Imagine that you or someone you love is desperately ill in Iskut, BC. You call an ambulance, usually stationed an hour away in Dease Lake. This time, the nearest ambulance is in Stewart, almost 400 kilometres away.

Every day in northern BC, understaffed ambulances are being shuffled between communities, at times sitting alongside highways between stations, waiting for calls. In rural and remote areas—like most communities in the North—where the vast majority of ambulance workers are part-time, understaffing has the greatest impact.

The Ambulance Paramedics of British Columbia CUPE local 873 is currently appealing an essential service order that requires staff to continue working during the strike, which began in April. In the meantime, there appears to be little incentive to improve working conditions for local paramedics, who say they are overworked and underpaid. As a result, ambulances sit unmanned “all the time,” says BJ Chute, public education director for Ambulance Paramedics of BC.

“In fact, every day there’s about 20 to 30 ambulances in rural and remote communities that aren’t staffed,” Chute says. “Every single day the ambulance service puts patients’ lives at risk by not adequately staffing our communities.”

Prevalence of part-timers

Out of roughly 3,500 ambulance paramedics throughout the province, more than half are part-time, Chute says. The vast majority of those work outside the major centres, stationed in rural or remote communities, which are most prevalent across the North.
“They’re treated as little more than volunteers,” Chute says about BC Ambulance’s part-time staff.

Critical Condition, a report published by the union almost two years ago, notes that remote communities—those like Hudson Hope, Tumbler Ridge and Chetwynd—are staffed solely by part-time ambulance paramedics. As a result, workforce migration towards busier stations offering full-time employment creates a southward flow of experienced paramedics and the constant challenge to maintain adequate staffing levels in the North.

Jerome Lake, an ambulance paramedic in Dawson Creek, agrees that being a part-time wage earner with BC Ambulance isn’t the glamourous job one might expect. For five years, Lake has been a part-time paramedic there, where the station has only four full-timers out of 20 employees. This year, he finally received his first raise, but isn’t eligible to start receiving paid benefits until next year.

Being on-call at the station—known as the foxtrot shift—earns a part-time paramedic $10 an hour until being called out, when they make a full wage for a minimum three hours. Being the second on-call, a kilo shift, means earning $2 an hour until getting a call, at which time they make a minimum four hours of full pay. Lake’s full pay is a little over $20 an hour.

He estimates he gets called out 60 percent of the time when on call, with up to two or three calls a night.

“To me, it’s a slap in the face. Working with a person who’s making a regular rate and you sit there at the station and get $10 an hour—it’s rude.” Lake says. “Unless you’re willing to wear your pager 24 hours a day, it’s almost impossible to make a living working for BC Ambulance.”

Being on call comes with many sacrifices: Lake pays for restaurant meals when he orders and often takes separate vehicles when eating out with his wife; he remembers when a co-worker was caught in the shower—three times in a row; and on-call staff can’t stray more than a few minutes’ drive from the station.

Response times also suffer with fewer full-time staff. The national benchmark for response times, Chute says, is eight minutes. In BC, it’s nine minutes, although this only applies to metropolitan areas, where it is met about half the time. In rural and remote areas there is a lag in the response time: the on-call person needs to get to the station, get ready and then attend the call. According to Chute, “In rural or remote BC, it’s not unusual to wait over an hour for an ambulance.”

Looking elsewhere

More and more, ambulance workers are finding short-term jobs outside the service to supplement their incomes. This leaves the workers that are left behind stretched even thinner and comes with its own setbacks: Any worker not available for eight shifts a month loses a month’s seniority, pushing back the opportunity to earn benefits or get a raise, Lake says.

Instead, people leave. Chute says there’s the opportunity to earn between 18 and 22 percent more in Alberta. In Dawson Creek, two paramedics left recently for the neighbouring province, where they landed full-time salaried positions with benefits immediately. Or, they head south, to urban centres where full-time jobs are available.
“The only way I can get a full-time position right now is by moving to Vancouver,” Lake says, adding that the last time someone local was hired to fill a full-time position at his station was 17 years ago.

According to Chute, the two biggest complaints within the service are the personal cost of training—which he estimates at up to $20,000 including lost income—combined with the desperately low $2 an hour on-call pay when new paramedics start with the service.

“As far as patient care goes, all the service workers did prior to the strike is essential and is being performed now,” he says. “It’s putting little pressure on the government to negotiate with paramedics.”

While the union appeals the essential service order, in mid-October the government filed another order to make Olympic test events an essential service in order to have them attended by ambulances.
“It’s kind of like somebody in the government woke up this morning and realized they’re going to need paramedics for the Olympics,” Chute says. “I’m sure they’ll deem it essential, but even if it is essential we don’t know where the bodies are going to come from. What’s going to happen to communities like Smithers if all the paramedics are at the Olympics?”

In the meantime, ambulances in the North are increasingly left unstaffed as paramedics “hour out,” completing their maximum number of consecutive on-call hours, or leave for higher-paying full-time jobs in metropolitan areas.

“We’re getting to the point now hopefully the ambulance is manned, but if not, sorry—I’ve done my time,” says Lake, who has been known to spend 27 days straight, almost around the clock, at the mercy of his pager. “We love to help people, but it’s getting to the point where people are looking for alternative work.”

Editor’s note: since the writing of this article, the provincial government passed legislation ordering the ambulance paramedics “back to work,” just days before they were set to vote on a proposed agreement. The paramedics, of course, are deemed an essential service, so their strike had been more or less symbolic anyway. In the meantime, the issues outlined above remain unresolved.