N.S. to train 200 new emergency responders to ease paramedics’ workload, ambulance wait times

Up to 200 emergency medical responders will be trained over the next two years in Nova Scotia to fill a new role that will make more ambulances available, reduce wait times and allow paramedics more time to focus on emergency calls.

“The demands on our system and paramedics continue to grow and with emergency medical responders we are taking another step toward transforming emergency health services for Nova Scotians,” Health Minister Michelle Thompson said in a news release. 

Emergency medical responders will work on ambulances, where they will be partnered with a paramedic, to assess, stabilize and transport patients to hospital. 

Teaming with a paramedic will expand the number of teams available to respond to an emergency call.

Emergency medical responders will also work in teams of two to transfer low-risk patients who have been assessed and do not require medical care during transport, or in emergency department offload areas, freeing up paramedics to focus on and respond to emergency calls faster.

“We have a world-class system in our province and the addition of these new team members will allow us to enhance the care Nova Scotians have come to expect,” Thompson said.

Emergency medical responders will receive three months of training, be licensed and regulated by the College of Paramedics of Nova Scotia and must pass a national exam administered by the Canadian Organization of Paramedic Regulators.

To increase the number of paramedics working in Nova Scotia, a bridging program will be developed for emergency medical responders who want to become paramedics.

Track records

“In the evolution of emergency medical services systems, the incorporation of the emergency medical responder role provides relief and support to our paramedics,” Charbel Daniel, executive director of provincial operations with Emergency Medical Care Inc., the Medavie Health Services operating company that manages and operates ground ambulance services in the province, said in the release.

“With a proven track record in numerous emergency medical services systems nationwide, this role will help enhance service delivery to communities throughout Nova Scotia,” Daniel said.

Announcement of the new hiring and training comes just more than three months after a report from the provincial Auditor General Kim Adair found that the ambulance service in the province is in critical condition.

Adair found in her report that the government is not effectively monitoring Emergency Medical Care Inc., pointing out that while the provincial government spent more than $147 million in 2022-23 to operate the ground ambulance service, the average wait time for an ambulance in Nova Scotia spiked from 14 to 25 minutes, an 89 per cent increase, in 2022.

Response times across the province have been increasing since 2017, and Adair said it poses a risk to Nova Scotians.

The audit concluded that poor response times are a symptom of the strains on the ground ambulance system, including a 17 per cent increase in 911 calls requiring an ambulance over the past five years, paramedic staffing shortages that force available ambulances to sit idle, the temporary closures of community emergency departments resulting in the diversion of more patients into regional centres, and the backlog at emergency departments that delay the transfer of patients from paramedic care to hospital care.

Offload, wait times

“The provincewide average wait to transfer patients to hospital care, or offload delays, increased from 60 to over 90 minutes,” in 2022, Adair said. 

“As a result, paramedics are spending more time in emergency department hallways, unable to respond to new calls.”

In 2022, paramedics spent a quarter of their working hours in offload delays at a cost of more than $12 million, the auditor general said.

In 2021, the provincial government set a new offload standard of 30 minutes for all ambulance patients arriving at emergency departments but audit testing throughout 2022 found that none of the emergency departments in the province’s largest hospitals consistently met that 30-minute standard.

The offload problem is more pronounced in the Halifax area, which experiences the longest delays in the province. The average offload times in the metro Halifax area are: 195 minutes, more than three hours, at the QEII Health Sciences Centre – Halifax Infirmary; 155 minutes at the Cobequid Community Health Centre; and 170 minutes at the Dartmouth General Hospital.

Working by summer

There are more than 1,000 paramedics employed in Nova Scotia but the Health Department revealed last year that the number of paramedics who have left work for reasons other than retirement has steadily increased over the past five years.

“A lot of paramedics are off because of the environment,” Daniel told a legislative standing committee meeting in October.

“It’s a tough job, there is no question about it. We lose paramedics that go off on medical leave, mental health reasons or physical injuries.”

Daniel said the work itself and compensation are contributing factors to people leaving but recent initiatives have helped address additional approval of vacation time to ensure paramedics get the time off they need and can end their shifts when they need to. 

Paramedics, members of the International Union of Operating Engineers (IUOE) Local 727, ratified a new three-year agreement in November to cover compensation, health benefits and a retention allowance for paramedics employed in a permanent or term position.

Several other Canadian provinces already license and employ emergency medical responders and the Health Department says training in Nova Scotia will exceed national standards.

Training in Nova Scotia will start in March and the first graduating class should be working by summer.

The emergency medical responder role is nationally recognized with pan-Canadian essential regulatory requirements including a competency framework, regulatory practice standards and a national exam.