May 24 to 30 marks Paramedic Services Week 2020 in Canada.
This year marks a Paramedic Services Week like none other, the COVID-19 pandemic causing extra stress for paramedics who are already doing a stressful job, always with uncommon efficiency and compassion.
They are often at the very front of the front line, driving quickly yet safely to the homes of patients in distress, assessing, treating and comforting patients long before emergency department nurses and doctors can get to them.
“At the beginning, when the pandemic was first announced, there were quite a few changes that were happening on a daily basis for us, so it was very stressful at the beginning,” said Cathy Marshall, Sault EMS primary care paramedic and acting commander, speaking to SooToday.
“It was a brand new kind of stress that none of us had ever encountered.”
“Everything was changing really rapidly, like policies with the way we do things as paramedics and the way the hospital does things, how they would receive patients. Our medical directives were also changing, on a daily basis sometimes,” Marshall said.
“I would go on my four days off and come back and things would be completely different, so you’re trying to stay current, you’re trying to stay safe, you’re trying not to let all the added stress get to you, so it was overwhelming at times.”
“But, paramedics as a group, all across the world really, have this incredible ability to adapt to constant changes and persevere through stressful situations. We feel very passionate about serving our community,” Marshall said.
“Every week, the list of potential symptoms a patient with COVID could have has been increasing,” said Kevin Mitchell, Sault EMS primary care paramedic.
Classic COVID-19 symptoms are fever, cough and respiratory problems.
“(But now) it’s been hard for us to differentiate. Now it’s sore throat and other symptoms, so it’s adding a lot more potential COVID patients to our pool, so we have to protect ourselves a lot more than we usually would,” Mitchell said.
“Another thing, for me, is I have two daughters and I don’t want them exposed to anything that I might be exposed to, so they've been staying with their mother. I don’t get to see my girls because of the whole unknown surrounding COVID.”
While always mindful of safety precautions, for paramedics, the COVID-19 pandemic has led to a great deal more requirements regarding personal protective equipment (PPE).
Hot, uncomfortable requirements.
“We’ve always encountered viruses in the past so we have our gowns that we wear, and we have our surgical masks, our N95 masks, and our safety glasses as well, but now, any time we encounter a patient we’re wearing a face shield, or safety glasses and mask regardless if they’re screening positive or negative. If they’re screening positive we put the gowns on and our full face shield. The face shields are ‘the big new’ for us,” Marshall said.
“Today (Wednesday, May 27) is a very hot day and we had to wear the gowns they were able to find for us. Our management team is doing an incredible job to keep us safe, but they’re not always able to find our regular protective equipment, and the gowns that we have now are almost plastic, so you can imagine wearing what feels like a garbage bag on your body while doing a call, in a hot apartment or outside in this heat. It’s quite challenging.”
“And, wearing the mask and the face shield creates this ‘barrier.’ I like to get personal with my patients when I talk to them. You sit down beside them, you try to make them comfortable and you calm them down, but now you’re wearing all this gear and I feel like there’s a distance between us now. It’s really hard to hear through the face shield, you’re having to speak louder...it’s a whole different way to do our job but it (the extra gear) is keeping us safe, and our patients safe,” Marshall said.
“With the gown and the face shield, it took a little bit to get used to it, but now the days are getting hotter it’s making it a little bit more uncomfortable,” Mitchell said.
Even worse, donning that extra gear at all times before entering a patient’s residence, paramedics must now go through a time consuming COVID-19 screening questionnaire before approaching a patient in cases where timing is critical.
“Somebody could be really suffering, you can see they’re suffering, but we still have to go through this screening questionnaire to protect them, protect ourselves, to inform the hospital as best we can so they’re ready to treat the patient appropriately too,” Marshall said.
“So we approach the patient, staying two metres away, we go through the questionnaire, and then you screen them positive or negative for COVID-19, and that doesn’t mean they're confirmed positive, it’s just we’re screening that so they go to the most appropriate place at the hospital, and then we go through our regular assessments.”
“Everything takes longer. It’s hotter with all the extra gear on, but it’s to keep everybody safe,” Marshall said.
That process takes an extra couple of minutes.
“That might not seem like a long time until you’re facing someone who's having a really serious medical emergency,” Marshall said.
“It’s awful. It’s awful, having to wait to provide care. It feels awful. As paramedics our job is to help people, to comfort people, and now we have to wait to go through the screening process. It’s an awful feeling for us, to see them suffering and not being able to help right away.”
“It makes it harder because people in this job want to help people, so going to a call, we have to run through the protocol of trying to determine if there’s potential COVID on scene or not, and it’s harder to communicate with the patient because we have the face shield on and the mask, it’s harder to move around, and certainly we want to help people as quick as we can, but we have to protect ourselves first so that we’re healthy enough to help others,” Mitchell said.
Added COVID-19 stress aside, Marshall and Mitchell said Sault EMS paramedics have been receiving a great deal of community appreciation during this difficult time.
“It’s kind of nice to see the community voicing their appreciation. We know not everyone in the community will go through the types of emergencies that others do, so they don’t know everything we do on a daily basis, what we’re capable of and what we’re trained to do. But now, it seems we’re a little bit more in the spotlight as well as other health care workers, and it’s nice to know they appreciate the job we’re doing, the extra things we have to go through during this time,” Marshall said.
Marshall said people have been showing their appreciation through such gestures as dropping off food at the EMS base.
“We love food!” Marshall said.
“It feels good,” Mitchell said.
“We don’t generally do the job for the glory but it is nice right now because we are getting recognized a little bit more than we usually would. There've been a lot of businesses in town who have contributed food and thanks to us. It feels good. Generally we’re with people during their toughest time, the focus on getting them to the hospital and getting them better, so to get that little bit of bit of extra recognition right now is a nice feeling.”
A native of Englehart, Ontario, Marshall graduated from Cambrian College’s two-year paramedic program in Sudbury before moving to the Sault, having served this community as a paramedic since 2002.
Outside of work, Marshall said she loves running, hiking and quilting, helping out at Homespun Treasures and The Quilt House (a Queen Street shop in the downtown core) as well as being involved in her church (Bethel Bible Chapel).
Mitchell, a Sault native and White Pines Collegiate graduate who also went through Cambrian’s paramedic program, first worked as a paramedic in Barrie for a year before moving back to the Sault, where he has lived and worked as a paramedic since 2002.
Mitchell said he enjoys spending time with his family, having also enjoyed vacationing in Europe and the United Kingdom.
“It’s definitely unlike any other Paramedic Services Week because we haven’t been able to do anything publicly, have open houses or mall displays that we’ve done on occasion in the past,” said Robert Rushworth, Sault EMS paramedic services chief, with over 60 paramedics under his command.
“These are exceptional times but we have an exceptional team here and we’re dealing with it well. We will carry on.”