Even as Kingston Health Sciences Centre (KHSC) struggles with staffing shortages, the unions representing paramedics in Kingston are pushing the health-care organization to hire more people and to do so immediately.
On Tuesday, Nov. 1, 2022, the Ontario Public Service Employees Union (OPSEU) and the Canadian Union of Public Employees (CUPE) issued a call for KHSC to “immediately add 180 full-time staff to deal with higher patient volumes from this fall and winter’s COVID-19 wave and pressing flu season.” Should KHSC fail to do so, “patient care will continue to decline, and ambulance offload delays will increase,” CUPE and OPSEU asserted in a press release.
Further, the unions stated that even more staff are needed beyond those 180 new hires – far more. “Just to maintain existing services and curb rising ambulance offload delays, 1,000 more staff need to be hired in 2023,” the unions said.
The unions stated their call for these hires is based on “a modest three per cent COVID-flu surge over the next few months.”
Dave Verch, a registered practical nurse (RPN) and first vice-president of CUPE’s Ontario Council of Hospital Workers (OCHU-CUPE), said, “Failure to staff up immediately and prepare for the influx of patients coming in the next few months will mean the care and staffing challenges KHSC has faced during the last year will deepen. COVID hospitalizations are already increasing rapidly across the province. The hiring of the 180 additional staff needs to happen now to avoid a new COVID-flu season fueled crisis, on top of the existing staffing shortfall that’s created significant patient care challenges in 2022.”
KHSC, the health-care organization which oversees Kingston General Hospital (KGH), Hotel Dieu Hospital (HDH), and the Cancer Centre of Southeastern Ontario, is not alone in its need for more staff, the unions admitted. They stated 47,000 more hospital staff are needed across Ontario “to keep hospital emergency rooms and other units from closing and to decrease the time paramedics spend offloading patients at hospitals.”
Offload times – the time it takes for a patient to be moved from an ambulance into a hospital and fully checked in – seem to be the primary factor in the OPSEU- and CUPE-represented paramedics’ call for additional hospital staff. These wait times mirror those for emergency room/department (ER) admittance, the unions said, noting that under the current provincial government, ER wait times have “consistently spiked,” increasing by 47 per cent across the province in 2021 alone. ER wait times at KHSC hospitals have increased 25 per cent during that time, the unions asserted.
KHSC responded in an email to Kingstonist that the offload times, like ER wait times, are compounded by multiple factors. With hospital beds at capacity, patients in the ER awaiting a bed must wait until another patient is discharged before being moved from ER to an inpatient bed; only then can paramedics offload a patient waiting to be admitted to ER. Add the aforementioned staff shortages at KHSC and at health-care facilities across the province, and everything is slowed down further.
Still, KHSC’s offload times are not among the longest in Ontario, the organization pointed out: “While we have seen an increase in our ambulance off-load times during the pandemic, we currently are able to off-load roughly one-third of patients arriving by ambulance in less than 30 minutes. The remaining patients average an off-load delay of roughly 48 minutes, which places us in the middle of the pack for Ontario hospitals.”
“The factors contributing to growing off-load delays across Ontario are complex, but at KHSC, we continue to work diligently to accept patients arriving by ambulance as quickly as possible.”
KHSC further addressed the unions’ call for additional hires, reiterating that the problem is certainly not unique to Kingston.
“Kingston Health Sciences Centre (KHSC), like all hospitals across the country, has been impacted by the ongoing shortage of health-care workers. This challenge has been further complicated by an ongoing provincial surge of very sick individuals requiring care, which has placed additional strain on the health-care system,” the KHSC email said.
“We continue to work with our staff, physicians, leaders, regional partners, and government representatives to find solutions to these challenges. While we may question the exact numbers provided by the union, we continue to focus on recruitment and retention initiatives and, since January 1, 2022, have hired 881 new staff at KHSC. We will continue to work to bring new individuals onboard and are also implementing a number of human resource strategies with a goal of continually supporting our staff and providing highly-specialized care to our patients,” KHSC continued.
“Recognizing there are likely no short-term solutions to address the shortage of health-care workers in Canada, we encourage anyone who is interested in working in any kind of role in the health-care sector to consider applying for a position with KHSC.”
Indeed, a glance at KHSC’s current advertisements for open positions shows over 140 listings for external career opportunities at its sites, and those jobs posted internally are not available to the general public. And it is not as though KHSC is not trying to fill those vacancies, something Kelly Pender, CAO of Frontenac County, pointed out.
“You just have to look at the Kingston Health Science Centre’s job board,” Pender said. “I’m not speaking for KHSC, but we have the same thing in our long-term care, [and] so does Rideaucrest. They all need bodies — people — to make it happen, to make everything run smoothly.”
Pender has first-hand knowledge of the operations of Frontenac Paramedic Services — which serves all of Frontenac County, the City of Kingston, and areas of Lennox and Addington — as well as Fairmount Home, the long-term care home he referred to above. Rideaucrest Home is operated by the City of Kingston, and all of those entities are having issues filling vacancies, Pender explained.
“With Frontenac Paramedics, we hired a full new 12-hour shift at the start of 2021,” he said, noting that they, too, are experiencing difficulties hiring. “Even our part-time hiring — we used to get over 100 applicants, now we’re getting a handful.”
In fact, for their spring hiring phase, Frontenac Paramedic Services didn’t meet its target, Pender disclosed. “And we’ve got a fall hiring that we’re just finalizing. [With] the raw numbers I’m looking at, it’s going to be difficult to hire.”
“It’s a wonderful profession,” he emphasized, “but like everything in health care, the pandemic has affected attitudes and behaviors, and… there is no quick answer. The next nurse that will solve this problem just started school in September.”
Pender, speaking on behalf of Frontenac Paramedics, detailed the most recent offloading statistics for paramedics locally, admitting frankly that the problems cannot be laid solely at the feet of those who oversee the hospitals.
“I have full confidence in the Kingston Health Sciences Centre staff to be able to make their decisions… Our offload delay issues, it’s not just in Kingston or Ontario, it’s across North America, our whole health-care system,” he said, noting that Frontenac Paramedic Services currently has a plan which includes the recent groundbreaking of a new paramedic base and the aforementioned hiring.
“But every aspect of health care at this point is strained. For us — and I think what [the unions] are getting at in their message — the pinch point is the offload delay, which was [already increasing] prior to the pandemic. The pandemic certainly didn’t help that.”
According to Pender, for the last week of October 2022, the average offload delay for Frontenac Paramedics was about 50 minutes.
“You go in an ambulance and it takes about 50 minutes [to be admitted]… I suppose if you’re a parent there with a four-year-old and it takes 12 hours to get in – which is happening these days – 50 minutes doesn’t sound like a long time, but that’s two paramedics tied up for 50 minutes,” he said.
“And 90 per cent of all of our offload delays are under one hour and 20 minutes… Paramedics in Toronto or Ottawa or some of the bigger regions would see that as being fairly expedited. But for us, it’s part of a long-term trend [that] has been increasing since long before the pandemic.”
Still, for the unions representing the paramedics, the problem of delays for those first responders can only be alleviated by new hires. In 2021, paramedics responded to over 26,500 emergency medical calls in Kingston and Frontenac County. From January to June 2022, there was an 11.89 per cent increase in calls compared to the same period the year before, OPSEU and CUPE stated.
“Actual call volumes have far exceeded projected growth of 4.5 per cent per year, but staffing levels have not kept up with this increased demand for paramedic services,” Shauna Dunn, President of OPSEU/SEFPO 462 which represents area paramedics, said in a statement.