Ambulance Victoria struggling to fill intensive care ambulance shifts in Geelong
One local paramedic revealed Ambulance Victoria was routinely unable to staff Mobile Intensive Care Ambulance (MICA) units, and said there was often just one unit covering the "huge" region stretching from Werribee to Warrnambool.
The Geelong-region MICA paramedic, who spoke on the condition of anonymity to discuss internal matters, said they knew of eight occasions in May where a local MICA unit was unable to be staffed — known as "dropped shifts".
"It's pretty routine that we're dropping shifts," they said.
The region's MICA resourcing has become so problematic that there is now a documented workflow for staffing the Norlane-based MICA unit with lesser-trained paramedics.
Ambulance Victoria declined to confirm how many dropped shifts had occurred in the region.
MICA specialists are some of the highest-trained paramedics in the state.
To become a MICA specialist, an Ambulance Victoria paramedic needs two years' experience before undertaking a three-year internship, which includes a 12-month diploma.
The wider Geelong region, from Werribee to Warrnambool, is covered by MICA units based at Belmont, Norlane and Leopold, while a unit in Warrnambool — almost 200 kilometres west of Geelong — is included in the Barwon South West region.
"It's all the one team, the Geelong MICA team, and they run a single responder out at Norlane, they run a unit at Belmont — both those run 24 hours — and then the one out at Leopold is 10am till 10pm," the paramedic said.
Ambulance Victoria, however, appears to be consistently struggling to fill those shifts.
The ABC has seen a cache of text messages from Ambulace Victoria calling for paramedics to fill local MICA unit shifts, including 46 messages sent over a 57-day period from late April to mid-June.
The texts are an example of how often the agency is scrambling to fill shifts in Geelong, the paramedic said.
"The messages come out as a last resort, so they've got no spare staff, [no-one] in reserve to work those shifts, so that's sent out to all MICA paramedics," they said.
"We're getting a text message, essentially at 4pm or 3pm and the crews need to work at 5pm, so as you can imagine there's not usually much uptake at that time of day to come in."
Geelong's MICA staffing struggle is the result of a "multitude" of issues, the paramedic said, including staffing shortages, long shifts, burnout, the massive distances covered by the local units, hospital ramping, and the highly-trained paramedics regularly being sent to non-emergency jobs.
"We don't have the pool of staff that we used to have," they said.
"I think employees are also fed up of coming in and putting a band-aid on the solution.
"It puts a lot of pressure on someone when they're the only intensive care paramedic… and putting themselves under undue stress and feeling like they've got to support the whole region constantly.
"It's not just a once off — it's once a week, twice a week.
"We need to fill these shifts. We need to have intensive care paramedics available to the region."
A lack of staffing for the Norlane-based MICA unit has become so frequent Ambulance Victoria now has a documented workflow for manning the vehicle with lesser-trained paramedics.
Emails sent in March by Ambulance Victoria managers in Geelong, seen by the ABC, advise staff of the workflow to utilise the Norlane 24-hour MICA vehicle as an Ambulance Response Unit (ARU), designated AR208.
The workflow includes a list of MICA equipment to be removed from the vehicle, and a list of equipment that can be used instead.
"This is becoming more common due to poor MICA resourcing, and you may have your night shifts changed to fill AR208," one manager's email noted.
Victorian Ambulance Union secretary Danny Hill said the struggle to fill MICA shifts in the region meant "categorically lives are put at risk".
"We have a dual capability model for a reason, Advanced Life Support (ALS) working alongside intensive care (MICA) paramedics," Mr Hill said.
"The model is set up to work that way, and when it is not available — particularly in an area the size of Geelong — it's not sensationalising to say that yes, lives are definitely put at risk by that.
"We regularly hear from our ALS paramedics that they're calling for MICA backup, their patient is quite unwell, they need intensive care backup, and they call for it and they're told there's none available, or they're told they've got to come across from Ballarat or metropolitan west."
Mr Hill said that Geelong's MICA staffing struggle was a result of numerous issues, including local paramedics working long, difficult shifts with little downtime, leading to burnout.
"They're not going to do that if they're burnt out, if they're cooked.
"It is a vicious cycle and we're so far behind the eight-ball it's hard to see us getting back in front of it.
"To us the answer is bringing Ambulance Victoria back to its core role of being an emergency service, and not enough has been done about that in recent years.
"I would say categorically that it is at crisis level, but it's just this state of inertia that we're in at the moment, that we don't seem to be able to break out of."
Ambulance Victoria declined to confirm how many "dropped shifts" had been recorded in the Geelong region this year, nor how many occurred in May.
It also did not respond to the ABC's question of whether it was struggling to fill MICA shifts in the Geelong region.
The agency instead provided a statement from an unnamed spokesperson.
"Ambulance Victoria uses a dynamic operating model to get the right care to the right place at the right time — using tools like shift texts, flexible crewing and cross-regional support to make sure emergency care is available when and where it's needed most," the statement read.
Ambulance Victoria's annual report shows the level of full-time equivalent MICA staff fell to a 10-year low in 2023-24 at 503.4.
It compares to the next lowest of 520.2 in 2014-15, and the highest staffing level of 569.1 in 2018-9.
It is hoped that a record number of MICA trainees will help increase the number of full-time equivalent MICA paramedics.
Ambulance Victoria did not say whether it was concerned by the 10-year low, nor why the drop in staffing levels had occurred.
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