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Medical First Response departments provide a vital service in rural Manitoba

Sometimes what appears to be a diligent approach gets in the way of practical service.
Miniota Fire Dept 1
Miniota Fire Department are joined by a number of trained EMR. PHOTO/ANNE DAVISON

To whom it may concern,

This letter is meant to inform you that there is a movement in Manitoba that will result in the disappearance of Emergency Medical Responders (EMRs) who work in Medical First Response Departments (MFRs). They are typically on call volunteers who live in the local community.  EMRs are medically trained personnel who are dispatched to medical emergencies and in most cases are on scene prior to the arrival of an ambulance. The wait time for ambulance in many jurisdictions can be up to 30 minutes. EMRs are typically on scene within 10 minutes.

The newly formed College of Paramedics of Manitoba (CPM) is presently in the process of drastically altering the requirements for EMRs to be eligible to serve on their local MFR departments. Currently, EMRs receive training through a 120-hour course, at a cost of about $1200. This course provides them with the basic skills to attend medical emergency calls. Once serving on an MFR department, they are provided with opportunities to enhance their skill level.  Additional skills, referred to as Reserved Acts, are available to learn. This is a model that has been in place for many years and has been successful in allowing MFR departments to remain viable and sustainable.

The CPM is proposing that EMR status will only be available upon completion of a 360-hour course, at minimum. The cost of that course will be approximately $5000. This is a financial burden that Rural Municipalities may be reluctant to foot, as this would represent a significant increase in their expenses. Upon completion of this course, the entire Scope of Work, or the skill sets that the EMRs will be equipped with, will be taught. This model of teaching everything, the entire scope of work available to EMRs upfront is unnecessary. Some of the Reserved Acts are not necessary to have in some RMs. A more reasonable model would be to teach the core knowledge which would enable EMRs to respond to calls and allow for selected, relevant Reserved Acts to be added on at a later time. 

EMRs are local residents, with families, who work at full time jobs outside the realm of paramedicine. Becoming an EMR is an act of public service. Their wish is to provide their community with a valuable, potentially lifesaving service. Communities where MFR departments exist have become valued and relied upon. Their cost of operations is funded by local RMs and does not pose a financial burden to anyone other than local residents. Volunteer’s dedication and commitment to becoming EMRs and serving their community is admirable. They are paid minimally. They receive remuneration if they attend a call and when they attend a training session. A typical EMR may earn $2,000 - $4,000 a year. They’re not doing it for the money, they’re doing it out of sense of community service.

If the CPM follows through on their quest to increase training requirements from 120 hours to 360 hours, the death of MFR departments is inevitable. No volunteer would be willing to invest 360 hours of training to achieve EMR status. They would be unable to fit 360 hours of training into their busy schedule. Remember, these are people who work full-time and are raising a family. Without the ability to attract recruits, MFR departments will be forced to forge on with existing members. Over time, retirements occur, people move out of the community, the decision is made to step down. Staffing numbers will go in only one direction, down. Eventually, staffing numbers will become so low that sustainability of the department will no longer be possible. As that “death date” approaches, staffing numbers will be very low and the stress and strain, expectations to be available to respond to emergency calls will be crushing. 

My previous profession was that of an educator in the public school system. Entry level to become a practicing teacher was a Bachelor of Education. This required four years of post-secondary education which resulted in becoming a Class 4 teacher. Once working, teachers could avail themselves of continuing educational opportunities. With every subsequent year of university education, their class would increase.  The maximum class level is 7, or a Masters Level of education.  If the CPM continues on their intended path, it would be analogous to only Class 7 teachers being entry level educators.  This would obviously be a ridiculous and unsustainable model.  This is the model that the CPM is proposing, and is equally ridiculous and unsustainable.

To share an analogy given to me by an EMR education provider: if you want to own a Cadillac but can’t afford one, you start off with an entry level sedan. Over time, you work up to your desired Cadillac. The CPM wants their Cadillac now. We can only afford the sedan.

 

The CPM needs to stop, step back and reevaluate. They need to consult with stakeholders, MFR managers, education providers, Shared Health, and come up with a plan that works. This would be a plan that can eventually lead to the ability of EMRs to attain their desired level of competency and in the meantime, be able to serve their community and save lives. They need to be creative in finding a solution; they need to consult with front line workers. They have to abandon their unilateral model of decision making. The College is obviously out of touch with how MFR departments operate and who their members are. If they had listened, if they had asked questions, if they had consulted, they would have known that their proposed plan will fail and only result in the death of MFR departments in Manitoba.

Given the CPM’s current trajectory, the end result is inevitable. What’s to be lost? Every MFR department in Manitoba will eventually cease to exist, due to their inability to attract recruits to fill the vacancies. Residents who call 911 will be forced to wait up to 20 additional minutes, if not longer, for life sustaining, lifesaving assistance to arrive. Unnecessary deaths will surely and inevitably occur. What’s to be gained? Absolutely nothing. In fact, things will become worse. Residents will no longer have access to medical assistance in a timely manner.

If the CPM decides that is prudent to change course, reevaluate, consult with stake holders and come up with a plan that will allow MFR departments to survive, what’s to be lost? Nothing!  What’s to be gained? MFRs will continue to operate and communities will continue to receive lifesaving medical assistance in a timely manner.

The appropriate, logical and ethical plan moving forward is clear.

 

Respectfully, Glenn Reimer

MFR Manager, Headingley Fire Department