Edmonton remand health workers say loss of paramedics risks safety
Health workers at the Edmonton Remand Centre (ERC) say a decision to remove on-site paramedics will compromise emergency care and put inmates at risk in Canada’s largest jail.
ERC staff received a memo late last month saying four paramedic positions at the facility will be eliminated after June 3. The laid-off paramedics will be offered other Emergency Medical Services (EMS) jobs, and the plan is to hire four more registered nurses to work at the ERC.
Paramedics have worked at the Edmonton remand for almost a decade, starting shortly after the massive facility, with capacity for 1,952 inmates, opened in 2013. Internal emails sent among ERC staff, obtained by Postmedia, show many nurses are alarmed by Alberta Health Services’ (AHS) plans for change.
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One called the news “scary and stressful,” warning there’s “danger” in not having paramedics. Other nurses said they hope the decision can be reconsidered.
“I must admit that (this) news seriously upset me and others here at ERC. It was shocking and concerning,” another nurse wrote a few days after the memo was sent.
One nurse described how paramedics’ ability to give life-saving medication in an emergency has averted deaths in custody.
“With the elimination of our paramedics, there will not only be an influx of potentially preventable deaths, but an influx in EMS calls for individuals that, had a paramedic been onsite, could have been prevented and/or stabilized.”
The AHS memo, obtained by Postmedia, says the way admissions and discharges work at the ERC is changing, “and we need to be able to use staff broadly.” It also says the move will “align” ERC with other provincial correctional facilities.
“There will obviously be a deficit created in our current response to medical emergencies, but we will still have response from community EMS and have started to uptrain nursing staff to new areas in order to meet the need,” it says.
In a statement, an AHS spokesperson said ERC inmates “will continue to receive the care they need.”
Vulnerable inmates at the ERC could die, paramedic says
Damian Cunningham, one of the advanced-care paramedics who works at the remand centre, said he was blindsided by the news he’d be leaving.
He’s publicly raising concerns because he believes the decision will cost lives.
“If management could come out with some sort of reasoning as why this is being done that makes sense, that’s not going to increase death, give it to me,” he said.
Remand centres are where people accused of crimes are held until either they go to trial or are released on bail, meaning most people there haven’t been convicted of a current offence.
People with addictions, who may be dealing with health issues from withdrawal, frequently come into ERC custody. Other remand centres in Alberta also transfer medically complex inmates to Edmonton because there’s more capacity to care for them.
“Without advanced care, a significant number of these people are going to die, because we take more people off the street in admissions,” Cunningham said. “That is why our numbers of emergencies are far greater than other centres.”
Registered nurses aren’t trained as first responders in the same way as advanced-care paramedics, who also have specific training for emergency procedures and authority to give a variety of life-saving medications.
Cunningham said despite the decision to “align” with other correctional centres, the size of the ERC makes it impossible to compare to Alberta’s other jails. It’s nearly three times larger than the Calgary Remand Centre, which has space for 684 inmates. Remand centres in Medicine Hat and Red Deer each have a capacity of fewer than 200 inmates.
Including staff, Cunningham said around 2,500 people can be at the ERC each day.
“That’s the call volume of a small town.”
If ERC staff have to resort to calling an ambulance in an emergency, Cunningham added, they’ll be waiting longer and adding more pressure to an EMS system already straining under a 30 per cent spike in call volumes.
AHS says paramedics leaving due to ‘change in staffing model’
According to AHS, the ERC currently has 166 full-time correctional health staff and 67 casual health employees.
The health authority said replacing the paramedics with more nurses is a “change in staffing model” so that nurses rather than paramedics can assess inmates upon admission.
“This will expedite any further assessments or treatment a client may require, including access to Suboxone treatment for opioid use disorder upon admission,” an AHS spokesperson said in an email, adding nurses will also do more “safe transition and discharge planning” and screen for sexually transmitted and blood-borne infections.
United Nurses of Alberta (UNA) president Heather Smith said the union has started the process of filing a professional responsibility concern over the removal of paramedics at the ERC.
“It’s come out of the blue, the decision to have a different model of care — and quite honestly, I’m tired of hearing about different models of care, which usually means, ‘We want you to do more with less,’ ” she said.
“Why would you take on additional and unnecessary risks when you can have the complementary services (from paramedics)? Seconds count.”
Calgary-based prison justice lawyer Amy Matychuk deals with cases where people have been injured in provincial and federal correctional institutions.
She said it’s often “politically unpopular” to advocate for inmates, but people should be concerned about the quality of health care they can access.
“Because they’re out of the public eye, it’s easy for everyone who lives in their nice house in the suburbs to forget that they also have human rights, and that it actually doesn’t matter what they’ve been found guilty of — if they’ve been found guilty at all,” she said.
“They still are entitled to a baseline level of humane treatment.”
— With files from Jonny Wakefield