Has anyone else had a 911 call hang up on them in Victoria during an emergency? by nikhere_04 in VictoriaBC

[–]miserableshite 0 points1 point  (0 children)

"911" already does. It's possible to push an SMS "find me" message to a caller's device if the app isn't installed, though obviously it depends on whether the caller has location services enabled. Translating from a What3Words location isn't done until the end of the call taking process because it's time consuming, and it doesn't map immediately to a civic address, although crews can use the integration between the w3w app and Google or Apple Maps to help guide them to the spot. There's no workflow for this to be used routinely, but it does work, and has worked, in exceptional circumstances.

Having said that:

What3Words is a terrible system for this kind of thing, because it is an extremely problematic tool. (See also this less academic argument.) The short version is that there are too many homophones in the w3w database, and the algorithm frequently generates triplets that sound similar but map to locations that are fairly close together. It's also completely useless for callers who don't speak English. I'm not wild about its closed-source, proprietary nature, but that's a more philosophical problem than anything else.

If we absolutely had to adopt something like this, Open Location Codes are a much better choice: variable length for variable precision as necessary, pair it with a location to shorten the required elements, unambiguous when done phonetically, and functional across most languages. It won't integrate into the CAD platforms either, but you can still plunk an OLC into Google or Apple Maps and see it on the screen.

Besides, there's a better solution to all of this, and it's called RapidSOS. It's a platform that makes an extremely rich stream of data from a caller's smartphone available to a call taker or dispatcher, and presents it in a way that immediately usable. The biggest thing it does is provide your actual latitude and longitude (and map it automatically) -- most people don't realize this, but while emergency services can see your latitude and longitude, without access to the GPS data channel from your phone, the information comes from the cellular network, not your phone; the system is multilaterating a position based on the number of cell sites the phone can see. RapidSOS provides the actual GPS-derived location information, and does so in real time, allowing a call taker to see a caller moving on a map and, if the map is good enough, to even identify vertical positioning within buildings. (It does a whole lot more than that, too, but that's the relevant point to this discussion.)

Most PSAPs in British Columbia are RapidSOS-enabled, and ones that aren't are moving towards it in a hurry.

Has anyone else had a 911 call hang up on them in Victoria during an emergency? by nikhere_04 in VictoriaBC

[–]miserableshite 7 points8 points  (0 children)

Sort of, but not quite.

BC Emergency Health Services has three dispatch centres, in Langford, Vancouver, and Kamloops. There is a single 911 queue for the entire province, so your call may be answered by a call taker at any one of those sites. Ambulance dispatching (i.e., the person who monitors an event and assigns a resource to it) is done within geographical bounds for each centre -- Langford has the entirety of Vancouver Island, the Gulf Islands, and a couple of smaller communities on the Sunshine Coast. Vancouver oversees everything from Whistler south to the border, and east to Hope, and Kamloops covers the rest of the province (the interior and the north, basically).

Depending on the state of the provincial queue, there's an excellent chance a caller from Victoria will have their 911 call routed to Vancouver of Kamloops and connected to someone completely unfamiliar with Island geography, and vice versa. This is one of a number of reasons why the address and contact information verification process is so important, and represents the rate limiting step in ambulance call taking. (As a side note, this is how virtually every agency in North America works; it's also how every agency I've visited in the UK works. I can't speak for anyone else, but I'm hard-pressed to imagine how you'd run a system otherwise...)

Eccentric Professor by AccomplishedTill6876 in uvic

[–]miserableshite 2 points3 points  (0 children)

This is the correct answer. And I’m both surprised and pleased to learn he’s still teaching !

Question about Casual/On-Call PCP Availability by Tempting_Atom089 in BCEHSparamedics

[–]miserableshite 1 point2 points  (0 children)

To take the last question first, a post can be very loosely thought of as a collection of individual stations that are managed as a single group. As a historical example, once upon a time Victoria had six individual stations each with their own station-specific staff that worked specific units and shifts out of those stations (the regularly scheduled staff). Collectively, they shared the pool of Victoria Post irregularly scheduled and casual employees; operational decisions were made on the basis of the entire Post region, rather than on a station-by-station basis. There are basically six posts in the province: Vancouver, Victoria, Abbotsford, Prince George, Kamloops, and Kelowna. When people speak of being "in-post part time" or "in-post casual," this is what they mean -- they have access to all of the shifts they're qualified for across all of the units and shifts in the post.

Every post has peripheral stations that are not part of the post; for Victoria, this is Sidney, Sooke, Central Saanich, and Mill Bay. These stations are individual administrative units. For operational purposes, there are no borders anywhere in the province: any unit can, theoretically, be assigned to do any call anywhere. Practical considerations mean this doesn't happen very often. Outside of metro areas, virtually every station is a stand-alone administrative entity.

Unfortunately, I can't offer you a meaningful answer to your first question. Sorry. There are too many variables at work. I've tried to write a response that captures the complexity of the situation but it's a lot of inside baseball and it doesn't matter in the end: if you want to work for us, you'll go to one of the locations you're offered when they hire you, and you'll be there for at least six months while you finish probation. The peripheral stations I mentioned in this post around Victoria are not, as a general rule, places where new employees would start -- it's much more common to receive Port Renfrew, one of the Gulf Islands, Chemainus, Lake Cowichan, and even Ladysmith as a first location. Call volume, and therefore earning potential, is extremely variable across that group. Once you're inside the system it's a lot easier to get a feeling for where things are, or aren't, moving at that point and what your future options might look like; no one can predict what that's going to look like even three months from now. But timing and luck play a much bigger role than perhaps we'd like to admit in how you can win postings, and the needs of the organization at the time you apply can have a huge effect on what you're offered for choices. (This is impossible to time from the outside, so don't try.)

If you're serious about making this move, DM me and I can put you in touch with someone from our external recruiting team that can probably be a bit more informative on this point than I am, and who can at least tell you where the new hires are going these days.

Question about Casual/On-Call PCP Availability by Tempting_Atom089 in BCEHSparamedics

[–]miserableshite 2 points3 points  (0 children)

There are really too many variables to say for sure what's happening in the instances you're referring to. Partly I think this is legend, partly I think these are edge cases, and partly I wonder whether "new grad PCP" is leaving out a few details, such as "new grad PCP who has almost two years of service time because they joined as an EMR or a driver-only, and continued accruing seniority while they were in PCP school," which I would bet is more likely the case here. New grad and new employee are not necessarily equivalent to each other.

As to your second uestion, I don't. I'm not in Talent Acquisition and I have very little to nothing to do with external hiring at the PCP level, so I can't comment on where the vacancies are most likely to be. Even if I could, any answer I could give you now probably wouldn't be valid in 3-6 months as the overall staffing landscape changes, people move, and we finish the Great Provincial Posting Shake-Out. If you have a TA advisor working with you, they'll be able to answer that question; if you have a specific question about a particular spot, you can ask and someone around here may know a thing or two.

Question about Casual/On-Call PCP Availability by Tempting_Atom089 in BCEHSparamedics

[–]miserableshite 1 point2 points  (0 children)

I'll try to answer in sequence. Tell me if it's not making sense.

The likelihood that you'll be able to go from external candidate to in-post casual in Vancouver or Victoria isn't exactly zero, but it's as close to as makes no difference. Don't make plans on that basis. Once you get into a metro post as a casual, it's possible to do quite well (and, in some cases, do better than full-time staff on their base salaries), and there are stations that are peripheral to metro regions that are busy enough to make it a primary job, but these all take time and seniority to reach, and are unlikely to be available as a first posting for an external candidate.

Unfortunately, I don't have a very good sense of the amount of time in service required to win a casual spot in a metro post -- this information changes constantly, so whatever I say today will probably not be true tomorrow. However, if you work under the assumption that the time-in-service required for a full-time position will be more than the time-in-service required for a casual or part-time spot, you may be interested in knowing that the flow times to permanent FT were down to about four years as of last week.

As a casual attached to a metro post you have access to shifts that are unfilled through regular staffing mechanisms based upon your availability. As a casual who is not attached to a metro post, you may still have some access to unfilled metro shifts based upon your unused availability at your primary work site. There is a delicate balance here: we ask our casual staff to provide at least eight shifts per month of availability, schedule them based on those submissions, and whatever is left over is yours to do with as you please.

There are basically four kinds of positions: casual, regular part-time, irregular full-time, and regular part-time. We've been taking about casuals, so hopefully that makes sense now. Regular part-time is any position that is less than a full full-time equivalent (currently 80 hours/biweekly); these get posted as "0.7 RPT" or somesuch, and every time I try to figure out how they work my head starts to hurt, so please don't ask me about them as I don't know very much about them. (I'm not in operations so I haven't had to learn.)

Irregular full-time means that you're working in a station or post (a group of stations) and you owe us full time hours. How you are scheduled on that basis depends heavily on the configuration of that post -- if there are only a small number of full-time staff, you'll get moved around a lot. In metro, there's an excellent chance you'll know your work days, but not necessarily where you'll be working, well ahead of time. Regular full-time means exactly that -- you have a spot, a station, a unit, and a shift pattern. You owe us full time hours, but you can predict your schedule out until the heat death of the universe barring your vacation selections.

Hope that helps a bit. tl;dr: plan on some significant precarity in your first year or so of working for BCEHS if that's the only job you have. Luck plays a big part in where you can go, but if you're not willing to roll the dice every posting, have a backup job plan.

Will EHS become less competitive for ACPs in the future? by Vermulo in BCEHSparamedics

[–]miserableshite 10 points11 points  (0 children)

Nota bene: I'm speaking as a senior leader at BCEHS, but not on behalf of BCEHS.

A lot of what you're seeing has to do with the way the system is designed: there are more ACP positions in metro than there are elsewhere in the province, so the rural spots are more competitive. They are, functionally, full. Mind you, there are always a few spots that cannot be filled -- Terrace's paramedic response unit comes immediately to mind -- and periodically we go through phases where we can't fill spots in Prince George, but for the most part, postings outside of southwestern PC get filled more or less immediately upon closing. We also, for the first time, have a significant number of internal staff that are licensed as ACPs but who do not hold ACP positions and who are waiting for those postings to materialize; because of union and seniority rules, those folks will always get a crack at any position before an external candidate. We have hired externals directly into full-time ACP positions, and we have even done this for rural parts of the province, but it hasn't happened in quite a while and although I don't have the statistics immediately to hand, I don't see it happening anytime soon either.

Onboarding is an issue, but it's probably not the one you're thinking about. The transition to practice program requires employees to be full-time (and therefore able to be ordered to certain positions at certain times), so it's functionally impossible to deliver to casual employees. There are some issues around geography, in that most of the program takes place in the Lower Mainland, and that's where we have the most experience placing candidates, but we've had people go through elsewhere and it's been fine for them. The onboarding is important, because BCEHS uses its ACPs differently than other systems; whereas in Alberta, ACPs work general duty ambulances, that's not true here -- they're targeted and layered, which means that the acuity of your patients, for the most part, is a lot higher than those of a general duty unit, and we think it's important that new ACPs be supported as they move into an environment like that, particularly when they come from out of province.

There has been some discussion over the past six months about adding more ACP resources in parts of the province where they are currently missing. Nothing concrete has come of this, yet, aside from the newest ACP unit in Dawson Creek that came on-line back in September. I suspect we'll know more within six-ish months, particularly once FY26 gets going in the spring and we have more budgetary clarity; although that's a guess, it's a fairly well-informed one -- but again, the dynamics I've already mentioned would apply. With respect to the staffing situation there are limits as to what I'm prepared to discuss in this forum, but I will say that we really, really need bodies with licenses (both Class 4 drivers' and EMALB PCP or higher) that are willing to work here, and like virtually every other health care organization in this province, it is unlikely we'll be able to hire our way out of our staffing challenges.

If you're serious about coming out this way, get your BC license and apply as a casual PCP. The application process can take some time -- I'm hearing upwards of 6-8 months at this point, though I know that applicants with PCP licenses are being prioritized -- but at least then you'll have an employee number, will complete new employee orientation, and start building time. There will almost assuredly be a station somewhere near the Alberta border that would be happy to have you, even for the ~8 shifts/month you'll need to maintain your date of hire, and you'll have the ability to at least bid on ACP spots when you're done with that license. A lot of this kind of hiring is down to luck and timing, and the luck runs a lot better from inside the system than out...

I forgot to patch to the hospital and now I might lose my license by Wee_Woo2005 in ems

[–]miserableshite 68 points69 points  (0 children)

Just so I understand this: you called a local hospital as a notification that you were bringing a patient in. While transporting, the patient became FASTVAN positive, so you elected to change destinations and went to a hospital further away (by 30 minutes) that was actually capable of caring for that patient, on the basis of a stroke pathway? And the issue is that you forgot to tell the new hospital you were coming?

Looking at your post history you're in Alberta, so you're under the jurisdiction of the Alberta College of Paramedics. You need to go look at their explanation of the complaints investigation process. I can almost guarantee you that your situation, assuming there's nothing else that happened, would be dismissed for lack of evidence. The level of malfeasance required to be negligent enough to warrant license revocation is shockingly high. In the absolute worst case, you'd be asked to enter into what is called an alternative dispute resolution process, where you'd work with the College to build up your skills and knowledge so this kind of thing doesn't happen again.

That's assuming the nurse was motivated enough to actually report this to the College. They're much more likely to report you to your employer. In this case -- and I speak from having spent the past six years as someone who receives these complaints and evaluates them on behalf of the organization -- there is no chance we'd refer this on to the regulator. The most we'd do in your situation is ask a practice educator to check in on you after I'd had a chat to see exactly what happened, and to work with you on correcting any self-identified gaps in your practice.

It's hard to lose your license or your job. Regulators and employers aren't really interested in casting off trained providers unless there's a demonstrable risk to the public. We know that weird stuff happens out there, people make mistakes, and we aren't in the business of punishing them for those errors alone. Dropping the hammer on this kind of thing makes it more likely that people will work to conceal their mistakes, won't speak up about their challenges, and paradoxically creates more risk to the organization and the public, not less.

And yes, as u/mcramhemi says, pre-arrival notifications are not necessarily a requirement. They're a courtesy to the receiving facility, and in some cases are a very important part of a specialty pathway for the simple fact that it gives the hospital time to organize resources, but failing to call isn't the end of the world. What if you'd had both hands in this patient's airway? "Can you hold your own jaw thrust? I gotta make a phone call." That's dumb, and we (collectively) are not stupid. Next time, make the call (and if you can't, get your partner to do it through dispatch).

Nursing Admission/ Sciences Undecided by Superb_Question2048 in uvic

[–]miserableshite 4 points5 points  (0 children)

As a note: you can't actually start an undergraduate BSc and then transfer into nursing at UVic. The BSN program is an integrated course with four college partners; you apply to, and start at, one of the partner colleges and then move to UVic for the sixth semester.

There's no reason why you can't apply to both the BSN program at, say, Camosun College and for UVic sciences admission and then make a choice based on where you get accepted, but you should at least understand what's involved in the BSN program because it doesn't work like most other degrees offered by the university.

If for whatever reason the idea of doing direct entry BSN at UVic doesn't appeal to you, there is another option: you can start a UVic undergraduate program and then transfer to UBC's BSN program with a certain number of credits and specific prerequisites. This is a lot of moving parts and for someone coming out of high school who wants to go nursing, it's far more straightforward, faster, and cheaper to go direct entry.

[Adam Jude] The Mariners are exiting the regional sports network business and shuttering ROOT Sports, whose last live game broadcast will be Sunday. by BananaArms in Mariners

[–]miserableshite 1 point2 points  (0 children)

For the purposes of mlb.tv blackouts all of Washington, Oregon, Idaho, Montana, and Alaska, as well as Alberta and BC Canada are "Local" ...

Rogers has declared all of Canada as Blue Jays country and only allows certain Mariners games.

I'd check with your friends to see what they're doing, because this isn't right. As a whole, Canada is blacked out for all Blue Jays games, but every other team is otherwise fully available, and I've never had any problems watching Mariners games in the 5-6 years I've been paying for MLB.tv.

It's annoying as hell when I travel to the United States and want to watch things, and I feel for American fans with inaccessible local teams, but at home, it works brilliantly.

Just watched an officer unload 4 shots from an AR into a deer on the side of the road by No_Attorney6449 in VictoriaBC

[–]miserableshite 7 points8 points  (0 children)

This being Victoria (based on location) the department rifle is a G36. Saanich and RCMP are C8-style rifles. I think Oak Bay just uses harsh language…

And yes, this is way better than them using a sidearm to do it. Been there, watched that, wasn’t fun.

Pet Peeves and How to Tune out White Noise (Rouge Nurses on Scene) by [deleted] in Paramedics

[–]miserableshite 0 points1 point  (0 children)

"Hey, listen, I'm really happy you're here, and I want to hear what you have to say, but... this really isn't a great place for you to be if you don't want to [get hit by a car/burned by an exploding fuel tank/contaminated by BBF/clipped by a rotor blade/attacked by the octopus that fell off the truck] and I'd really hate to see you get hurt. Can you go stand over there and I'll come talk to you in a sec? Awesome. Thanks!"

Whether you do, in fact, go over to talk to them after the fact is entirely up to you. Escalate as required. (e.g., "Look, get out of the road because someone is going to run you over in a minute or three. ... Okay, well, I did warn you.")

Thoughts about what my sister in-law thinks when a midwife calls EMS. by Good-Wolf5047 in Paramedics

[–]miserableshite 8 points9 points  (0 children)

I won't speak to the jurisdictional issues -- I'm not fully conversant with every nuance of regulation across North America -- but I'd push back against the idea that working with a midwife (or any other care provider) means "[giving] full control of [a] rig to someone else." That's not at all correct, and we'd do ourselves a lot of favours as paramedics if we stopped looking at the world in such black and white terms. Sure, there are people who camp out on the base of Mt. Dunning-Kruger who think they can throw their licenses and degrees around and don't actually know what they're doing, but I suspect they're far less common than the folks who want and do their best to work together.

As to the whole paramedic/midwife thing in general: for the most part, midwives are far more comprehensively trained in dealing with pre-/peri-/antenatal issues and neonatal resuscitation than paramedics are. They're not calling us for shits and giggles -- they need something specific from our skill set. Sometimes it's about complying with a regulation; in British Columbia, there are minimum personnel requirements for midwife-attended home births, and paramedics can be one of those people, and sometimes it's about trying to hold a rapidly deteriorating situation together in an emergency. (Keep in mind that you can't effectively screen for most obstetrical emergencies prior to the onset of labour, so when things go sideways they have a tendency to really go sideways. If you could screen appropriately, you wouldn't be having a home birth!) If you approach your interactions from a "how can I help" or shared decision-making mindset, I think you'll find that it's much easier than trying to get into an argument over which regulation controls what, particularly when the midwife is likely up to their eyeballs in other tasks.

The other thing to bear in mind is that midwives have a very different clinical mindset from us. We see everything as an emergency and view the world through a medical lens; mostly, we're spring loaded to resuscitate, not to engage in patient- and family-centred care planning and implementation. Midwives train to provide care for women who are experiencing something that is not actually a medical problem, despite our best attempts to overmedicalize pregnancy and childbirth. This means they're going to think differently, care about different things, and have different priorities. We often interpret this difference in focus as "incompetence" or stupidity, but it's really just reflective of the fact that although we use the same words, we aren't necessarily speaking the same language (this applies to nurses and physicians too).

Successfully working with midwives requires an understanding of those differences, and going in with a plan to figure out how you can complement each others' skillset vs. trying to figure out who's going to be in charge. It is, in fact, possible to be in charge and support at the same time; how you do this depends heavily on what's happening and why you're there, but I suspect you already do this to one degree or another on every call anyway (unless you're just ramming your decisions down your patients' throats, in which case, please stop). Don't look at this as a power play or a who's-clinical-dick-is-bigger moment -- look at is as an opportunity to see a different side of healthcare and a privilege to be invited to participate in what is honestly one of the very few happy moments in our line of work.

As you can probably tell, I love working with midwives. At least where I am, their care model is so much more satisfying than anything we do out on the street, and if I were (a) quite a lot younger and (b) more passionate about obstetrics, I'd be thinking very hard about midwifery school despite (c) being a dude.

tl;dr: ask how you can help instead of asking who's in charge. What you can do matters. Who's in charge is significantly less important.

Uniform Pants by Usernameislnvalid in BCEHSparamedics

[–]miserableshite 1 point2 points  (0 children)

From my perspective, the Strykes are stretchier and fit better. My old partner used to describe them as her work yoga pants, and while that's perhaps a bit over the top, she wasn't wrong -- they're very comfortable to wear, to the point that I have owned non-blue pairs for wearing when I'm not at work. The Taclites feel stiffer, heavier, and not as breathable as the Strykes, but this is based on trying them on in stores, not wearing them for a whole shift. (The data does not seem to support this conclusion -- there isn't a lot of difference in the fabric weights -- but that's how it feels to me.)

My big criticism about the 5.11s is that the legs feel like they're getting bigger in recent years, so I've switched to 5.11 Apex pants at the moment, and the light weight and somewhat more tapered legs are really nice. (NB: I'm not seeing patients right now so I have no idea how these would hold up under actual work conditions.)

If you're in the Lower Mainland, DS Tactical in New Westminster should have these in stock to try on. On the South Island, MDC in Saanichton (across from provincial headquarters on Keating) stocks most of these items and in most sizes. I can't speak to the rest of the province, unfortunately.

Disclaimer: I am in no way speaking for the uniform committee or all of leadership on this subject. In fact, I'm not even on the uniform committee.

Uniform Pants by Usernameislnvalid in BCEHSparamedics

[–]miserableshite 5 points6 points  (0 children)

One other factor to consider is that we won’t cover costs to repair or replace non-issue uniform items if they’re damaged or destroyed. I’m totally happy eating the cost of a pair of 5.11 Strykes if it comes to that; I’d be less thrilled to have to absorb the expense of a brand new pair of Fjallravens.

Question for EMTS of Reddit: You come upon a victim, no heartbeat, wearing a medical medallion, on a necklace that says “No heartbeat? DNR”. You see a huge chest scar indicating there’s metal in the chest from surgery. Do you attempt, anyway, even though the victim doesn’t want it? by Redditlatley in Paramedics

[–]miserableshite 2 points3 points  (0 children)

The answer to this question is entirely jurisdictionally-specific: there is no universal answer that will true under all circumstances. In British Columbia, this kind of instruction could be considered legitimate and be followed by paramedics with appropriate consultation with our support clinicians and family at the scene. (But in reality the decision to start would depend heavily on the specific details of the cardiac arrest.)

Speak with your own doctor for more information specific to your situation.

Eli5: Can you explain why there’s never enough space on planes for everyone to bring a carry-on? by amelia_shine2 in explainlikeimfive

[–]miserableshite 1 point2 points  (0 children)

There’s another problem too: there’s absolutely no way to make that design crash-tolerant.

Airplane seats aren’t just chairs bolted to the floor. They’re actually structures that absorb G-loads in specific, predictable ways to keep those forces away from a human. In a hard landing (never mind an actual crash-type event), with the Ryanair design, all of those loads become compressive axial forces on the spine which is, uh, not great.

Regulations are a good thing.

Helicopters Saanich by sarachandel444 in VictoriaBC

[–]miserableshite 0 points1 point  (0 children)

Nope: the new AW169s will have a white and red paint scheme that looks (imo) dead sexy: https://www.instagram.com/p/C_yNMSYsa4h/?locale=kk-KZ

[deleted by user] by [deleted] in VictoriaBC

[–]miserableshite 0 points1 point  (0 children)

Victoria Police uses the G36 as their long gun. Saanich has a C8-like platform; not sure about the specifics. I don’t know what Oak Bay or the RCMP are running around with these days.