Taking care:

🕔Jan 28, 2008

When Carl Wassink picks up the phone, it can be a matter of life or death…so it’s not surprising his job is not for everybody.
What Wassink does for a living is emotionally, mentally and physically tough, regularly plunking him into the frantic unknown while demanding quick and life-threatening—or life-saving—decisions.
Minutes after answering the phone he may be speeding through a blinding snowstorm to a multi-vehicle accident with an unknown number of casualties. Or he might be chopping through the air in a helicopter on his way to a logging camp a hundred kilometres from nowhere, knowing only that an accident victim is bleeding profusely and needs his help.
Of course, he might also be jumping into an ambulance to transfer his sweet little-old-lady neighbour to the hospital in the community just an hour away, to ensure she gets the medical tests she needs.
But that’s exactly what Wassink loves about being a paramedic.
“It can be anything from one day to the next—literally anything. It’s an exciting profession.”
Wassink has been an emergency medical professional for the BC Ambulance Service for 23 years. He was working as a first aid attendant at the mill in his hometown of Houston when the local ambulance station recruited him.
Now, having worked in various positions in different sized communities all over BC, Wassink is station chief in Terrace, a position he’s held for eight years.
“I didn’t picture it as a career at first,” Wassink says in his soft and calming voice.
But the longer he was on the job, the more he liked it. And the more time he put in, the easier it got, he says. “When you do it for a great number of years, things feel like less of a challenge.”
That’s not to say the job no longer tests him. Every paramedic frequently faces new and difficult challenges. “You’re expected to control some pretty chaotic scenes,” Wassink says.

Job challenges

No matter how experienced a paramedic or how careful he or she is, certain factors can never be contained. These can range from nasty weather, to people under the influence of alcohol or drugs, to the number of patients requiring care. Some situations, such as performing river rescues or attending a patient on a busy street, can be especially dangerous.
And emotionally, Wassink says, “Everybody has their triggers.”
Calls that are often the most stressful are those that involve children or multiple casualties, he says. Many paramedics have children of their own, so when young people are involved the call hits close to home.
But that’s all part of the job. And that’s when a paramedic’s training and experience kicks into gear, Wassink says. Current training programs—which vary from three to 18 months—prepare rookies well by giving them a good idea of what the job entails before they have to commit.
“It’s all about keeping your eyes open and having to see the big picture,” he continues. “You have to remain cool under fire but still be able to take charge when you need to.”
For Wassink—a man whose height would be physically intimidating if his smile and demeanour weren’t so gentle—it’s about focusing on what is required to make the situation better. He is careful not to be overwhelmed by any disturbing, gory or heartbreaking details he must contend with.
“If it’s an injury, I see the treatment. I don’t focus on the bleeding or something that might distract me,” he continues. “The patient always comes first.”
“You have to want to help people. You have to love people. That’s got to be the driving force.”

Black smoke

When asked to relay the story of a particularly memorable call—be it traumatizing, stressful or successful, Wassink draws a blank. “There’s been a lot of calls,” he says simply.
But reflecting on those thousands of rescues, Wassink does mention one element that puts him on edge: black smoke…driving onto the scene of a motor vehicle accident with a fire, and seeing black smoke puffing into the sky.
“I’ve had some pretty intense calls with black smoke,” he says, his mind elsewhere for a moment.
Paramedics work in teams of two and in shifts or on call. In Terrace, the shifts are 11 hours long. One shift can get any number of calls. In the two days before he was interviewed, Wassink said the station received 15 calls on one day and 16 calls on the next.
The job of a BC paramedic is demanding no matter where they are stationed in the province. But for all the physical demands of the work—kneeling, lifting, heaving-and-ho-ing—and the emotional stress it dishes out, being an attendant in northern BC’s more isolated communities is generally considered tougher than having the same job in larger centres such as metro Vancouver.
In the larger centres, traffic is more of a problem. “Driving to a scene can be a challenge. You never know what people are going to do.”
But in rural BC, many more taxing factors come into play.
Recruitment—of both already-trained professionals and community members willing to be trained—poses a major problem.
Full-time work is not guaranteed; even in Terrace, only four out of the station’s 22 paramedics are officially full-time.

Long-distance life-saving

Paramedics plow through nasty winter weather on long and isolated stretches of highway. And the geographic areas served by more remote stations can be huge, upping the hours of driving and lengthening response times.
Not only do Terrace ambulances respond to calls as far away as halfway to Kitimat, Kitwanga, and Prince Rupert, Terrace paramedics also help those communities if any of them need extra help. And in the meantime, Terrace paramedics also respond to all calls from the four villages in the Nass Valley to the north, the farthest being 168 kilometres away.
The Nass Valley used to have a station, but the BC Ambulance Service hasn’t been able to fill the vacant positions there.
The long distances limit the resources available to paramedics. When they are far from their home base, they can’t quickly access extra equipment or people should they be required. Longer response times are a major issue as well. The longer a patient waits for treatment, the greater the risk. In serious cases, that could mean death.
“Obviously, there’s a golden hour,” Wassink says.
But Wassink says it’s all part of the northern lifestyle. “It’s just where you live. You choose to live in the north and you are more rural. There are less amenities.”
On the positive side, he adds, most of the approximately 3,000 calls to his station each year are transfers between medical facilities by ground ambulances. And when it comes to local calls, paramedics are usually at a patient’s side within five minutes.

BC Ambulance Service (BCAS) Fast Facts

BCAS has 191 ambulance stations around the province and employs about 1,100 full-time paramedic and dispatch personnel, 2,200 part-time staff, and 100 management and support personnel.
• The provincial call volume is about 530,000 annually, ranking BCAS as one of the largest ambulance services in North America.
• The urgency call breakdown for 2006/2007 is as follows:
29.1 percent were potentially life-threatening, emergency calls
41.2 percent were not life-threatening, routine calls
29.7 percent were non-emergency, inter-facility transfers
• Service in rural areas is largely provided by part-time staff paramedics trained to the Paramedic 1 level, and who respond to a page issued from the regional dispatch centre.
• In urban areas, such as Terrace, ambulance stations are staffed by a mix of full-time and part-time paramedics.
• In the major metropolitan areas, Advanced Life Support (ALS) paramedic service is available.
• Response times in metropolitan areas are measured against a standard of less than eight minutes for the most urgent calls. Response times in rural areas are predominately determined by the distance traveled to an accident scene.
• BC Ambulance Service provides public ambulance service in BC under the authority of the Emergency Health Services Commission of the provincial Ministry of Health. It provides emergency pre-hospital treatment and transportation by ambulance to the public and visitors to BC.

Source: www.health.gov.bc.ca/bcas