Halloween is only forty-eight hours away, though I am unsure whether the correct emotion leading up to the frightful night should be fear or disappointment (No, I am not thinking about little ghosts and goblins coming to the door Monday night for a trick-or-treat - I will get to that topic in due time). The divided sentiment is the offspring of the latest news that our healthcare institutions may be pillaged for staff to care for patients using our Provincial air ambulance system.
With a demonstrated shortfall of healthcare professionals to fill positions within the hospitals, robbing the hospitals of highly trained caregivers will push our citizens further and further behind the proverbial eight ball. Inpatients are already failing to receive the proper patient-to-caregiver ratio they need inside the walls of specialized units. The pundits at the top think that changing legislation will fix all the ills. From the outside, I suspect many Ontarians may be chided into the notion that any healthcare provider could simply cross the boundary between one discipline and another. It is simply not that easy.
Ask most paramedics about their counterparts providing different and specialized treatments in a hospital. They have witnessed enough care being provided to respect each specialty: nursing, respiratory therapy, emergency department technicians, etc. There are literally a dozen specialties within the nursing field, which is a conservative estimate. Healthcare is the common thread, but that’s where the commonality ends. Another area that spans medicine is the ever-evolving technology that practitioners depend on to assist them with clinical assessments, monitoring and treating their patients. Caregivers are trained and rely on that technology in their respective working environments, in and outside hospitals.
The pundits mentioned above would also have us believe that they can easily find paramedics that can take a minimum of training and walk into an emergency room ready to provide care. Specially trained ER nurses and physicians are already stressed to the max. They are doing their best to provide treatment in already trying circumstances, between patient volumes and bed blockages preventing them from getting patients out of the ERs and up to overpopulated floors. Patients in hospitals need doctors and nurses, period.
Ontario’s world-class air ambulance system uses two styles of aircraft. Fixed-wing airplanes and rotary-winged helicopters. Airplanes are tasked with inter-hospital transfers of the most seriously ill and injured patients. Helicopter units provide a dual service. In addition to the inter-hospital assignments, rotary-winged aircraft do “scene” calls. This is where the rubber meets the road.
Assigning hospital staff to do inter-hospital transfers when the environment is clinical, stable and calm is common. An example would be an ambulance or aircraft’s well-lit, warm and calm interior. This is done routinely in land ambulances and chartered aircraft. A paramedic accompanies hospital staff to assist in their out-of-hospital experience.
Critical care flight paramedics staffing the Province’s airplanes and helicopters are highly trained in patient care and technology and experienced in pre-hospital care, which involves the unparalleled skill of working in non-clinical surroundings. Institutional professionals never signed up to work in an uncontrolled setting. It is not that you cannot bring motivated caregivers up to speed. Healthcare providers thrive on continuing education.
First-response calls for service can be like working in the “untamed” world. Paramedics are trained, experienced and prepared to work in severe conditions. Institutional staff would likely not wish to participate in caring for victims while exposed to the elements, incident-related hazards, and noisy and low-light conditions. The work can be stressful and frightening. And not the Halloween kind. Paramedics bring all the necessary elements to the scene as a base of knowledge and experience long before they train for the advanced aspects of pre-hospital care.
The repercussion of admitting outside caregivers to pre-hospital assignments. I believe those pundits already have a solution. No more scene calls. Victims of misadventures in remote or inaccessible locations and uncontrolled circumstances will be removed from the eligible taskings for the air ambulance system when aircraft are staffed by nurses, doctors and respiratory therapists. Accidents on highways, farms, remote cottages or work locations come to mind. What will the ambulance dispatchers say to callers making requests in extraordinary circumstances? I hope the group representing paramedics that have been vocal with well-founded concerns convinces the Province to rethink their plan.
Now, back to the focus of my original post. Halloween. Struck with yet another fit of nostalgia, we went about the business of decorating our front entrance for Monday night (Check out the pictures below!). The cost-to-benefit ratio is not there, with the kid count of less than three dozen trick-or-treaters last year. Then again, the celebration has nothing to do with a rational decision. It is all about the challenge and seeing smiling faces at the door. The activity drives our tiny black cat crazy, and I get to pirate a few mini chocolate bars back to the couch for TV later in the evening.
Are you ready for Monday night?
