Moose Jaw’s Community Paramedicine team fills the role of boots-on-the-ground primary healthcare for the city’s most difficult-to-access populations, but significant challenges remain for them to be recognized for the expert medical services they provide.
May 19 to 25 is National Paramedic Services Week, observed in Saskatchewan as a time to recognize the work of the more than 2,200 licensed paramedicine professionals in the province. They respond to more than 181,000 calls each year.
“We still run into the perception that we are just ambulance drivers,” explained Angela Sereda.
Sereda is the visionary who saw an opportunity for community paramedics in Moose Jaw. Along with fellow Moose Jaw paramedic Cari Evenson-Carlton, she was in the first intake of the program in Saskatchewan.
“It took about 18 months to finish school, and then, it was a new concept for Saskatchewan, so we were just having some public engagement conversations about this program,” Sereda said.
After Michael Seiferling at the Saskatchewan Health Authority heard about the program, he approached Sereda to co-ordinate a pilot. The SHA funded eight hours a day during the project, and then Sereda and her husband Kyle, who at the time were the co-owners of Moose Jaw Emergency Medical Services, put up the money for the remaining four hours of a standard shift.
“It took us a good, I want to say nine months of community engagement before we even started the program and offering services. So, we really laid the foundation and the groundwork with a lot of community partners.
“We officially launched on April 11 of 2021 and it was only myself. ... I worked every day for three months straight, really just trying to create that proof of concept.”
Moose Jaw paramedics are now under the umbrella of Medavie Health Services West. Sereda said that Medavie’s more-established community paramedicine program in Canada’s East Coast provinces has been a big help as Saskatchewan builds its program.
What are paramedics qualified for and capable of?
The levels of paramedicine are integrated upward, with each qualification building on the previous one. They include Primary Care, Intermediate Care, Advanced Care, Critical Care, and Community Paramedicine.
The profession is protected, so only practitioners who have been qualified and licensed at each of these levels by the Saskatchewan College of Paramedics can refer to themselves as Advanced Care Paramedics, Community Paramedics, or any of the others.
Each of the Moose Jaw team members, including Evenson-Carlton, Jim Madden, Shantel Molnar, and Braelyn Kirstein, are Advanced Care qualified, and have been on the frontline for decades.
Each of these paramedics are capable of all kinds of routine, emergency, and critical healthcare. Their experience varies constantly, and they are highly mobile. From chronic conditions to emergency scene control, from birth to death, from the emergency room to home care, health education in classrooms, and treating potentially dangerous clients directly in police cells — they are capable of life-or-death calls, diagnoses, and more.
“Yes, really, Community Paramedicine is primary healthcare, but it is a change of practice from decades of how healthcare has been delivered,” Sereda said. “There’s still a lot of individuals that don’t necessarily view paramedicine as part of a solution to the healthcare system.
“They view it as, ‘someone calls 911, we’re going to send and ambulance and they’ll just drive them to the hospital, where they’ll actually get care.’ But when you call 911, the emergency department is actually coming to your door at that moment.”
What does a Moose Jaw Community Paramedic do?
Cari Evenson-Carlton opened the trunk of her Community Paramedicine SUV to show the equipment and supplies they carry, and to explain the scope of practice she is capable of. Although the ambulance trucks have more equipment, she still has almost everything necessary to show up to emergency scenes and provide life-saving critical care.
“We have oral medications, equipment to take vital signs, lots of wound care supplies... This kit here is more if we have to respond to an emergency call, so intubation and airway equipment. IV supplies, oxygen, here we have a Lifepak 15 if we need an ECG or to defibrillate or shock someone.
“We also have an IV pump for those times we need to deliver medication in a controlled way, or in-house therapy for fluid resuscitation. ... One thing we have that the ambulances don’t is an IV pole that can be taken into people’s houses for homecare. ... Oh, and this fancy vein viewer, for if someone has really difficult veins or is really dehydrated or something.”
When the Community Paramedic pilot program was ongoing, the team was also helping at long-term care facilities, working with primary healthcare, and with homecare support programs.
“Unfortunately, when the pilot project ended, there was no funding support to provide services to long-term care and primary healthcare,” Sereda explained. “Our only funding source at that point was through Mental Health and Addictions. So, that's currently where our focus is now.”
That focus includes regular weekly clinics at the places where residents struggling with mental health and addiction crises congregate. Evenson-Carlton and Madden also engage with clients in their homes; they visit the Moose Jaw Police Service (MJPS) cells regularly; they are very familiar with the staff at community-based organizations such as John Howard and the Wakamow Manor Detox facility; and, of course, they co-operate closely with staff at the Dr. F.H. Wigmore Regional Hospital.
As Jennifer Robinson continues walking her own path to recovering from a substance abuse disorder, she volunteers much of her time to helping others with their recovery. She said that of all the programs and supports in Moose Jaw, having Evenson-Carlton and Madden on her side made the difference.
“It was the Community Paramedics that got me into my first treatment centre,” she said. “They came and got me from the police station and brought me to the treatment centre, and they helped me see there were people who actually cared.
“They have set up a system where ... they build relationships and get to know who (their clients) actually are. ... I’ve brought a few people down to see them and they offer services like changing bandages and things like that.”
Cari Evenson-Carlton at Zion United Church with Jennifer Robinson (photo by Gordon Edgar)What is the program’s worth to the system as a whole?
By treating wounds, chronic conditions, and the side effects of addiction on the street, regularly, Sereda explained, the program saves space, staff hours, and equipment costs at the hospital — to say nothing of the current shortage of family doctors and walk-in clinics.
“There is a significant amount of value, when we’re looking at long-term care,” Sereda said, “to prevent that ambulance transport to the hospital.
“The (number) of vacancies that are within our healthcare services right now, in all levels, but especially frontline, are significant. So, we’re not coming in to replace those services, we’re coming in to augment some of them. ... Plus, it’s patient centered.
“The amount of times that individuals go up (to the emergency department) and have to wait for services, because again, the need is just so great ... if there was another means to meet people where they’re at, to provide that support ... I think that’s the value that community paramedicine adds.”
Stay tuned for the Discover Moose Jaw News Podcast of our ride-along with Cari Evenson-Carlton
Sat, Jul 27, 8:00 AM
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