How are the negotiations going?

When calling 911 …

The majority of people that call 911 in our region speak to an operator asking them if they want police, fire or ambulance. The various police and fire agencies in each city get calls for their community downstreamed to them, but if you ask for the ambulance, you get BCAS. We are the only game in town, and as such take a lot of requests for help from a large population.

Sometimes, when the calls are put through to us they disconnected or we lose the caller for various reasons: caller hung up, bad cell connection, etc… A coworker and friend picked up a 911 call like this early in his shift recently. When he answered the phone, “BC Ambulance Service, for what city?”, he heard a baby crying in the background and man’s voice. Then the line went dead.

Cell phones and 911 can be a pain in the @$$. All we know is the address of the cell phone tower near the patient but not the patient’s actual location. Lack of this address location information makes our jobs a lot harder if the caller isn’t able to tell us where they are. This particular caller called from a cell phone. The next step is the most obvious: call them back.

No answer. Next, the call taker phoned Telus (the predominant phone company here) to try to find an address. Telus told us it was a Telus Mobility number and to call them. After calling them the call taker was told that it was actually a Bell cell phone number and to call them. The call taker worked to find a billing address from Bell who refered him to their security department. As you can imagine, this has a low probability of success due to the ‘mobile’ nature of mobile phones. The cell phone security division provided us with a billing address and a landline phone number.

He tried a call to the landline number – Pizza Hut??? No one at Pizza Hut needed our help.

The call taker, finding this a little odd, phoned the police to have them attend at the address with us for our crew’s safety. The event was created and an ambulance is started on the way.

One final attempt by the call taker was made to call the cell phone. SUCCESS!! The voice he heard earlier answered the phone:

“Hello sir … did you call 911 and disconnected? Can we help you?”

“I was worried about my friend, but everything is alright now.”

“Alright, did you hang up on 911?”

“Yup. I hung up to go check on my friend.”

The outcome? Well, a call taker in a very busy communication centre took almost 30 minutes to try to track down a caller who didn’t need help. All he needed to do was tell us he no longer required help before disconnecting.

There is a lot emphasis placed on not making prank 911 calls. I would say that these types of calls happen far more often than prank calls. Many people don’t dial ‘9′ then ‘1′ and wait to dial the last ‘1′ to be sure they are needed. They dial up the whole number and give little thought to the consequenses of hanging up before making contact.

Please don’t hang up. We’ll try for a long time to track you down assuming the whole time you desperately need help.

Needing some clean-up?

Back-up Phone System

 

The Future?

Well, what’s next?  What else can we do?

A friend has a few options:

Bring on the tshirts?

We’ve started on a campaign to give us the ”opportunity to be “civilly disobedient” and demonstrate union solidarity without putting patients at risk” by wearing “on strike” tshirts at work rather than the normal uniform.  While the implementation has been a little bit dicey, the idea could be fairly sound.

While it has been argued that there is no decision to be made, members are making the choice of whether to rise up and show the public how unhappy we are with bad faith bargaining by donning a new white tshirt with a flourescent annoyance printed on both sides or, since the public don’t see us in the centre, just wear our normal uniform. 

Actually, some staff have made their choices based on other factors:

• wearing it since the tshirt is more comfortable than the regular uniform shirt,
• wearing it to show our other union brothers and sisters we support them in our job action even though we’re not seen by the public,
• wearing it when they know they won’t be seen by management,
• wearing it to avoid retaliation from other staff who are wearing them,
• not wearing it because the smaller sizes available make you look like a French cyclist,
• wearing to show off your ample male bosom,
• not wearing it to avoid discipline from management,
• wearing it only at dinner time since it’s better to soil a tshirt,
• wearing it to keep others from being singled out,
• simply giving them to a coworker to be used as a shop rag,

 

Where do I sit on the fence?  Well, to be honest, I’m not sure yet.  I am sure that I’ll be wearing one sooner or later, but I can’t say it won’t be for any really good reason other than to keep my tires from being slashed.

Walking a Very Thin Line.

The vast majority of our EMD and EMCT staff are licensed Primary Care Paramedics.  All of our staff are Cupe 873 members.  We believe as all our members do that our ambulance service is “a system in peril”  (saveourparamedics.com).  Our short staffing (which, understandably, is also a Nationwide problem) and haphazard coverage in some of British Columbia’s smaller towns can create some uneccesary delays in patient care.  We desperately need a good contract so we can all get back to our busines.

We see Management on an regular basis in the Dispatch Centre due to our proximity to regional headquarters.  They stop by to check in, ask questions or just observe.  On any given day, there are as many or more Management staff within 200 feet of our office than we have EMD/EMCT staff on duty.

Don’t get me wrong.  Without exception, the management we deal with on a day to day basis are very respectful of the Dispatch staff.  There is, however, always going to be that niggling deep down inside feeling that we are being watched.

On the other side we have our Union brothers and sisters on the street; all out looking for the same outcome.  The dispatch centre has responsibility to look out for them and the work they are doing while keeping up the strike plan outlined by our union executive.

This is where it gets dicey.  As an example, part of the strike plan was ”Crew members are not to do vehicle exchanges”.  In the dispatch centre, a manager directs me to ask a crew to switch into a spare vehicle.  I do as I am directed and am called by a strike coordinator asking me why I am directing crews to go against union direction.  Wow!  All I’ve done is as I was directed.  The crews can say no, call the manager in question or call their strike coordinator to ask for direction, but to call me out as going against union direction makes me feel like I’m caught in the middle more than I already am.

The Essential Services Order (ESO) from the Labour Relations Board (LRB) is pretty specific when it comes to following the direction of the employer.  Cupe 873 is seems to be focusing more on what we can’t do and less on what we could do.

I think it’s about time we started to get a little bit more creative in our job action.  We need the media and the public behind us which doesn’t seem to be the outcome of the road the union executive have put us on.  We need to show the public we are unhappy, without giving the impression that we aren’t still looking out for their safety.  We need to have journalists riding along with us to see how busy we are and how dangerous it can be on the streets.

This is destined to be one of those long and drawn out battles that no one will win.  The dynamic between managment and the union AND the dynamic between some of the members within the union will never be the same.  Hopefully we end up winning more than we have lost.

Where is the ambulance?

Like all kids, my brothers and I regularly bugged our parents for stuff while growing up.  We couldn’t figure out why instant gratification wasn’t ours.  Whether it be for a toy, a milkshake or simply some money to go to the corner store, the answer was always the same:  “Money doesn’t grow on trees.”  That statement inevitably conjured images of a money tree growing in the back yard; a white glow surrounding the branches with the money leaves glimmering magically with light from an unidentified source.  My younger brother would most likely break my trance with a tantrum soon after.  As most kids do, with the vision over, we would move on.

I see a similar pattern at work.  People do not understand why there isn’t an ambulance waiting on every corner ready to pounce from the trees onto the next emergency.  They need an ambulance and why isn’t it already there?  Doesn’t the ambulance fairy know?  I’ve tried bibbity, bobbity, boo, but it hasn’t worked so far.

I’m being overly dramatic.  But am I?  Medical emergencies seem to cause a change in brain chemistry – no matter who it is that is having the emergency.

Our latest job action has made this situation worse.  Some paramedics have taken to putting large “ON STRIKE” stickers on the sides of the ambulance.  Delays chalked up to call volume 6 months ago are now, in the eyes of the public, due to a perceived refusal to attend - seemingly job action related. 

If you read this blog (and I know at least 4 people do), get the word out.  We have issues with the employer, not the public.  We became paramedics, EMDs and EMCTs to help the people of our communities.  Up until now, that help has been at the expense of our families and ourselves.  The hope for job action outcome is that we can have a healthy family and community while being compensated appropriately.

Who Are We Punishing – A Tale of AVL

Automatic Vehicle Location (AVL) was adopted by BCAS a short time ago.  In broad terms, AVL is a system by which a cel phone type arangement using GPS signals sends information to our CAD system showing a live version of where all our ambulances are.  It is a great help for confirming who is the closest car to a call, assuring callers that an ambulance isn’t far away from them and, heaven forbid, finding an ambulance that’s been involved in an accident on a far away, dark country road.

Several of our fellow paramedics find it necessary to unplug the power cord to their AVL modem in the ambulance.  Aside from the obvious safety implications here, what are they proving?

I think it’s not well known how the data for AVL is managed.  In the dispatch centre, we know pretty quickly who’s AVL is not functioning and who’s is functioning fine.  We can see the little blips a moving vehicle displays and we can see a stationary unit that should be moving.  This is easy peasy but often not reported due to the EMD being too busy to notice or having bigger fish to fry.  The system ‘polls’ each unit on a scheduled basis either by time or distance depending on the status of the unit.  Every time a unit is polled, the data is logged.  EVERY TIME IT’S POLLED! 

These logs are for record keeping in our eyes and of no concern to the dispatch centre.  Management on the other hand, has the ability to easily sift through the log and look for patterns.  They can play a route taken by a particular unit last week as simply as you can watch a video of your trip to Mexico on your iPod.  They can tell who seems to have a problem keeping their modem plugged in and who doesn’t

I implore crew members:  Stop playing with the AVL unit.  It’s in your best interests.  I promise.

Hmmm … I Wonder (part 2)

What’s the deal with …

… needing to announce to crews that a patient is MRSA+ in his urine?

… crazy people trying to justify their sanity by name dropping using the names of supervisors they have falsely accused of threatening them?  I know, I answered my own question on that one.

… paramedics getting a patient’s vomit in their own mouth?  There were a few things I didn’t need to be taught growing up; one of those was to close my mouth when I was near someone who looked like they were about to hurl.

… part time staff allegedly staging an unofficial <pick a homonym for ‘job action’> that has little effect other than to make their own Brothers and Sisters have to work harder?

The Changes Roll In

A lot of things have changed over the months I have been away.  You may be surprised to hear I have some thoughts on them.

Looming Strike Action

The Ambulance Paramedics of BC (CUPE 873) will be in a position to strike as of April 1.  Let’s not delude ourselves, strike will happen.  The hardcore members of the union will be hardcore and the conservative members will be conservative.  My job as a leader on my team is to encourage the team to do the business we need to do.

In the dispatch centre, our team has discussed the looming job action and have acknowleged that we have some core responsibilities:

1. Using MPDS, assess calls in a consistent and respectful manner.
2. Do our best to get ambulances to patients.
3. Manage ambulances to get patients to the care they need.

Those core items should not be affected by any job action.  Staffing worries on the street and in the dispatch centre may affect response times, but we can’t let the public suffer (not to mention our fellow Brothers and Sisters).  This is about the employer.

AVL

 Automatic Vehicle Location (AVL) hasn’t really changed how EMDs do business much at all.  It confirms most of the closest car decisions we make on a daily basis, but can’t be relied upon to pinpoint the locations of ambulances with 100% accuracy so, at best, it’s a nice toy for the EMDs. 

For the call takers, on the other hand, being able to tell a frantic call taker with even a modicum of accuracy that the ambulance coming for their loved one isn’t far away is a nice monkey off the EMCT’s back.

Supervisory Structure

I would say we finally have a supervisory team in place except one of our Dispatch Officers is leaving.  It’s nice to have some peers to bounce some ideas on or share some concerns with (see the next item).  Meeting a bit more often as a group would help.

Training

Holy crap there are a lot of students buzzing around.  I think we have around 19 EMD students in the centre in various stages of developement – from pupa to butterfly.  In a few short weeks, there will be a bundle of new call taker students following suit. 

I know we are short staffed, but it’s too much, too fast.  The second class of EMDs was too large for us to handle and their practicum time needs to be delayed to finish the first class off.  Who is going to precept the call taker calss?  Can you say burn out?  I can.  Watch – “Burn out”.  See?

… so what am I excited about?

I’m not sure why I am so excited about the room reorganization we have scheduled for later this month.  It seems silly.  I know it’s going to be the same shite, only in a different shape, but I’m all a twitter because of it.  The current format of the room was done without much input from front line staff.  The new layout seems to actually have been thought out rationally.  What a concept.

Hmmm … I Wonder

Do …

… Firemen get called “Fire Truck Drivers”?

… Taxi dispatchers get told to “just send the #$%^*@& Taxi!” without getting an address first?

… normal people phone for an ambulance for an upset stomache?

… pizza delivery companies use their ESP to just ‘know’ what kind of pizza the caller needs?

… ambulance radios not work within a 100 meter radius of the hospital?

… people feel guilt when taking an ambulance to the hospital for a medication renewal?

2010 Winter Olympics

I woke up early the morning they told the world who won the bid for the 2010 Winter Olympics.  Holding my breath, I cheered out loud when the IOC president announced “Vancouver” to the world.  Four years is a long time to be that excited.

We are starting to see movement in BCAS with regard to the 2010 Olympics in Vancouver.  Management is finally hiring the Venue Commanders – a posting that has been unfilled since November of 2007.  A good friend of mine found out today he will be the Commander of the Curling Venue during the Paralympic Games.  We are proud of him.

The upstaffing on the street and in the tower will be dizzying.  Dedicated ambulances and crews at each of the 9 venues (and the 4 Paralympic Games venues a few weeks later) will tap our staffing reserves to say the least.

My goal is to be in a higher level supervisor role before then – possibly still in the dispatch centre, but not necessarily.  I will, however, push to be involved in the games in some capacity.  Communications would be the most obvious choice, but I’m still licensed to practice on patients, so you never know.

Looking into my crystal ball, I see the communications centre being hidden off in a corner behind a broom closet though.  The lack of visibility of the dispatch staff leaves much to be desired.  Too easily sabotaged by nefarious types.  It’s not the invisibility I dislike, it’s that I won’t get to see much of the games and atmosphere while hidden away in the dark reaches of the basement.

Things change and evolve and I’m a bit of a pesimist these days.  Back to work soon.  We’ll see what tide brings.

New CAD … New Challenges

The move to the i/Dispatcher CAD system from the terribly outdated and about to implode Altaris system we were using went off without a hitch in June.  My first shift on the new CAD, a few hours after the move, was smooth and unremarkable.

The Summer, however, was painful.  Our staffing situation was getting worse than ever. At one point, we had 4 radio operators, 1 call taker and me in the room.  Did I mention the normal compliment for that time of day is eleven?  During one 12 hour shift, from a supervisor desk, I posted 97 requests for an ambulance and that doesn’t include the inquiries from partner agencies or complaints from the public.  I felt bad for the single call taker in the room who had it much worse than I did.

September brought a new crop of EMCT recruits.  Now we have a lot of call taker qualified people and a distinct lack of EMD qualified radio operators.  The supervisors sit on a channel for a few hours most mornings, but there is a room full of call taker staff.  The calls get answered very quickly.  It’s the dispatching times that become a thing of interest.

Next up is Automatic Vehicle Location (AVL).  It’s being installed in all the ambulances in our region as I type this and in the beta stages on the test platform.  Will it change the way we do business?  Sure it will.  Will the crews like it?  I leave that to you …

Soon to be heard:

<cue sounds of slots and blackjack>

“Momma needs a new Mobile Data Terminal”

<rolls the dice>

“snake eyes!  you lose”

… I think I’ve found it.

As you can tell from my last post, my heart wasn’t in the job for a little while. Call it what you want – burn out, being disillusioned, or me being a cry baby. The fact of the matter is things are changing.

I decided to do something about my ‘bad attitude’ shortly after you last heard from me. I talked to my manager and got more involved in some of the goings-on in the centre.

We have just finished initial training in the i/Dispatcher CAD product from Intergraph. It will change how we do business in some very profound ways. While it will make some of our easy to do items slightly more difficult, most of our job will get easier. In my opinion, the good far outweighs the ‘bad’. I am helping to train on the new platform.

BC Ambulance service has finally filled the Dispatch Officer positions (sort of an EMD floor manager) that have been vacant for far too long. I managed to win one of the 5 available positions.

Next on my list, I plan to take my renewed interest and put some of it into this blog.

I am sorry for my hiatus.  I’ve taken my fibre and plan to be more regular in the future.

Setting the Scene

In the dispatch centre, I am sometimes hyper-aware of the perception the public has of the ambulance service.  In British Columbia the ambulance service is run separately than the fire service.  Ambulance is a provincial operation while the fire departments are, for the most part, municipally funded.  The fire departments have done an amazing job at PR.  On the other hand, it is often assumed that we are part of St. John’s Ambulance or that we belong to the hospitals.  Neither are correct.

As dispatchers and call takers, we are the first contact with people in need of help.  I have the ability to steer the call in various directions, including into the toilet.  I can set the tone for how the paramedics are treated when they arrive with very little effort on my part.

I stumbled on the following passage from Nathaniel Lord’s blog (full post).  I think I need to create a version for the EMD. 

“This morning, as I was stopped at the intersection of Augusta St. and Church on my way to work, an ambulance approached with sirens and lights from the direction opposite me.  In general I don’t take to much notice of an ambulance besides making sure that I pull out of the way so it can get by, but this morning as the emergency vehicle rushed past I happened to look over and for a minute catch the face of the driver.  The ambulance was driving too fast for me to really be able to see what the driver looked like but it gave me enough time to catch the intense and determined expression upon her face.  I found the expression both profound and beautiful; the urgency and purposefulness of it really hit me in the gut.  I suppose this is the way the ambulance driver has to be; intense and determined; urgent and purposeful.  The vehicle they drive moves with the goal of potentially saving some other persons life.  Time is finite.  My friend Josh, from high school, who is now finishing up Nursing School, was an EMT and an ambulance driver for quite awhile.  He told me once that while he had only been on the scene of a few serious life threatening situations as a driver every call is regarded as a possible moment of mortality.  That is why there are the lights and sirens and that is why other drivers need to get out of the way.  Intense and determined; urgent and purposeful.  And it has to be dangerous, moving so much metal at high speeds on a mission to save life, while swerving through traffic never knowing for certain whether this car or that will get out of the way.  I do not know the statistics but I am sure that every year there are a good number of ambulance accidents.  This is not ironic it is just the reality of the game.  We are a culture of speed and single-mindedness, sometimes we cannot be bothered to be aware of what is around us; sometimes this costs lives.  Yet the EMT behind the wheel of a speeding ambulance knows that in taking the risk another person may have a chance to live.  For this I have a deep respect and gratitude.  I do not know where the ambulance was off to this morning or whether it was an emergency of life and death degree.  I do know the look I saw on the drivers face and should I ever be in a situation of emergency myself I can only hope whoever comes to my aid will be driving with that same expression; intense and determined; urgent and purposeful. ”

I love this description.  The driver is even rightfully described as an EMT (rather than an “ambulance driver”) and the intensity is fantastic. 

In our world, patient care always comes first.  That’s policy number one.  I hope Nathaniel’s obervation from the street is more than an archetypal experience.