- by Anna Pha
- The Guardian
- Issue #2028
Photo: Highway Patrol Images – flickr.com (CC BY 2.0)
“We are not excelling, we are drowning.” This is the headline of the NSW branch of the Australian Paramedics Association’s (APA) submission to the NSW inquiry into ambulance ramping. The queueing of ambulances at public hospital emergency departments (Eds) for hours on end has a serious impact on paramedics and patients.
In a survey of its members for the NSW inquiry, the APA found that two in three paramedics want to or are considering leaving the profession. Bed block has been identified by many as contributing to burn out. More than eighty per cent reported missing meals on almost every (minimum) twelve-hour shift in the metropolitan areas. It has serious impacts on their mental and physical health as well as being dangerous.
“Paramedics are largely, no longer responding to emergency work. For the most part, they now act as an extension of the Emergency Department. They have no power, no resources, and nothing to provide the patients with comfort,” the submission said.
There are examples of mobile x-rays in parking lots; medical histories being taken, nerve blocks being placed, joints relocated, and catheters being inserted in patients in hallways. Patients are denied dignity and privacy.
“It is demoralising to see a [patient] sit there for over twelve hours even into the next morning when you come in for your second shift and they are sleeping on the floor,” responded one paramedic to the survey.
As ambulances ramp they are unable to attend to emergencies. “The highest priority incidents, 1As, which include heart attacks and patients who cannot breathe, are only getting attended to on time sixty per cent of the time. Bed block is a substantial contributor to those delayed response times,” the APA’s submission said. As a result, lives which might have been saved have been lost.
The following are a few examples of the consequences of bed block cited in APA’s submission:
- A patient with intracranial bleeding after a fall with worsening symptoms waited for several hours in bed block.
- A patient with shortness of breath waited forty minutes for an ambulance response. By the time the ambulance arrived, they were in cardiac arrest and pronounced dead shortly after.
- An elderly patient with a compound tibia-fibula fracture was stuck lying on the floor for three hours waiting for a response and could not receive adequate pain relief, as Intensive Care Paramedics were stuck in bed block.
- A patient who was hit by a car was left waiting for forty-five minutes in the middle of a busy road as Paramedics were delayed due to bed block.
The submission also attributes lack of affordable and accessible community care as contributing to bed block. “Patients are experiencing wait times for GPs of weeks or even months, and as a result Paramedics are acting as “mobile GPs” and are “constantly called to people who can’t get into a GP,” the APA said.
The submission concludes: “A greater state-wide investment is needed to ensure no-one is left waiting for weeks on end for a GP appointment or mental health care. Along with more Extended Care Paramedics, we need more bulkbilling community healthcare centres, state-wide. Twenty-five community healthcare centres [promised by Labor] is a great start, but we need to make sure these resources are not only limited to Sydney. Importantly, community care also means community mental health care that is free and accessible. Communities across NSW deserve the same standard of care.”
Ambulance ramping is not unique to NSW. It is a national affliction requiring urgent attention.