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Privilege in Paramedicine

At a glance it may be difficult to see how the life of a Paramedic is one of privilege. Between shift-work, long hours, high stress workspaces, ever changing practice expectations, and remuneration vs. cost of living concerns; being a Paramedic isn’t exactly an occupation that will land you on “Lifestyles of the Rich & Famous.” Statistics regarding work related stress injuries for paramedics are frightening, with suicide data in particular a major cause for concern. Even those of us who retire “healthy” are more likely to suffer from heart disease than the general public. One might ask “What is this Privilege you speak of?”

 

A paramedic’s greatest privilege is trust. Paramedics (alongside firefighters, nurses, and physicians) consistently rank highly as one of the most trusted occupations in Canada. In Australia Paramedics are the most trusted occupation a number of years over. On what may be the worst day of a patient’s entire life; not only do they allow paramedics into their homes, they specifically ask paramedics to lead them through whatever crisis has occurred. Patient’s invite a complete stranger (a paramedic) to take control of their personal crisis out of trust and respect for that strangers occupation alone. This public trust extends through all levels of paramedicine, ranging from the Primary Care Paramedic responding to a simple diabetic call to the Critical Care Paramedic initiating ICU care on behalf of a rural sending facility.

 

With the consistent high degree of trust placed upon paramedics by both the public & other health professionals, it seems unfathomable that paramedics would fail to trust themselves; yet evidence would suggest paramedics do not trust themselves (at least in Canada that is). If paramedics trusted their own judgement as completely as the public seems to, British Columbia would have its own College of Paramedics. A profession that trusts itself has the knowledge, confidence, and maturity to regulate itself for the protection of the public. A profession that trusts itself seeks to build upon the body of knowledge that makes it a unique entity through research and education.

 

It’s time Paramedicine learned to trust itself. It’s time Paramedics extended their profession the same privilege the public has deemed them worthy of.

 

Paramedic Self-Regulation: Its Importance and The Big Picture of The Paramedic Profession

Paramedic Association of Manatoba Self Regulation FAQ

BCPA President’s Message [November 2018]

President’s Message [November 2018]

Welcome to the British Columbia Paramedic Association. After over 44 years of paramedic practice in the province of BC, the time has finally arrived for paramedics to take control of their own profession. Professional Leadership, Clinical Practice Excellence, Higher Education, and Paramedic Research will form the basis of this non-partisan advocacy group. I’m proud to be a member of one of the most passionate, patient focused, professions in healthcare. I’m more proud to play a role in giving paramedics the voice of professional advocacy they have historically been without.

Moving forward members can expect the BCPA to advocate for improved education (for new and existing practitioners), improved clinical practice, paramedic practice research, and a self-regulated professional college. As part of this plan, members can expect to see EMALB approved continuing education material, future symposiums focused on clinical practice, advanced education program development advocacy, and paramedic driven research. None of this can happen without membership support. At this critical start-up phase I implore every member to take on as active a membership role as possible. The BCPA board will be seeking educational content creators, advisory board members in all areas of practice, research coordinators, and governance experts. The success of the association relies on the participation of the membership.

Paramedics spend their entire careers caring for the needs of others. It’s time to continue the exceptional care paramedics provide their patients by caring for the needs of the paramedic profession.

Welcome aboard everyone,

Ed Peters

 

BCPA Organisational Structure and Director Roles

Following the most recent board meeting, the board has finalized the board positions moving forward and adjusted for some of the various expertise of the volunteer directors.

In the very near future we will be releasing application for committee members.  Committees are open to membership that qualify for and hold  “BC Paramedic – Full Membership”.

Organisational Chart

Association President

Executive Director

Vice President & Director, Communications

Registrar & Secretary

Treasurer & Director at Large

Director, Policy & Governance

Director, Research Programs

Director, Education

Director, Clinical Practice

Director, Conferences & International Liaison

 

 

 

 

Leading on the edge: The nature of paramedic leadership at the front line of care

“Leading on the edge: The nature of paramedic leadership at the front line of care”

Few research articles look closely at leadership in Paramedicine specifically. This is one of the few and it just happened to originate right here in Canada!

BCPA Welcomes Dr. Philip Yoon as an Advisor to the Board

The British Columbia Paramedic Association would like to welcome Dr. Philip Yoon as an appointed volunteer advisor to the board.  Dr. Yoon has a long standing involvement with Paramedicine in Canada and has established expertise in the areas of professional licensing, clinical medical practice and as a clinical professor of medicine.  With these areas of expertise Dr. Yoon will be advising the board on matters pertaining to licensing, clinical practice, medical education and clinical research.

An advisor position with BCPA is a non-voting position extended by invitation to persons that support paramedicine in BC and have detailed areas of expertise, that can provide substantial input and advise for paramedic professional development. Those selected as advisors have a deep and active interest in the development of the paramedic profession in the interest of optimal patient care and patient safety.

About Dr. Yoon:

Philip Yoon, MD, MBA, CCFP(EM), FCFP

Dr. Yoon works as a staff emergency physician at the Royal Columbian and Eagle Ridge Hospitals and is a Clinical Professor within the Department of Emergency Medicine at the University of British Columbia. He moved to British Columbia in 2012 from Nova Scotia where he was a Professor in the Faculty of Medicine at Dalhousie University and the District Chief / Department Head of Emergency Medicine.

Prior to his move to the Maritimes in 2009, Dr. Yoon completed all of his medical training at the University of Alberta and was an academic emergency physician based at the University of Alberta Hospital for 13 years. He also served as the Associate Medical Director of Special Operations for Edmonton EMS. Throughout his medical career, Dr. Yoon has remained involved in emergency medicine/EMS operations, administration, education, and research.  Additionally, he has maintained membership in the National Association of EMS Physicians (NAEMSP) since 2006.

He is also a Navy Reserve Medical Officer in the Canadian Armed Forces. Since February 2013, Phil has held the position of Medical Director of the EMS Physician Online Support (EPOS) service with the British Columbia Emergency Health Services (BCEHS). Dr. Yoon has been a EMALB member since November 8, 2012.

Development of Active Leadership in Paramedic Practice

What does it mean to be a reluctant leader? Vocabulary.com would describe the word reluctant as “disinclined,” or “unwilling to do something contrary to your custom.” (Vocabulary.com) The same site would define a leader as “a person who rules or guides or inspires others.” (Vocabulary.com, leader) By extension, a reluctant leader is someone who guides or inspires others while being reluctant to do so. As a ten year paramedic the definition of a reluctant leader strikes closer to home than I care to admit.

As paramedics our first samples of true leadership often come minutes to hours after the commencement of our first shift as a licensed/registered paramedic. The safety net of our veteran preceptors has fallen away and we are left to our own madness as thoughts of what our first independent call may be swirl through our fertile imaginations. Will it be a big trauma? Will someone’s mother, father, brother experience a cardiac arrest? Imaginations wander fervently until the phone finally rings or the tones drop. What was your first call?

Every paramedic, no matter their license level, remembers their first independent call. For some it was a simple lift assist; for another it might have been their first opportunity to help bring life into the world. No matter what the call was, it was that paramedic’s first chance to lead another person (the patient) through a trial that exceeded said person’s ability to cope. In that moment a reluctant leader was born. In that moment a paramedic was born.

From the Australasian Journal of Paramedicine, “Three factors: ‘wanting to help people’, ‘exciting career’ and ‘saving lives’, emerged as the most important motivating factors for participants’ to pursue a paramedic career.” (Ross, Hannah, & Van Huizen, 2016) Isn’t it interesting how none of the identified factors included a desire to lead, yet every patient care episode a paramedic participates in involves leading a patient through a trying episode of some variety. Leadership is thrust upon paramedics by the nature of the work. It’s time for paramedics to own the very nature of their role within the healthcare system. It’s time paramedics found comfort in knowing their role is to provide leadership when patients or other health providers have lost control.

How does one transition from the role of reluctant leader to active leader? One definition of active leadership states that, “Active leadership seeks to involve staff in the challenges facing the group and gives them a role in solving those challenges.” (Albers, 2016)  Paramedics can become active leaders by engaging each other as agents of change for their own future. By becoming active leaders, paramedics take ownership of their profession in ways not previously afforded them. Formation of the BC Paramedic Association is one form of active leadership. As active leaders the BCPA will be seek the assistance of all paramedics in facing the challenges before the profession as it continues to grow and develop.

Moving forward the BCPA will ask paramedics to provide Professional Leadership in the areas of Clinical Practice Excellence, Higher Education, and Paramedic Research. Leadership in these areas does not have to come through direct committee involvement. Participation in study data collection, precepting, interdisciplinary communication, and following evidence based standards of practice, are all areas every paramedic can actively display the leadership qualities necessity has breed into the profession.

 

Bibliography

Albers, J. (2016, 02 22). Active vs Passive Leadership. Retrieved 11 07, 2018, from linkedin.com: https://www.linkedin.com/pulse/active-vs-passive-leadership-james-albers

Ross, L., Hannah, J., & Van Huizen, P. (2016). What motivates students to pursue a career in paramedicine. Australasian Journal of Paramedicine, 13(1), 01 to 07.

Vocabulary.com. (n.d.). leader. Retrieved 11 07, 2018, from Vocabulary.com: https://www.vocabulary.com/dictionary/leader

Vocabulary.com. (n.d.). Reluctant. Retrieved 11 07, 2018, from Vocabulary.com: https://www.vocabulary.com/dictionary/reluctant

BCPA Research Agenda – Why the BCPA?

How does one become a researcher? Or, more importantly, a paramedic researcher? How many paramedics consider themselves a reasercher? Do paramedics contribute to their own unique body of knowledge to enhance patient care and safety, in the specific work environments of pre-hospital, out-of-hospital care and transport medicine? Do paramedics as practitioners translate knowledge to their practice as a result of paramedic led research?

These are all questions that drive the board of directors of the British Columbia Paramedic Association. But, before we look at these questions, let’s first consider why a paramedic association?

There are varied types of representation or regulatory bodies for paramedics in Canada and BC. There are labour unions, licensing boards, employers, and in some provinces self-regulatory bodies know as professional colleges, or a College of Paramedics.

A professional association is meant to be an independent entity, in our case, a corporate (not-for-profit) society under Societies BC. An association’s focus, should be on representing the profession of paramedicine. We do not represent paramedics to an employer for the purposes of wages or working condition, and we should not have conflicts of interest or bias for any one employer. Those interests belong to other representatives. An association should be focused on outcomes that protect and enhance the care to those we serve.

The purpose of an association is to ensure optimal patient care and safety to the patients we serve in our unique work environment, with our unique scope of medical practice, through development of the profession and paramedic professionals, regardless of their employer.

In British Columbia Paramedics carry out many different roles and although the largest employer is BCEHS, there are paramedics that work for the Canadian Military, Search and Rescue Agencies, Ski Patrol, Private Emergency Providers, Hospitals, Corrections Services and Public Health Agencies. Our interest is in how paramedics as a profession can best serve patients through development of our unique body of knowledge, in the environment with which we work, and methods that we use to deliver care to those in need.

The British Columbia Paramedic Association as an initial act by the board has adopted the pillars of professionalism for our association. These are: Professional Leadership, Clinical Practice Excellence, Higher Education, and Paramedic Research. All of these are key elements to professional accountability and ultimately professions with self-regulation. We will explore the associations values and goals in these areas in future articles.

So, let us explore the research agenda a little bit more.

How does one become a researcher or paramedic researcher? There are several types of researchers. The main thing that researchers have in common is development through university academic programs. Some researchers are post-graduate students, some are practicing clinicians, some are professors or academic researchers and some are employed specifically in health care institutions or businesses in research roles. There are very few, if any, actual paid employment roles for paramedic researchers, nor is there a faculty of paramedicine in Canada that staffs academic paramedic researchers. There are some paramedic researchers in academic roles, there are some as post graduate students, there is one in an employment position, and there are many that are practicing clinicians unofficially in ad-hoc research roles participating in various projects. We strive to enhance the research opportunities in paramedicine to better enhance the practice, safety, education and knowledge of the profession and therefore care and safety of patients in our unique environment.

While we have successfully delivered paramedic service to the public for several decades in Canada with an exemplary world-wide reputation, It has typically been as a public safety service or a sub-specialty or extension of emergency medicine, but not as a fully matured health care discipline. This model has served our patients well, but, some of what we have learned is that because things are done certain ways in a hospital, does not necessarily mean that it works the same or has the same benefits or risks in the paramedic environment. Another aspect that we have learned is that the public safety model does not take full advantage of health care system integration in the best interest of the patients journey to optimal care. As well, we have learned that in health care, inter-disciplinary teams of varied practitioner skill-sets and experiences, contribute greatly to patient care, safety and overall system performance.

Which brings us to the role of the British Columbia Paramedic Association in the pursuit of paramedic research. First, we are advocates for the patient and developing paramedic research to enhance care and safety for patients in our unique work environment. Second, paramedics who know this work and provide this care, are best to be engaged to look at the clinical and operational factors that contribute to enhanced patient care delivery in our unique clinical environment. Third, We can provide an independent and focused environment to support paramedic researchers and their development. As an independent corporate entity, without labour interests, we can apply for grants, subsidies, enter into agreements and partnerships to participate; fund; and support paramedics as researchers and their projects. Our focus is on the profession, for the patients.

In development of our research agenda we will enhance the educational opportunities for paramedicine as an academic faculty with opportunities for post-graduate research and university education. Work with any number of employers or agencies with varied paramedic work environments, and develop expertise in knowledge translation for the unique care and environment that paramedics work within.

BCPA already has paramedic researchers as inaugural board directors and members who sit with various research groups such as The McNally Project and the Canadian EMS Research Network. Our leaders have, or are pursuing higher levels of university education and conducting post-graduate research. Our goal is to bring this paramedic led education and research to British Columbia. The unfortunate aspect of those leading the way is that many are contributing to the body of knowledge abroad, taking their courses and conducting research in countries such as the United Kingdom and Australia that have already established university faculties in Paramedicine. In order to best benefit the patients of British Columbia, we need to bring this talent home to research and develop paramedicine in BC within our BC system.

The gold standard of clinical and academic research in most fields is having a peer reviewed journal to submit your research for evaluation and publication. An extended goal of the BCPA research agenda is to work with other associations and professional college’s throughout Canada to establish a Canadian Journal of Paramedicine and share our expertise by participating on the editorial board evaluating the most current paramedic research that ends up being produced in Canada.

Finally, with a desire to be a leader in paramedic research, it is our goal to showcase British Columbia Paramedic research, Canadian Paramedic research and provide learning opportunities for the paramedics of BC through an annual research symposium and Paramedic Gathering (Conference).

Currently, all of these things are  a spectacular ambition with some dedicated front line paramedic clinician leaders. However, with the extremely motivated and passionate team that has come together, we have the right mix of people to move these goals forward. We look forward to engaging with paramedics throughout BC to participate with the association, especially in areas of interest around our four pillars; Professional Leadership, Clinical Practice, Higher Education, Paramedic Research.