Key Takeaways
- Paramedics in Ottawa face widespread violence, with 37% experiencing it monthly and 21% experiencing it weekly.
- Despite this, 82% of respondents to a survey said they had experienced violence they did not report, often due to concerns that it wouldn’t be taken seriously.
- The Ottawa Paramedic Service has been criticized for its handling of violence against paramedics, with unclear expectations for reporting and time-consuming follow-up procedures.
- The service has also been found to have gaps in its management of controlled substances, including a lack of oversight, missing documentation, and poor access controls.
- The City of Ottawa’s paramedic chief has acknowledged the problems and has committed to developing new processes to document and escalate incidents of violence and to improve the management of controlled substances.
Introduction to the Audit
An audit into the Ottawa Paramedic Service has found that paramedics face widespread violence, but few report it. The office of city Auditor General Nathalie Gougeon administered a survey to Ottawa paramedics and found that every one of those who responded had experienced violence while on the job. This is a disturbing trend, and it is clear that more needs to be done to protect paramedics from violence. The survey found that 37% of paramedics face violence or threats of violence while on duty on a monthly basis, while 21% said it happens weekly.
The Prevalence of Violence
The survey sent to more than 450 active paramedics this June got 128 responses, and it also conducted follow-up interviews. Gougeon said the violence "runs the gamut" and could range from threats to spitting to hitting. Ottawa paramedic Chief Pierre Poirier said those are "absolutely regular occurrences." The survey found that 82% of respondents said they had experienced violence they did not report. The paramedics gave multiple reasons for failing to report violence, with some saying it’s simply seen as part of the job. Others said the violence was verbal or minor and they didn’t consider reporting necessary.
Barriers to Reporting
Yet others cited a different reason, telling Gougeon’s office that "there is no visible action from the service once reported." Paramedics feel like the reports do not go anywhere and there is no obvious outcome, including a perceived lack of action from the Ottawa Police Service. This lack of action can create a culture where paramedics feel that reporting violence is not worth it, and that it will not lead to any meaningful consequences for the perpetrators. Gougeon’s audit said expectations for reporting violence are not always clear, and the follow-up procedures are time-consuming and cumbersome.
Consequences of Not Reporting
The report noted a backlog of incidents, and Julia Weber, an audit principal who presented the document, told council’s audit committee that those issues could dampen employee morale and create legal risks for the city. Bay ward Coun. Theresa Kavanagh, a member of the committee, called the findings "very disturbing." The report recommended that the service revisit and clarify expectations about violence, while leaders should formally commit to actions paramedics can expect. The City of Ottawa’s paramedic Chief Pierre Poirier accepted that recommendation and called violence against paramedics "a significant problem" that isn’t limited to Ottawa.
Response from the Ottawa Paramedic Service
Poirier said the service is developing processes internally to document, escalate, and involve police services in cases of violence. He also acknowledged that some of the people lashing out at paramedics may be homeless or face other precarious conditions. He later told media that the cultural barriers to reporting are longstanding and go back to when he was on the road providing care. The Ottawa Paramedic Service has committed to changing this culture and to taking violence against paramedics seriously.
Gaps in Handling Controlled Substances
Gougeon’s report found still other gaps at the Ottawa Paramedic Service, especially around how it is managing controlled substances. Paramedics are authorized to carry and administer controlled drugs, a category that includes narcotics such as opioid medications. However, the report found a lack of oversight, missing documentation, and poor access controls. The service is required to conduct monthly audits and reviews about the use of controlled substances, but this is not happening. The report found multiple gaps in documentation in patient care records when controlled substances were used.
Conclusion and Recommendations
The report found weak inventory management, including for expired drugs, and said oversight in some areas is limited. Finally, the report found that staff members on leave still had access to the substances, as did personnel that weren’t involved with the management or administration of the drugs. Management accepted the recommendation to review and update policies. Poirier noted that, despite the gaps reported in the audit, it didn’t point to any actual incident of misuse or loss. Gougeon confirmed that to media on Friday. The Ottawa Paramedic Service has a lot of work to do to address the issues raised in the audit, but it is a step in the right direction that they are acknowledging the problems and committing to change.
