Medical Services restructuring...

[starlight_745]

As long as there is no QL5 equivalent course for the reserves, there is little hope of any type of large scale employment of reservists.  At best I think there will be a few amb drivers and maybe QL3 types to fill out a med pl.  While I have civilian PCP qualification and lots of prehospital experience, there is no possible way to obtain full equivalency at the QL5 level so once reservists are finished QL4 there is essentially no medical training remaining in their careers.  I know 6A includes some but how many sergeants are out doing direct patient care?  The majority I know have thier hands full with administration.  While we're at it can someone outline what is contained in the current reg force QL5 and if there are plans to change the content any time soon?

 

[Fraser.g]

You hit the nail one the head:

I think the problem with using reservists to backfill is that most of the reservists ( or anyone who isn't a student for that matter) who have civilian qualifications can ill afford the time off work to fill a position for say 2-6 months while someone is on course.   I have a helluva time just attending all unit training as well as my career courses and keeping of top of admin such as PER's etc.   Without any type of job protection it would be very difficult for most people I know to backfill unless it was perhaps an operation.

And just because they are PCP qualified, does not mean they can work as a QL 5 in a UMS.

So Nurse as needed ( I couldn't resist   ) while you suggestion is valid for filling Pte QL 3 positions at medical company, which by the way there are no shortage of, how do we back fill those QL 5 Cpls, and MCpl positions?

I have two Paramedic or new PCP Advanced medics who have gone out on several taskings and have been employed at the 5b level due to their skill set. Here in Saskatoon we use advanced care paramedics in our trauma center along side the nurses and docs.

If they can function there then they can certainly function in a UMS or MIR. All that has to happen is that the area surgion has to sign off on their skills.

 

[Armymedic]

What rank were they?

5b means they worked as a senior cpl or a MCpl position in the reg force...But also as a jr Sgt.

The task you mention must have been a type of range coverage because I doubt that civilian paramedics have the clinical experience to take care of 2 or more jr med techs at sick parade at that 5b level.

 

[Fraser.g]

Nope,
The task was with 1 Field Amb both in garrison working in the MIR and also for NO Duff coverage on Ex.
He was also going to be on tour working in the 3 VP UMS but was unfortunately unable to deploy due to a leg injury.
The individual that I am referring to works Trauma both pre-hospital and at the level 1 trauma center in Saskatoon.
Not exactly range coverage.
By the way his rank in the reserves is Cpl. but I would put his skill set and knowlage up against any Regular Force Sargent I know.

Grant

 

[Armymedic]

I think we're getting pissy over nothing, I am sure your troop is good to go.
I had a bad experience with a civ paramedic reservist MCpl who thought that he was civilian qualified meant that while he do everything in the military that  he learned in school, without consulting the MO...

It wasn't pretty.

 

[starlight_745]

Just for my own benefit, could someone outline the current reg force QL5 content or direct me to a link that does?

Thanks

 

[Fraser.g]

Sorry Armymedic,
Long night shift with multiple traumas all at once.
I agree there has to be a definite scope of practice for EVERYONE in a medical facility. My frustration has been that certain members of the field ambulances and above do not use reserve medics with civi qualifications to their utmost. this discourages them from going out on future taskings and it turns into a downward spiral.
It is my hope that once the PCP program is fully integrated into the Regular Force qualifiactons there will be more use of Primariy reserve and PRL members.

 

[Donut]

Soon to be medic:

The Reg F (Justice Institute of BC) PCP is 13 weeks long, not 2-3 years.  You still need to do the 16 week clinical block in ontario, but taking the civi course is certainly an option, is recognized, and not that long.




DF

 

[vr]

So what becomes of the non-PCP Reserve Med-A?  The ones who went to Op Peregrine after doing all their mandated training and were handed a shovel or if they were senior enough could drive an ambulance.  What taskings and employment are left for these guys?  GD by the sounds of it.

It is extremely unlikely that the powers-that-be (? new weekly abbreviation) are going to spend the money to bring the majority of currently serving reservists up to a PCP standard.  Are we going to have 2-tiered medical units?

At peace with my bitterness.

 

[Armymedic]

Actuall a bridging program is currently in progress, whith three courses currently underway. At 2 Fd Amb, they load them with 1 MCpl, a QL 5 Cpl and the remainder of the 5 or 6 pers, QL3 medic who are awaiting thier 5s course.

As for this 2 tier thing...2 Fd amb is desprately short of fit Med Techs at all levels and so employment is not as restricted as you menationed above. Non PCP qualified ptes who can drive..do. Those who don't get tasked supporting the understaffed UMS's as need.

 

[vr]

I was referring mainly to the Reserves where the biblical separation of the sheep and the goats has already begun.

 

[Donut]

I fear we're going to see two things with the move to 50% civi licenced pers among the reserve Fd Ambs:

Those reserve medics without a civilian qualification are going to get tired of being a driver and underemployed, and will get out. (that 2nd class citizen thing)

Those who do enroll with civilian qualifications are going to look at the kit and equipment they have to work with, look at the amount of money they give up to work for the CF, and the amount of time they are expected to commit, and leave.

Someone on this board asked if the Res Fd Ambs were going to become PRL holdding units; not a bad idea if they opened the PRL to trades other then NO/MO types.  RT's, EMT's, Lab & Pharmacy techs etc are already overcommited  in their day to day jobs, and, while many wish to serve, the sacrifices are too much, especially if they have to do CME for two (or more) different organizations.

We can offer incentives to keep them around, Spec pay might help with some, enrollment bonuses etc, but ultimately the CF can't retain and challenge health care providers so long as the only unique opportunities it offers are field time and  "challenging" (read frustrating, demanding, under-staffed, -equipped and -supported) working environments.  Who, really, wants to trade in their Ford with a crestline body for an LSVW?  or their nice pharmacy with no concerns over drug stability at room temperature to handle meds at 40 degrees below zero? or their nice, well appointed ICU/CCU to put up with bugs (have you seen those freakin' camel spiders?!?)  and dust and boredom in Afghanistan?  There's virtually no "jammy" goes to counter those anymore, no jump courses, Air Evac, DCIEM rotations to provide the carrot, just the stick.

We can show up at recruiting venues with our ECS beepin' away, and get the attention, but how long will people stay in if there's no further advancement for them, and the working conditions and pay are both below the civilian standard? 


There's a huge number of bugs in the system that need to be worked out;  we should solve as many as we can before we actively seek out huge numbers of civilian practitioners to join and become disillusioned and bitter.  If we look like morons the first time they walk in the door, they're not going to come back in five years when we say we've cleaned up our act. "no, this time we're serious..."


Free advice is worth what you pay for it.


DF

 

[Fraser.g]

I agree that there is allot to upgrade and improve before we go out and actively recruit for civi qualified pers. Right now the state of the Res Field ambs is abysmal to say the least.
0 Funding and what we have is being cut back every day
0 Kit comperable to the civi level
0 training other than to the AMFR 2 level
0 Practicums to get hands on experience
0 courses to keep people interested etc.

As for the PRL, it is being offered to any member with health care training. I have a member of my unit who is going PRL as a Phisio Officer,
PCP qualified members are the same as well as Pharm Os and any other allied civi trade.

One day we may go 50% but at this point it is an unrealistic goal. We have to develop our own infrastructure and nurture those that we already have rather than throw them away or off to the side and hope for a new pre-qualified cadre.

GF

 

[starlight_745]

I agree that we need to focus on retaining and looking after the medical staff we have.  There is a shortage Canada wide in virtually every health care occupation I can think of off the top of my head.  We are not going to be able to compete with the rest of the private/public sector any time soon.  The reserves already has (had I guess) a relatively successful tuition reimbursement program.  Why not institute a health care specific one through CFMG?  For example Cpl Bloggins has spent 5 years in the reserves and attends school for his PCP/Lab Tech/X-ray Tech/PA etc.  and CFMG reimburses his tuition with conditions that he stay in the reserves for another 4 years or whatever.  The constant focus on recruiting on not retention really irritates me.  If a unit loses a senior Cpl/Mcpl that is probably a 50-60 grand investment and will cost at least that to recruit and replace that member.  It sure makes shelling out for a $3500 PCP course look cost effective in comparison.  People that have been in for 4 or 5 years already are likely to stay in if we stop over tasking them and kicking the crap out of them and making them hate the CF.

 

[Fraser.g]

The tuition reimbursement program is back, all we are waiting on now is the final signatures on the budget. At least that was the last I heard from my OR.
The big problem is that we do not have fixed commitment periods or contracts in the reserve. If we were to have that then the education incentives that starlight might work.

 

[vr]

One detriment to bringing in qualified civilian personnel is the amount of training required.  This relates mainly to physicians & nurses.  One unit in BC had a neurosurgeon interested in signing on and when he asked what he had to do for basic he was told the full BMQ-CAP R, BOTC and anon.  This came down from CFMG.  Well that was the end of that.

There used to be a course called BOTC-Specialist AKA the Chaplains course.  This was for personnel who were to be solely employed in their specialties without wider responsibilities.  I believe that this was done away with.  Something like this is required if the Reserves wish to attract health professionals.  People at this point in their careers & lives are unable to take a whole summer or even half of one to go off on course.  If they then wanted to play Platoon Commander they could then go off on that course but their duties would be mainly clinical.

If the powers that be ( I forget this week's title) are serious about making the Reserves 50% civvy practitioners then they have got to make it easier to get in.

 

[Donut]

We were debating something similar the other night:

Now that reserve medics only need QL3 and a block of time in to be promotable Cpl, does this mean we are taking civi paramedics, giving them BMQ/SQ, writing off their QL3's with a Fd Med bridge, and making them instant Cpls?  

If so, if this is the plan, what does this do the currently serving Cpls, what does it do to the rank of Cpl, and is this a good thing?

I personally am of mixed opinions on this.   We're not going to attract civi health care professionals at the bottom of the food chain, nor should we expect them to enroll as such, they are technical experts in their fields, and deserve to be treated appropriately.   But, at the same time, by effectively making cpl a rank that carries no additional tng beyond basic MOC qualification, we are degrading the rank and adding another useless rank/pay step that gives us no benefit (anyone remember that Cpl used to be a Section Commander rank?!?)  

Do we want 50% of our Cpls to be good soldiers, with a couple of years in the CF and no clinical experience while the other 50% can't come up with a contact or loc rep but can place that ETT perfectly at 0300 inverted in a MVA?   Are we moving to a de facto â Å“streamedâ ? medical service even as we argue that it's not feasible with our current levels of tng and staff?

How are the â Å“non-clinicalâ ? cpls going to get along with a guy with 3 months in the CF, who's uniform still has the shine on it and his boots still don't?   Having MCpls and Sgts driving around Paramedic Ptes and Cpls on Op Peregrine didn't go over very well on Op Peregrine, and I expect the reception to be even worse if this becomes the natural order of things.

So, the topic is accelerated promotion to Cpl of civilian qualified enrollees.   Discuss.  

â Å“I'm a little verklempt.   Talk amongst yourselves.   the holy roman empire was neither Holy, nor Roman, nor an empire.   Discussâ ?

 

[HCA]

I would have to say that my chief concern with bringing in the medical professionals is our lack of kit. We shake our heads in dismay at the poor state of affairs and carry on as we always have.   This is the way it has always been and we are used to it. Unfortunately I don't think it will be too impressive to the health professionals we are trying through our doors.

SO what can we offer them that would bring them in then keep them in?

 

[starlight_745]

The lack of kit is something that I think is one of the easiest to remedy.  To do something like say buy brand new kit to outift all the tailgates in the unit would not cost all that much.  If a unit was willing to cancel a couple class A saturdays of training there would be enough money to kit out at least a med platoon with all the items we're short of.  The consumables are easy enough to get from CMED but kiss any big ticket items good bye like a pulse ox or new spineboards.  I thnk the lack of proper medical kit in most units is a liability waiting to happen at best and a scandalous display of the standard of care for our troops at worst.

 

[elliott.t]

ParaMedTech,

it sounds like your talking about the semi-skilled or skilled enrollment plan that CFRG has in place.

Cheers