Paramedics: Life on the Line

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For those who work in emergency health an average day is… well, average.

But that same day for someone who has needed our service and care is unforgettable, with moments of shock, awe and gut-wrench; often, it’s one of the worst days of their lives.

But for paramedics, emergency call takers and dispatchers, it’s just Tuesday. Or is it Wednesday..?

Now, British Columbians are getting an up-close and personal view of what happens during the handling of real-life health emergencies before patients get to a hospital. BC’s educational public broadcaster, Knowledge Network, commissioned 10 one-hour episodes of a documentary series focused on the work of BC Emergency Health Services (BCEHS). BC Emergency Health Services (BCEHS) provides pre-hospital emergency services and inter-facility patient transfers throughout B.C. BCEHS handles 1700 emergency calls every single day.

Vancouver-based Lark Productions accepted the challenge and started its eight-months of production in December 2017.

This was not Lark Production’s first exposure to the lesser-known world of urgent and time-critical health crises. Lark produced two successful seasons of “Emergency Room: Life + Death at VGH”, a series that documented the emergency room at one of Vancouver’s busiest hospitals, Vancouver General Hospital. Many BCEHS paramedics were captured on that series, which prompted the idea for a TV-series solely focused on the world of paramedics and emergency call takers and dispatchers. After all, how many people truly understand the life cycle of a 911 call?

“We’re thrilled that British Columbians are getting a glimpse into the life-saving work performed by our paramedics and dispatch staff,” said Linda Lupini, the executive vice-president of BC Emergency Health Services. “Our paramedics, and the expertise and medical equipment they bring to the scene, are in many ways an extension of hospital emergency departments, and I think people will enjoy learning about the incredibly important role they play.”

The goal of the documentary series is to educate and inform British Columbians about emergency pre-hospital care from the perspective of those who work on the front lines.

More than a year after cameras first started rolling in the Vancouver Dispatch Operations Centre and out on the streets of Vancouver and some of the neighbouring communities, the first episode of Paramedics: Life on the Line” finally debuted on April 2 on Knowledge Network and is available online.

Out of the 130+ filming days, production crews attended approximately 600 emergency calls in total. Throughout the process, nearly 500 BCEHS staff were filmed doing their work, however the production team focused in on a small, core group of paramedics to give viewers a closer, more personal view of the job. They followed these paramedics shift after shift, often for several blocks of shifts.

16-year primary care paramedic, Tara Williams, was one of those chosen for a more intimate experience. She said having people listening and watching her and her partner all the time took a bit of getting used to, but for her, the hardest part was having to speak about calls all the time (in the cases where patients and families agreed to filming).

“The debriefing was kind of a weird thing,” explained Tara. “For most paramedics, especially partners who’ve been working together for years and years like Alana and I, it’s not normal practice to debrief after calls. Long-time partners who work well together rarely need to debrief because of an understanding with one another. But of course, the production team – and by extension – the viewer at home, might not understand all that went on in a given call so it’s important to explain it.”

Tara hopes those explanations go a long way in helping to dispel misconceptions about what paramedics do.

“This show is going to give the public a really good view of what we do – but also it’s an education. We’re not just a driving service, like some people think. We’re an emergency service trying to help a continuously growing and aging population. I think if the public knew of some of the emergencies we deal with on a day-to-day basis, they would think twice about using us as a taxi service. There are very serious things happening all the time,” added Tara.

18-year BCEHS paramedic Kris Erickson was another featured in this series. Kris agrees with Tara in the hope for improved public education.

“One of the hardest jobs I have is explaining to family members what the course of treatment is going to be; what we’re doing, the technology and tools we have, that kind of stuff,” explained Kris. “It will be fantastic for the public to have a better understand how we operate within the healthcare system and to know what paramedics have to offer.”

Kris is a BCEHS paramedic specialist. Paramedic specialists represent a small group of highly trained advanced care paramedics within BCEHS who are de-paired, responding in single-vehicle units and do shifts in dispatch in a clinical advisory role. As specialists are often working solo, it made the accompaniment of a production crew all the stranger for Kris.

“You’ve got a bunch of people all crammed into a vehicle that’s really made for one, chasing down calls around the city. It was exciting but a little overwhelming at the start,” said Kris.

“For the amount of space we had in the car, I thought we’d be tripping over one another but it went surprisingly well. It was pretty seamless.”

Seamless, but a wide scale production such as this did have an impact on staff.  But the impact wasn’t in the way one might assume. According to Kris, it was the mundane everyday tasks that caused the most consternation.

“Some of the most challenging times were going to get something to eat, or when to take your washroom breaks – because you’re constantly mic’d up and being watched. Those (filming days) were some of the most fatiguing days of my career…   You know, over the course of a ‘normal’ day you get downtime, quiet time, alone time to reflect – here, I was always reflecting on a microphone,” said Kris.

Although respecting patient privacy was initially thought to be this project’s biggest challenge, paramedics Kris and Tara both agreed that aspect went more smoothly than expected. A filming agreement outlining clear no-go zones became the guiding authority throughout filming.  BCEHS also dedicated a full-time staff liaison to oversee adherence to the agreement.

“I would say patient privacy was handled well, almost too well, if I could say so. If there was any question about the patient’s mental state or if one family member was saying yes but another wasn’t sure, respect was paid and privacy was kept intact. There were no questions asked. The crew backed off immediately and we would continue to do our work as though they weren’t even there,” explained Tara.

“I thought when they first came out they were going to get no approval (patient participation),” confessed Kris.  “I thought everyone would say no. And I had a really hard time even guessing which patients would say yes – and which would say no. I was shocked at some of the cases where patients really opened up to the film crew where I thought they would shy away. Human nature is a mysterious thing. In the end, patients and families were more willing to go on-camera than healthcare providers. We had the most reluctance with other agencies and healthcare providers because they didn’t understand what we were doing. Patients and family members were really open to it. I was surprised.”

Patient care and wait times were never affected by this production. All production staff involved were given training in scene safety as well as privacy and patient confidentiality. Also, an Advisory Committee was established to ensure the portrayal of BCEHS staff, patients and the extended community was ethical and respectful of privacy.

It seems the production crew’s past experience shooting in a bustling, unpredictable emergency room contributed to their adaptability in the pre-hospital environment.

“You’re trying to bring these people, who’ve never had any exposure to paramedics or what they do, into your world in a shift. The amount of insight and detail that’s already understood when talking with other paramedics just isn’t there,” said Kris. “Stuff that you take for granted when you talk with other paramedics or others in health care – you end up having to explain in detail, all the little things of why we do what we do, how we operate, some of the sarcasm and humor that we share.. that people outside of paramedicine don’t quite get. It was neat to see, over the course of even just four shifts, how quickly they fall into the role and start to share in some of those experiences with you.”

Another group the production team focused on for the series was BCEHS dispatch operations. Peyman Namshirin is a dispatch supervisor at the BCEHS Vancouver Dispatch Operations Centre. He’s been with the service for 22 years. He recalls the initial days with the documentary crew required some adjustment.

“It definitely brought a different element to our environment with the cameras, the lighting, the microphones… but I don’t think it really distracted us from our work,” added Peyman.

Peyman said he is personally hoping the series results in a better appreciation of dispatch operations by his colleagues on the street.

“I worked on ambulances before dispatch. I recognize how paramedics perceive our work in dispatch – and I get it – but I hope this series will show them it’s really not how they think of it.”

For Tara and Kris, they too consider what their peers will think.

“Do people see us the way we see ourselves?” questioned Tara. “We are open to scrutiny by being in this series, especially among our peers. I mean, no one is perfect all the time but I’m proud of what we did and am confident in what we did.”

Despite the challenging logistics for integrating this filming crew into one of the dispatch centres and out on the streets, those involved say they wouldn’t hesitate to do it all over again.

“I’d absolutely do it again. We don’t do this (job) for recognition but that’s definitely a subject that keeps coming up – a desire for greater understanding of what we do in a day. Every once in a while, everyone needs a little recognition – an acknowledgement that you’re providing a beneficial service… because I don’t think anyone gets into paramedicine for the money,” laughed Kris.

 

Tara Williams, Primary Care Paramedic
Kris Erickson, Paramedic Specialist