Staffing and Workload Crisis Update

Re:      Staffing and Workload Crisis Update
Vancouver Coastal and Fraser areas BCEHS Book-offs Memorandum


Last evening, I received a “heads up” that BCEHS Director Mr. Lucas Hawkes-Frost and I/Director James Towle would be co-authoring a memorandum to all staff who work in Coastal and Fraser Districts. []

I immediately communicated our concerns to senior leadership that although we appreciated the heads up, I requested they reconsider sending it out as, in our view, it would not be received well by our members. Sadly, our feedback and request fell on deaf ears and the memo was issued. 

In summary my comments were:

I appreciate the heads up for sure. I want you to know this will likely not be received well, it is the same message members have been hearing from the Region 2 leadership for some time, essentially blaming people booking off is how it is received. It is the message I heard relayed from the region’s leadership through Paul V on the weekend when we were experiencing significant OOS and workload issues on Halloween Night.

The main reason I say it will not be received well is there is no acknowledgement about how much they are working their b####s off with no real support or even acknowledgement from Management about the crisis. The fatigue and stress levels are through the roof, this is a symptom of a serious crisis and a system that is broken.  

Paramedics and dispatchers are fatigued, stressed, sick and cannot sustain the workloads and pressure. They want to know what “a responsible” employer is going to do to address the staffing and workload crisis, not put more administrative processes in place, or putting more workload on frontline supervisors that has the potential for conflict and pressuring or deterring members from booking off when they are ill.

I appreciate you are just relaying this message as FYI, so I hope you understand how difficult it is for the staff and members and the pressure we are under as their advocates. Please ask them to reconsider sending a memo out in this manner, and instead focus on communicating true actionable solutions to address the staffing and workload crisis.  

It’s clear from research and our position paper [] that the consequences of this staffing and workload crisis is, and was, predictable. It’s not a sustainable workload; the pandemic has just brought it forward and into the light. We beseech the employer to review and immediately implement a meaningful plan to address short, medium and long-term solutions and outcomes that truly incorporate the CSA standards for a healthy workplace []. 

To inspire confidence and build employee and public trust we need to hear and see BCEHS’s long term plan and solutions to these issues, as opposed to imposing more pressure and negativity. This memorandum approach is fundamentally flawed and quite honestly sad. It sends a message of how out of touch some managers are; and that the employers only ability to address fatigue, through-the-roof utilization rates and stress levels is to implement a system that will terrify its members to avoid calling in sick. This move will come across punitive and threatening. There is no acknowledgment of employee’s stress and fatigue. They have managed to adopt an administrative system that will instill fear and anxiety, further exacerbating the issues, yet never addressing the root causes hence further impacting systemic failure. 

With this memorandum the employer missed another opportunity to recognize our paramedics and dispatchers and build trust to construct something positive. Imagine actually building our members up, showing them how proud we are of them, making them proud to be a part of this organization. Some very real quotes I feel I need to share with you: 

What a crappy move BCEHS, not only for the front-line staff but also for the supervisors having to manage this. You think morale is low now, just wait. People are only going to see this as the Employer trying to bully their employees into not booking off. 

This is another example of a completely Tone Deaf “leader” within BCEHS shifting blame, suspicion, and a subtle threat onto the employees… where we now need to “prove” sickness and fatigue to another frontline supervisor. 

It’s not surprising that a junior manager with very little experience within our ranks doesn’t realize that this has been tried and failed and spurred the PEARL system to begin with. 

Well that is just what the OCUCs need another 20-30 phone calls per shift… on top of the 100-120 phone calls they dial out and receive every shift.  Fantastic. 

Although it’s true staff shortages and workload issues among ambulance paramedics and dispatchers have been problems for years, this year has exposed them exponentially and made a bad situation even worse.

There are communities who have more than 50 vacant paramedic shifts each for the month of October and November.

These resonate with me:

Kristi is a Paramedic who works in the rural community of Haida Gwaii: “Since September 3, I have been on shift every day and will do this until October 16 to ensure that my community has coverage. This is not sustainable.” 

Shane is a PCP in Surrey: “The global pandemic and escalating overdose crisis have made call volumes overwhelming, with the workload being the highest it’s ever been. When we arrive on shift, the first question we ask one another is: ‘How many ambulances will stay parked today.’” 


The staffing shortage can primarily be attributed to:

BC’s on-call model makes recruitment & retention difficult

Seventy-five per cent of British Columbia relies on an on-call service model, meaning ambulance paramedics are not employed full time, nor receive meaningful compensation. They get paid $2 per hour during an on-call shift with the hourly wage increasing only if they tend to an emergency or transfer a patient between health facilities. APBC says this makes recruitment and retention of paramedics difficult. Although we have significant staffing shortages in urban and metropolitan areas, there is a critical shortage in rural, remote and indigenous communities; and this on-call model that serves most of BC absolutely needs to change if we want to retain staff and recruit new paramedics. These paramedics cannot support their families on this model, so they choose to move on to other professions. 

Unprecedented call volumes & workload 

Recruitment, retention and failing to keep pace with call volumes and resource demands, coupled with the global pandemic and escalating overdose crisis, have made call volumes overwhelming with the workload being the highest it’s ever been. Paramedics and medical dispatchers are having to do forced overtime to cover shifts, and frequently they work their entire shift going to back-to-back emergencies without a break or downtime, often including extended tour of duty resulting in not getting off at the end of their shifts…. only to do it all over again.  

Physical, mental, and emotional demands

We know being a paramedic requires resilience, physical, mental and emotional strength, all of which test our resolve. We know being a paramedic is an extremely rewarding career, but it’s not a secret that it’s a challenging job, one in which we provide critical emergency medical aid and transport to hospitals – at times under extreme stress – and that takes a physical, mental and human toll on us. This can lead to burnout, mental health issues, physical injuries and leave from work – something which has increased in recent months, with leaves becoming longer. 

xxx is a paramedic and this has “meaning” for him because he always wanted to help people. In his role he has seen the impact of stress and burnout. “A paramedic whom I had mentored attempted suicide by cutting her throat with a box cutter in the parking garage of xxx Hospital. She thought by doing this at the hospital, she would spare her family from finding her, as well as spare her colleagues from managing the situation. Thankfully, her attempt was unsuccessful.”  

As your union president I feel a great burden of responsibility and duty to address and advocate for these issues and take them very seriously, APBC will do whatever it takes to ensure accountability and to address these problems. There is no more critical or important issue we face as a service and profession than addressing our staffing, workload, recruitment, retention, supervision and system issues. Our well-being and sustainability are dependent on it. 

Notwithstanding all the above, we remain unconditionally committed and have solutions to rebuild our service to be world renowned and restore paramedics and dispatchers trust and confidence in the organization.  We have solutions that include: 

  • Directing sufficient resources towards paramedicine in communities, which will ultimately lead to better recruitment and retention levels
  • Changing the on-call model 
  • Expanding the Community Paramedicine Program to urban and metropolitan areas. 

On behalf of your Ambulance Paramedics and Dispatchers of BC Executive Board and leadership, I personally want to thank each and every one of you for all your humanity, the sacrifices and personal impacts this profession and job takes on each of you and your families.

Be safe and kind,


Troy Clifford
Provincial President
Ambulance Paramedics & Emergency Dispatchers of BC
CUPE Local 873


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