Paramedics in Waterloo region say resources are starting to 'match the demand for our service'

CBC

15-03-2025

It was only a few years ago when paramedics in Waterloo region were sounding the alarm about being overworked and lacking necessary resources to effectively do their jobs, but recently they say there's hope.
At the end of 2022, Waterloo region experienced weekly Code Red events, meaning there were no ambulances available to respond to emergency calls.
This was caused by a variety of factors including being understaffed, long offloading times at hospitals and the overall increase for service demand that was brought on by the COVID-19 pandemic.
John Riches is the chief of Waterloo region's paramedic services. He says things are looking much better.
"In 2022, we were at a bit of a precipice where yes, investments were being made, but the number of Code Zero or Code Red events were still significant," Riches explained.
"What we're seeing now after the year of 2024 and still seeing it now into 2025, is that the number of resources we have are starting to be able to match the demand for our service."
Though Code Reds, now known as Code Zeros, are still happening once in a while, it's nowhere near the severity that it was during the peak of the pandemic.
In 2022, Waterloo region had 210 Code Red events, totalling roughly 76 hours, according to the region's performance measurement indicators update from that year.
A stark difference compared to 2024's year-to-date update released in September, indicating approximately 14 hours were spent in code red.
Riches attributes much of the improving metrics to the Region of Waterloo's council supporting an expansion for paramedic services.
Back in September 2023, it was announced that local paramedic services would receive $4.4 million to hire more staff.
The region also received an additional $1.65 million from the province for a designated offload nurse program.
"During peak deployment, we now have 40 staff resources available on the road and overnight that drops to 20, obviously because call demand drops overnight while people are sleeping."
As a result, emergency response times have also improved.
On average, regional paramedics were responding to calls in 2024 within nine minutes and six seconds. That's 22 seconds faster than 2023, when they were responding within nine minutes and 28 seconds.
"We do sometimes see response times lengthened out in the rural townships because there's a wide geography out there and it takes longer to get the calls," Riches explained.
Hospital offload delays
Although there are still available ambulances, hospital offload delays continue to remain long, though Riches says they're significantly decreasing.
Offload time refers to the period that begins when paramedics arrive at the emergency department and ends when their patient is placed in a bed and care is handed over to ER staff.
As of June 2024, paramedic services had lost an average of 47 hours over a 12 month period due to offload delays. This is equivalent to nearly four, 12-hour ambulance shifts per day.
"I think the biggest change that I've seen in the two years that I've been with the region is that our hospital partners are fully invested and involved at a senior executive level to improve ambulance offload time within the emergency departments," said Riches.
"It's no longer just an emergency department issue to deal with, they're asking the whole hospital to support the work. So that kind of buy-in to addressing the problem has probably been the single biggest thing that has improved ambulance offload times."
Burn out and exhaustion
As working conditions continue to improve for paramedics due to resources becoming more accessible, workers are feeling the benefits as well.
During the pandemic, there were many reports across the country of paramedics feeling burned out and exhausted from the demands of their work.
Now, Riches says there are indications his medics are slowly but surely recovering.
"They work in really challenging circumstances, in unusual situations in which the environment can be unsafe and they do an amazing job everyday," he said.
"I certainly am hearing from paramedics that they're not missing meal breaks … We're also seeing reduced end of shift overtimes, which is also an indicator that we have resource availability so we can get our paramedics off on time."
While those factors show a trend in the right direction, Nick Desclouds says they're not out of the water just yet.
"Mental health is still something that we really have to strongly advocate for," said the President of CUPE Local 5191, the union representing Waterloo region's paramedics.
Desclouds is also a paramedic himself.
"The career is difficult so having ways that we can support each other in the workplace and not having that overwhelming volume every single day we show up to work, it's definitely going to help improve that," he added.
The Region of Waterloo's Paramedic Services has a 10-year master plan that outlines investments within that time period. The current plan expires at the end of 2027.
"Things have changed so much coming out of the pandemic and population growth, which results in an increase of 911 calls," Riches explained.
"We are engaging in a new master plan development and once that master plan gets adopted and approved by council, that would take over for the current master plan and would start in 2026 to 2035."
Within that time frame, the Region of Waterloo plans to open a new hospital located on the University of Waterloo campus. Something Riches says would be a big change in terms of the service paramedics will be able to deliver to residents.