Private ambulance service becomes first in province to staff advanced care paramedics
By RYAN KING
SOUTHWEST COAST – MacKenzie’s Ambulance Service in Port aux Basques has become the first private provider approved for advanced care paramedicine in the province. Jeffery Stevens and Mary Beth Burrell were approved after undergoing the additional training necessary to become certified.
“Advanced care paramedics require additional schooling. Depending on the program you go to approximately 12 months in class and then additional clinical time in OR, ER, ICUs, pediatric, and obstetric units,” said Stevens.
The rest of the staff are either primary care paramedics or emergency medical responders. Emergency medical responders usually do a 14-day course and have a limited scope of practice. The primary care paramedics typically attend a two-year program and have a lesser scope of care than the advanced care paramedics.
“So you have to be a primary care paramedic before you can go and do your advanced care paramedic training,” said Stevens.
Burrell attended the program at Holland College in Prince Edward Island, and Stevens attended Medavie HealthEd in Nova Scotia. Burrell was certified sometime in August, and Stevens received his certification shortly after in September.
“Once you graduate the program you have to write a national exam done by the Canadian organization of paramedics and regulators that is considered our entry to practice exam. And then we have to be certified through the two provincial agencies that we have now: the Office of the provincial medical director, and the Newfoundland and Labrador Paramedicine Regulator. Then when we had all that paperwork done, then we were given our certification in order to practice as Advanced Care paramedics,” said Stevens.
Primary care paramedics carry around 12 medications to help a patient in distress.
“If a patient has low blood sugar, they have a couple options they can give for that, whether it’s intravenously or orally, and they carry a significant number of medications in order to help relieve symptoms in serious situations,” said Stevens.
By comparison, the advanced care paramedics carry 36 medications to render aid – everything that a primary care paramedic or emergency medical responder would carry.
“Plus we carry a higher profile of medications for things like cardiac arrest. Basically if somebody goes into cardiac arrest at their home, now we’re able to do absolutely everything that they’re able to do in the emergency department for that person in order to give them the best chance possible,” said Stevens.
Additionally, the advanced care paramedics carry medications to stop seizures. They are also able to slow or increase heart rate through medication or electricity, and have items needed for childbirth and trauma. Burrell shared that getting this certification was something they were both pursuing individually.
“At that point when we were pursuing schooling there wasn’t actually any private operators that had ACP spaces. Because you need more money from the government. You need more resources,” said Burrell.
“The contract between the private operators and the provincial government had a stipulation for advanced care paramedics for additional funding from the provincial government,” said Stevens. “So what we end up having to do was put together a proposal saying why it would be beneficial in this area, how the money would be allocated, how we would be utilized, and why we believe that this is the best area for basically a pilot project, because there were only five positions that were included in that private operator contract for the entire province. So we put that together, and we got approval in late September, and then we started putting all of our equipment together, and we’ve been practicing pretty much full-time since early October.”
Stevens shared that the advanced education has already been put to use in the community.
“I’ve had a few calls that allowed me to help people with some more pain management type things. I’ve done a few intercepts with the Codroy Valley in order to give them additional assistance with a few different patients, whether it be a chest pain patient that just needed further evaluation or helping them stabilize somebody else that’s in a more critical role,” said Stevens.
Additionally, this education has played a role in the transportation of patients out of town.
“I’ve done a significant number of inter-facility transports that they would normally have to send a nurse or a physician to Corner Brook with a patient. They’ve been able to just send me with a patient now in order to give the staff over here a little bit of a buffer, so they don’t go on every transport requiring an additional level of care,” said Stevens.
“It’s interesting with the drugs that we carry too,” added Burrell. “Because there’s a certain amount of drugs that we carry that we can administer, but we’re allowed to give even more drugs when we’re doing inter-facility transfers, because they do it on the classes of drugs as opposed to the individual drug names. So we’re allowed to carry even more drugs and the transfers with doctor’s orders and administer them under conditions, and that’s very useful for the patients and for the staff over there as well. With the doctor shortage and the nursing shortage, they were getting a little bit overwhelmed,” said Burrell.
Beyond the care of residents in the community, the purpose of their certification is to help take pressure off the hospital staff.
“The primary purpose of us putting advanced care paramedics here, and us staying here to work in this community, is to increase the level of care that people are getting in the community first and foremost. The secondary purpose is to definitely help alleviate some of the stress off of the physicians and the nurses over at the hospital so they can stay and remain in the community and focus on patient care inside the hospital as it is,” said Stevens.
Stevens hopes that soon other communities will see an increase in similar initiatives in paramedicine.
“Whether that be community paramedicine, or palliative care paramedicine, where were able to go into homes help keep people with the diseases that cause them to be constantly readmitted to hospitals. If we’re able to keep them at home, that’s better for our health care system, and hopefully we see the implementation of community paramedicine on the provincial government side in the near future. And palliative care paramedicine, if we’re able to assist with that it will alleviate some of the stress off the public health nurses here and provide a little bit of additional level of care for people that want to stay at home and want to die with dignity at home. That would be a huge step for our province and help alleviate hopefully even more costs on the provincial government when it comes to health care.”