Paramedics or does he want a pair of EMR's (roughtly equivalent to EMT-B ) who took a 3-4 week first aid course? The number of paramedics ready to move on to other careers is tremendous. I know of many paramedics who have received the golden handshake from various police forces who are also shortstaffed (and far better paid). Couple that with the large number ready to retire in the near future and we are quickly approaching critical mass.

What? Right after I've finally decide the best course of action is going to be to apply to SAIT ACoP loses what little it has left for intelligence. Guess I should still be okay as long as SAIT keeps it's 6 year accreditation. This may be an intelligent place to start. One of the best improvements I can think of would be to take paramedic programs out of the JI's hands altogether and move them to BCIT where they should have been to begin with. BCIT is the equivalent of SAIT or NAIT in BC.

Thanks Spenac. I didn't have time to look up one of the videos when I posted.

You make a very good point Spenac. I've worked with a few of these types myself. These people absolutely bust their rear and still barely scrape through practical exams and the actual application of skills. I remember one partner who could tell you every part of the heart, recite every protocol by wrote etc., and yet she was incapable of performing a competent assessment or actually using a protocol correctly. This particular individual actually has a Bachelor's degree in BIOLOGY and has been working on ambulance for 8 years. I think it's important to add the caveat that at least some of your particular gifts should be applicable to your chosen profession. With regards to EMS, the ability to "Think on your feet" would be high on the list of important skills to either have or at least be able to develop.

I don't believe in the "it" concept. I believe in education, hard work, and commitment. There will always be those with more of an aptitude than others but those same people would also be good at a lot of other things. In high school I was one of those kids who just rolled through getting A's and B's without having to work for them. I was accepted to the top engineering school in the province directly out of high school. I didn't continue with engineering because the more I found out about the actual job the more I hated it. I clearly had an aptitude for engineering but it just wasn't for me over the long run. Now I work in EMS which at first glance has not relation to engineering whatsoever. Or does it? My clear understanding of concepts like vectors, momentum, acceleration, kinetic energy, and force has been incredibly valuable to me. The ability to visualize objects in three dimensions has also served me extremely well. When I think of a 12 lead I don't think of squiggles on a page. I can actually picture what those squiggles represent in action. These are all skills typically associated with jobs outside of EMS yet they serve me well. By the same token other skills typically associated with EMS took me some time to learn and I'm still learning every chance I get. The point is that "it" doesn't exist. What does exist is using the gifts you have and busting your rear to learn the rest.

While I don't always agree with Dust, I would never question his altruism with regards to the betterment of EMS. He kind of reminds me of the ventriloquist Jeff Dunham's character "Walter". He is outspoken, sometimes abrasive, and right about so many things. Dust isn't always easy to post back and forth with, but he almost always elicits great debate.

Enjoy Victoria Eyedawn. If you get a chance tour the provincial parliament building. True it's filled with politicians, but it's also a marvellous piece of architecture. Afternoon tea at the Empress is another must if you can fit it in.

That's just the happy rumble of a well tuned powerstroke. In all seriousness though our new Chevy duramax is creepy quiet by comparison. It's kind of nice actually being able to auscultate a BP with the car running for a change.

All of the potential extrication hazards described here tell me that these vehicles need an emergency lock out and circuit discharge switch for the electrical system (including all safety measures such as air-bags that have not deployed). Prior to working in EMS I spent several years in heavy industry where the concept of "Locking Out" is strictly adhered to. Anytime you were required to work "in the bite" (an area that is dangerous when equipment is active) you were also required to lock out the power supply for the equipment in that area with a padlock. In addition to locking out the power supply you had to test the equipment controls to ensure the system was discharged. If such a switch where provided on these vehicles all that would be required is a padlock on said switch that prevents anyone else from reactivating the electrical system. Ideal location for such a switch would require some research but I don't think the cost would be overly prohibitive. As for "silent" hybrids "sneaking up" on people, that's an entirely different issue that is about to get even worse with upcoming new generation hybrids like the Chevrolet Volt. Hybrids of this new generation only run their gasoline or diesel engine after approximately the first 60 kilometres of use.

The short answer is no. The longer answer is maybe in the future. As things currently stand the ESO has no language pertaining to the Olympics and "Special Operations" (ie. extra staffing for special events) is shut down. That could change however as every time BCAS management has had a problem thus far they've simply run to the labour relations board and had the ESO amended. The real kicker is that we are not allowed to challenge an LRB ruling until the reasons for an LRB ruling are released. Rather than face a multitude of challenges the LRB has simply refused to issue their reasons thus far. The whole thing has been rather communist where "Everyone is equal. Some are just more equal." Frequently over the last 2 months the employer has invoked the "Mandatory Recall" clause forcing people to come in to work or face punitive and even legal action. The "Mandatory Recall" clause is supposed to be a failsafe in the event of a major disaster. It is not meant to be used just to keep the regular cars staffed on any given day. This is essentially admission by BCAS that the ambulance service is in a state of crisis. In addition the LRB has actually ruled that paramedics are to answer calls from scheduling and accept overtime shifts exactly as they have in the past. You can't even refuse to work regular overtime without risking being held in contempt of court. BCAS and the BC Provincial Government have taken things way too far this time. If this type of bullying is allowed to happen here it will eventually extend across the country and spell disaster for all of us. If we fail to take a stand here and now we might as well tear up the Canadian Charter of Rights and Freedoms because the precedent will be set. Ed Peters Just one of the 3500

Matt I have to say kudos to your employer for providing a fairly comprehensive new hire package. It's certainly a lot more than I received. When I started with BC Ambulance I was handed a "New hire package" that needed to be completed within my 6 month probation period and I was given 3 shifts as a third. The "New hire package" included WHMIS, ICS 100, the alpha bravo charlie... alphabet, company radio codes, and a review of company policy. No one is allowed to drive until they have completed a vehicle operations course. After completing the vehicle operations course everyone must complete a driving practicum with a driving preceptor before they can drive L&S. Operational area orientation was learned entirely on the job. There was no base hospital orientation because everyone in the province is bound by the provincial SOP for their respective license level. In order to drive in the Greater Vancouver Regional District you must complete the Vancouver Post Orientation Program. Basic CBRNE training, CTAS training, etc. are all provided via the Clinical Education Division but are not part of the orientation program. Clinical Ed courses are open to anyone who has yet to do that particular course. BC Ambulance seems to rely on new hires being somewhat familiar with operations because anyone trained in BC will have precepted with BC Ambulance. This didn't help me at all when I started out as an Emergency Medical Responder (roughly equivalent to EMT-B ) who didn't receive any kind of preceptorship. I did my PCP program after I started with BC Ambulance so initially I was essentially thrown to the wolves with minimal education and expected to "figure it out". I'm still around so I guess I made it out of the den.

No offence taken. I'm well aware of BCAS' flight program shortcomings. Anyone who lives in the north or on the Alta. border is far more likely to receive care at the hands of an Alta. provider than a BCAS provider. Alberta flight programs have been picking up the slack for far too long. This occured in Vernon during the provincial election campaign. Nothing like a blatant display of arrogance eh? I was thinking the top of the foot myself. Not that I would alter the standard of care I provide for any reason.

Within the province of BC only the British Columbia Ambulance service has a mandate to provide on the road or flight emergency medical services to the public (Alberta's STARS does step in and assist at times when air support is needed and BCAS can not provide it). This authority is granted to the Emergency and Health Services Commission via provincial legislation (BCAS is a subsidiary of the Emergency and Health Services Commission). Private contractors can provide onsite care for industry however they must transfer care to BCAS crews as soon as possible for transport to hospital. Non emergent inter-facility transfers can be provided by private contractors but this has only really started to emerge in recent years. BCAS is non-profit and is referred to as a "Crown Corporation", meaning it is owned and run by the provincial government. There are good things and bad things that come from this. The fee for an ambulance is a mere $85 for BC residents for example. This is regardless of whether a patient is granny who just needed help getting up or a major trauma victim who is picked up by a Critical Care Paramedic staffed helicopter. Back on the strike track. Here is a link to a recent web commercial put out by CUPE 873. CUPE 873 Critical Condition Video

My head started to spin just typing it out. You should see what my payroll looks like. It's 5-6 pages long and you damn near need an accounting degree to follow it. I think this is best left to another thread but is well worth further discussion. As a quick note I do think PA's will in part come from a paramedic background in Canada. Current PA's in Canada all come out of the armed forces. The vast majority of PA's in the armed forces where in fact paramedics first. Precisely. Now for the media blitz. As for the Essential Service Order our fight is going to be in court. I don't personally know anyone who will fail to support us in fighting something that violates the Canadian Charter of Rights and Freedoms.

Here is the breakdown of how the current pay structure works. There are 2 different part-time shift patterns. On a Foxtrot shift part-timers are paid $10.80/hour until a call comes in. After a call comes in that part-time crew bumps up to full pay for a minimum of 3 hours (longer if a call continues past 3 hours or if another call comes in prior to 3 hours coming up and the call continues past the 3 hour mark). Part time straff on a Foxtrot pattern are expected to be in the car and enroute within 90 seconds meaning they have to be at the station in uniform for the duration of the shift. As an IV endorsed PCP with less than 5 years of service my full rate when on a call is $20.57. On a Kilo shift part-timers are paid $2/hour to carry a pager and respond to the station then to the call. When paged part-timers on Kilo are paid a minimum 4 hour call-out at their full rate. If a call or series of calls carries past the 4 hour mark the staff are paid their full rate until they are clear at quarters. If a crew has cleared at quarters and they are paged again it is another minimum 4 hour call out regardless of whether or not it's been 4 hours since the previous call out. This is in accordance with the BC Labour Standards Act. There is in fact no limit on Kilo response time. The vast majority of us maintain as quick a response time as possible out of a sense of civic responsibility. In addition part-time staff are paid 17% in leau of benefits and holiday pay with only hours spent at their full rate being eligable for this in leau of pay. Part time staff with greater than 6 years service and a minimum number of call-out hours are paid 6% in leau of holiday pay and receive benefits. Part timers can at times fill in for full time staff on full time shifts. In that instance part time staff are paid their full paramedic rate for the duration of the shift. The big problem that arises with the Foxtrot pattern is this. BC Ambulance is able to staff a car with qualified people for approximately half the cost of a full time crew despite having equally qualified staff and equal to full time response times. It's like giving BCAS a full time car for half price and it need's to stop. On another important note only hours paid at full paramedic rate are eligable for Employment Insurance should one of us become ill or injured. The most upsetting thing is when BCAS runs a split part-time/full-time crew. Today for example I am making $10.80/hour between calls while my full-time equally qualified partner is making his full paramedic rate for the duration of the shift. At this point my biggest mantra is full-time pay for a full-time response. This is absolutely one of the best solutions to many of the problems. I would actually recomend going a step or two further and utilizing CCP's eventually followed by a Paramedic Practitioner level. As I understand it the Physician Assistant pilot class at McMaster University in Ontario is entirely made up of ACP's, CCP's, and RN's. This will be the best solution to rural emergency health care woes and is my current goal for my own rural community.

I take a couple of day's off and things just explode. Long term members attacking each other... Let's keep things in perspective. There are a few very important points that need to be made here. 1) We are all labourers. Some of us are educated and some of us are not. Some of us have significantly more education than others. Having a degree does not preclude you from being a labourer. 2) Healthcare in Canada is our "Sacred Cow". Finding a Canadian who doesn't support public, not for profit, healthcare is something akin to finding a hamburger in India. The majority of US citizens have strong feelings regarding the right to bear arms while Canadian citizens have strong feelings regarding healthcare. 3) It isn't as simple as moving to another service if you don't like what's going on with BC Ambulance. BCAS IS THE ONLY EMS PROVIDER WITHIN THE PROVINCE OF BRITISH COLUMBIA. Unless you are willing to move cross-country and re-license in another province BCAS is your only employer option. 4) I stated this previously but I think it bears repetition. This isn't about union vs. non-union. This about 3500 people with limited other employment options dealing with a very HOSTILE EMPLOYER. 5) If this job action results in a complete re-structuring of BCAS the majority of us will welcome it. What was sufficient 20 years ago just doesn't cut it now. BC paramedics know that and are not the ones who are unwilling to make major changes in both deployment strategies and educational standards. As a side note. I'm more than willing to discuss how BCAS has been a leader in the past. If you legitimately wish to have that discussion Dust I will participate in another thread. Discussing it in this one would end up being a major thread jack.

We haven't the ability to arbitrarily change when our contract ends on a whim Dust. How exactly would you propose we predict the economic situation and adjust our contract end date accordingly in the future? We didn't even end up with an actual contract the last go around. What we are currently working under is a "Memorandum of Agreement" that extends a previous contract. This isn't about "Union Vs Non-Union" as much as it's about dealing with a hostile employer that has zero respect for its employees. As for pertinent history I think much of it is obvious. BC Ambulance has gone from being a world leader in pre-hospital care to lagging behind on nearly every front. We're stuck in the dark ages due in lare part to mismanagement that borders on both criminal and gross negligence. Believe me this labour dispute is about a great deal more than wages. Wages are at the forefront because of how far behind we currently lag.

Just as an add to the discussion I thought I would add a couple of pertinent links Canadian C-Spine Rule Vs. Nexus Criteria Canadian C-Spine Rules

Docharris has our situation in BC pretty well summed up. There are a few other bits and pieces going on behind the scenes that have the potential to throw a wrench in the provincial government's plan. The additional staffing that will be required to meet BC Ambulance's Olympic obligations is an excellent example. As part of the ESO (essential service order) "Special Operations" have been deemed non-essential. This will include the additional cars and staff required for the Olympics. In addition to the students' inability to finish their programs staffing shortages will be further exacerbated by a portion in the ESO that deems hiring of replacement workers during the labour dispute illegal. The current situation has been brewing for a long time. We are dealing with both a hostile employer and a hostile provincial government that, thanks in large part to the current economic climate, has just received a new mandate. The way things are currently going it could come to the point that 3500 resignation letters are dumped on the premier's desk. We aren't completely out yet but it's becoming extremely frustrating for all of us. Portions of the current ESO violate both Labour Law and the Canadian Charter of Rights and Freedoms so much of our fight is going to be in court.