Exclusive: Critical Ambulance Shortage in Montreal and Laval this Weekend

Urgences-santé asking public to only call 911 in life or death situations

By Hal Newman

Already stretched to the breaking point after five waves of the COVID-19 pandemic, ambulance services in Montreal and Laval are facing a critical labour shortage this weekend.

Urgences-santé’s public information officer Stéphane Smith confirms that he will join other members of the management team out on the streets in ambulances. Smith says the organization is using news outlets and social media to ask the public to reserve 911 for life-threatening emergencies, to call 811 for everything else, and if safely possible to use their own transportation to get to the nearest emergency room.

Urgences-santé, which provides ambulance service for Montreal and Laval, will be missing 15 to 20 per cent of its paramedics Saturday and Sunday. And that's before anyone calls in sick before their shifts.

The organization had 63 fewer paramedics than were needed for optimal staffing Friday. That’s enough paramedics to have staffed 31 ambulances. 

Each of the three shifts on both Saturday and Sunday are affected by paramedic shortages. The shortage is so critical, Urgences-santé is offering four hour shifts to paramedics willing to find a partner for these mini-shifts. In addition, paramedics are being asked to consider starting their shifts early or ending them late in order to put more ambulances on the road.

Straight talk from an Urgences-santé dispatcher: "Far too many people call 911 for nothing. How many times do we explain that it doesn't go faster at the ER if you arrive by ambulance but people say ’I'm going to try the same thing again.’ It's frustrating."

Up until this morning, Urgences-santé had been transparent with their ongoing staffing challenges which The Rover has been tracking as part of our The Last Ambulance project. 

The staffing data was shared on a publicly accessible dashboard on their website. However, as of 16H25 this afternoon, all of that data has been removed from the dashboard.

This staffing challenge has been ongoing. Urgences-santé’s staffing model, like almost all ambulance services in Quebec, depends on employees to work overtime hours to fill-in the gaps in the schedule. After two years of the pandemic, the entire team at Urgences-santé and all across the prehospital care sector is mentally and physically exhausted. Add to the mix ongoing labour negotiations and legal strike action taken by paramedics, and the well seems to have run dry.

With the potential for large-scale protests and counter-protests in the city this weekend, the stage is set for one of the metropolis’ emergency services to be operating at far from optimal conditions. There is no cavalry to come riding in over Mount-Royal to save the day. Although the Montreal Fire Service provides first response services, if response delays for ambulances become much longer than normal, the Fire Service will modulate the type of calls they respond to – to ensure their crews can remain in-service for fire and rescue emergencies.

I was asked today how we arrived at this point — where paramedic shortages are a daily occurrence. Paramedic shortages are inexorably linked to a refusal to recognize the true value of paramedics. We don't pay them enough and we don't allow them to have schedules that balance work and life. We don't provide enough mental health support, we don't pay them or even allow them to take time off to get more training. So people get stuck in one gig for their entire career.

And then we wonder why they're burning out and leaving the profession in droves.

A colleague from my days as a paramedic told me they often have shifts when entire sectors of ambulance crews don't have a break for a meal because the contingency plan has been activated. In preserving the system's ability to respond to calls, the paramedics are placed under even more stress than usual.

Last weekend, I heard from colleagues in Montreal and Laval who told me it's common for some lower priority calls to wait four to five hours before an ambulance responds. Imagine waiting four to five hours for an ambulance if you've fallen in the bathroom. Paramedics call the space between the toilet and the bathtub 'the twilight zone' because once someone falls into that space, it's very difficult to move them out of that predicament. 

Even without complications a lower priority emergency situation can still be a painful, embarrassing, awkward, and often very lonely experience.

When did it become acceptable for an ambulance to have a four to five hour response time anywhere in Quebec?