Joan Zimmer is the first community Paramedic in Tumbler Ridge.
Zimmer, who has been with the local paramedic service since 2011, and who took over as Unit Chief last year, is now filling the community Paramedic role as well.
While she was hired in August, she only started the new position officially earlier this month.
Zimmer will be one of two community Paramedics in the community, though a second one hasn’t been hired yet.
The second person will most likely be hired from out of town, says Zimmer, as there are few people in town with the qualifications. “You need to have a PCP IV (Primary Care Paramedic) License to apply,” says Zimmer.
Whoever gets the position will have to commit to the community for three years.
The new role goes a long way to providing stable employment for Zimmer, and bringing stability to the paramedic services, which has been plagued by low staffing levels in recent years.
But Zimmer is hopeful that the two part time positions—one a 0.53 equivalent as community Paramedic and about four hours a week as Unit Chief—along with attending call outs, will provide her with the necessary hours to stay in the position.
In her new position, she will be focusing on a model of health care that includes prevention, health promotion and primary health care collaborating with local Primary Care Teams.
This means community outreach and awareness, helping improve access to health care in the community, promoting healthy lifestyles, doing seminars and CPR or using an AED, conducting wellness clinics and even taking on some of the services to help doctors, nurses and nutritionists to spend more time with their patients. This may include regularly scheduled visits to older patients living with chronic diseases.
And, she says, Community Paramedicine will be bringing another trained paramedic into town, who will most likely also work as an Emergency Paramedic. This will allow the two to alternate week on week off, so BC Emergency Services won’t have to bring in out of town crews as often.
With Community Paramedicine, the shift is towards preventative work. The long term goal is to keep people out of emergency care, freeing up doctors and nurses to deal with the true emergencies.
In the Peace Region, Chetwynd and Hudson Hope will also be receiving the equivalent of one full time employee.
The province has been struggling to justify the expense of full-time paramedic staffing for communities with low call volumes, and the withdrawal of locally-funded training has resulted in a steep decline in the number of paramedic applicants for rural communities, leading to critical staffing shortages across the province. This leaves many communities facing long periods of time with reduced or no ambulance service.
Community Paramedicine kills two proverbial birds with one stone. It provides gainful employment for Paramedics, allowing them to use their training and expertise, while reducing demand on the emergency system. It keeps the cost down, frees up the ambulance, and offers better care for the patient, bringing the care to them, rather than bringing the patient to the care.
It’s not a new idea. Community Paramedic programs have been rolled out in the US, UK and Australia, and are even making their way into other provinces like Ontario and Alberta. The shift in thinking is more towards preventative health care.
CALL HER CHIEF
In addition, Zimmer will be working as Unit Chief.
Her main focus right now, she says is to recruit and train new people. “In remote communities like Tumbler Ridge, it is really hard because you don’t get a lot of calls as a kilo car; it’s got to be a job for a second income family or for young people starting off on a career, for someone who is able to pick up and leave from work, or even for housewives at home with nothing to do. It’s a good side job for some extra income.”
Zimmer says the biggest change in taking over as Unit Chief is the administration side of things. “I’m learning it bit by bit, but there is so much to know. Telecommunications, for instance. I have to do a report on all the communications items we have in the car and in the station and get all the serial numbers… And I’m learning it on my own. There’s a big binder called the New Unit Chief.”
She stops, and changes her mind. “Well, being here, it can feel a bit secluded, but you’re not alone. I can call HR in Prince George, or can talk to other Unit Chiefs. We have month to month meetings and all the Unit Chiefs just got together in person. It was really good to meet everyone. I had the chance to meet Dispatch, HR, Superintendents and learn their roles. I learned how metro Vancouver works compared to Northern BC compared to the Okanagan. It’s really get to see how you all work together.”
Just a few months ago, the paramedic service in Tumbler Ridge was nearly non-existent. In addition to then Unit Chief Krakowka and Zimmer, there was only two other part-time Paramedics. Ambulances from Chetwynd and Dawson Creek were frequently in town doing cross coverage.
The Tumbler Ridge Ambulance station is what is known as a kilo station. This means that the Paramedics are only paid when they have an actual call-out. The rest of the time, they are paid $2/hour when they are on-call and carrying a pager. Paramedics on a kilo shift need to be able to respond to a call within 15 minutes. That means not being able to go out of town, and staying in their BC ambulance uniform, or at least, having it with them at all times. At busier kilo stations, Paramedics can make more money carrying a pager than a full-time employee, as each call out generates a minimum of four hours of pay.
However, in Tumbler Ridge, there are relatively few call outs. This makes it difficult for people to make a living as a paramedic, especially in a station with a low volume of calls. A person would need to work a second job to make a go of it, which has in the past proved problematic, as it can be draining to work full-time then cover an ambulance shift.
And, the low call volume makes it hard for new Paramedics to get fully trained. Recently, the ambulance service hired four new people. They are currently being trained, says Zimmer, which is building their confidence and experience to get them to the point so they can go out on their own, but it is slow going.
And while the majority of call outs are simple things like transferring patients to the hospital in Dawson Creek, she admits there are some drawbacks to working as an Emergency Paramedic in a small town. “The hard part is when you know someone and their family and you get a call. But if they make it through, it’s rewarding when they pull through, knowing you had a part to play.”
Because the station has such a low call volume, Zimmer is planning on doing more training with her young staff. She’s also encouraging them to go out of town and ride along with ambulances in bigger centres like Dawson Creek and Fort St. John. “We need to keep up our skills. We’ll be more active in doing that. We’ll also be more active in the community. You’ll see us a lot more.
She’s also hoping to teach more people basic lifesaving techniques. “The more people know how to do CPR, the better chance there is to save lives. The first person on scene is not usually us, and if that person knows first aid, knows CPR, they can keep the person alive. The other night a couple boys came across an incident and they didn’t know what to do, and the one boy decided to call 911 and it saved a person’s life. Sometimes it’s as simple as that.”
Over the last few years, the types of callouts have shifted. Even in Tumbler Ridge, she says, there has been an increase in the number of overdose calls.
Otherwise, she says, it’s hard to point at trends in Tumbler Ridge because there are so few call outs. “It’s seasonal,” she says. “It depends on time of year and weather. In summer, we see more falls, trampoline injuries. The more active people get, that’s when we see more incidents. As well as with the pollen, the wasps, we see more respiratory incidents. We didn’t see a lot of calls in winter, because people don’t leave their house as much in winter, but as soon as it gets nice, people start doing more stuff.
“I’d like to see even more Paramedics available here, but historically it’s been hard to recruit and retain,” says Zimmer. “We’ve doubled the number of Paramedics from last year, so that’s a good thing. The young people are very excited to work for us, because it’s a rewarding job. People like to serve, and this is just another way to give back to the community. It brings a sense of value to the community; it’s a privilege to have people let you into their homes when they’re at their worst.”