Paramedics fear for their lives
FATIGUE management is a hot topic among NSW ambulance officers, with proposed changes to rosters by the Ambulance Service of NSW sparking concern among Clarence Valley paramedics and their colleagues right around the state.
On Wednesday afternoon about 40 people attended a public meeting in Maclean, one of many to be held over coming weeks, to hear paramedics voice their concerns.
Current rostering has paramedics working five to six days in a row and be on call 24 hours a day throughout that period, and on some days being on the road for up to 19 hours, a paramedic said employees and the community are at risk.
He said the new roster would see paramedics on call 24 hours a day, seven days in a row, with a shift to start and end at midnight.
"The new proposal cuts days off from three to four down to two after working 24 hours for seven days," he said.
"Truck drivers cannot legally do what we do."
"The new roster will do nothing to change or improve the way we currently manage fatigue, and it will do nothing to change the way we operate between the hours of midnight to 8am."
"In my opinion, the rosters are not the problem. The problem is the ambulance service has failed to recognise and support the needs of the community.
"Changing and manipulating rosters won't work; it's a knee jerk reaction to an organisation that failed to identify and act upon increasing demands as it occurred."
He said much of time paramedics was spent on inter-hospital transfers, leading to ambulances being tied up for up to six hours at a time when they should be available on call for the community in emergencies.
He also recalled a number of instances where response times had been affected as a result of ambulances being used as a form of transport where clinical intervention is not required, or likely to be required.
"At any one time there can be one ambulance covering two towns, as the other is on transfers, the same occurs at Grafton.
"When it comes back the other one goes.
"A simple two car accident can cripple the Clarence as there are not enough ambulances to attend as expected.
"This occurs around the clock, the fatigue is enormous.
"The reality is - inter hospital transfers generate more money; we all know it's financially driven."
Paramedics also discussed how the new roster runs the risk of fatigue related accidents and clinical mistakes.
He fears it will be a cost that will ultimately be borne by the community as their one and only ambulance won't be in town, rather driving the north-coast or Gold Coast rendering the community un-covered by an ambulance.
"Significant delays in delivering clinical care will occur and when you do get the paramedic on scene, they will be looking tired from been over-worked, needing a shower to refresh and from that having to think clinically with drug doses and skills requiring attention to detail. Errors are highly probable," he said.
Paramedics were reluctant to speak out publicly because of real belief they would be personally targeted, and one said he had already been at the receiving end of nasty emails and abusive phone calls after raising concerns about fatigue management in January 2011.
"13 months later and I've had enough," he said.
Fellow NSW paramedic Wayne Flynn of Ulladulla was also at the meeting as a representative of the Emergency Medical Service Protection Association, known as EMPSA.
He said the organisation represented about 1400 members or 50% of paramedics in NSW, and the majority of those members were concerned about fatigue issues the affect current and future proposed rostering will affect safety, their families and the community.
"We have identified two major issues; the first being the ambulance control room is not working within policy guidelines and arranging hospital transfers late at night," Mr Flynn said, adding to fatigue issues.
The second is he called 'trolley block', where ambulance officers are kept waiting at the hospital door in non urgent situations, a situation that has become evident in many city hospitals.
Another paramedic said he and other paramedics were essentially gagged from telling the community about working conditions by a media order.
"I've been working as an ambulance officer for 23 years and things don't change. Regardless of how tired you were at the time of a call out, they didn't care.
"The community needs to make enough noise to make policy makers change policy and understand how ambulance covers occurs in their community"
About 40 people attended, including paramedics and their families, Jim Agnew, mayor Richie Williamson and councillor Karen Toms.
Member for Clarence Chris Gulaptis said he had recently been briefed by a senior ambulance officer and it was his understanding that the proposed roster reforms were intended to improve fatigue management.
"I have also had some discussion with ambulance officers in Maclean... I'm happy to meet with any local officers to discuss those matters raised," Mr Gulaptis said.
The Ambulance Service on NSW provided the following response;
"In regional NSW, peak demand period starts in the afternoon and continues into the evening," said a spokesman.
"As a consequence, Ambulance is introducing additional shifts during these peak afternoon/evening periods to ensure more paramedics are rostered on duty and available to respond.
"This approach helps support better patient response and helps minimise staff fatigue.
"On-call paramedics currently face extended work hours due to the high number of call outs, out of hours.
"Current rosters shifts are up to 11 hours, mostly during the day, with evening and night periods covered by on call paramedics.
"We are reducing shifts to mostly eight hours, introducing an afternoon shift which will cover the period up to midnight at stations experiencing high workload.
"Paramedics will work the same number of ordinary hours, but in shorter shifts over an increased number of days.
"The new rosters will provide 3-4 days off in a row compared to 4-6 under the old system.
"The changes follow a recommendation by the Industrial Relations Commission in December 2011 that Ambulance review its rostering and staffing arrangements due to concerns raised by paramedics about safety and fatigue issues.
"WorkCover has also raised concerns relating to fatigue due to the current rostering and after hours transports.
"Ambulance is also currently working with union representatives and paramedics to rewrite its Fatigue Policy to ensure it is current with the proposed rostering system.
"Bullying, harassment and inappropriate workplace conduct are unacceptable, will not be tolerated, and any allegations are taken very seriously by the Ambulance Service of NSW.
"Paramedics have avenues in place to raise any concerns over bullying and harassment. As well, paramedics have access to trained mediators and grievance contact officers to assist in resolving grievances and interpersonal disputes, any bullying or harassment issues."