New Critical Care Paramedic Program helping to advance profession in Nova Scotia

Mechanical ventilation session with Respiratory Therapy Clinical Educator Melissa Berry
Mechanical ventilation session with Respiratory Therapy Clinical Educator Melissa Berry

Paramedics are quite literally lifesavers and are working across the health system in emergency departments, air medical services and community clinics. The quality of care they provide plays a key role in the outcomes of individuals who are suddenly ill, have an injury, or require ongoing care.

The critical care paramedic class of licensure, in particular, has the broadest scope of practice within the paramedic profession. They operate with the goal of instituting and maintaining tertiary-level emergency and ICU care for the patients with the greatest need while facilitating their transport by air, land and sea to the appropriate medical facility.

In Nova Scotia, there are 1300 licensed paramedics, and approximately 24 of those are critical care paramedics. They can be found in two different practice settings: LifeFlight and in the emergency department at the QEII Health Sciences Centre.

Until this year, there was no approved Critical Care Paramedic Program in Nova Scotia. Previously, LifeFlight had utilized the critical care nursing program from the Nova Scotia Health Learning Institute for Health Care Providers to support Critical Care education, and the QEII Emergency Program developed an education program for critical care paramedics working within the emergency department. With an ongoing need to continuously replenish the provincial supply of critical care paramedics, as well as create a pathway for licensure, an opportunity was created to build on the development of those two separate certification processes into the Nova Scotia Critical Care Paramedic Program.

“It’s very forward-thinking of the province to have a succession plan,” says Barbara Fagan, Nurse Educator with the Nova Scotia Health Learning Institute for Health Care Providers. “When you think of one of these professionals leaving, that creates a big gap. To have that level of training and that level of experience – that’s not so easy to replace.”

The highly anticipated pilot program, offered by the Nova Scotia Health Learning Institute for Health Care Providers, officially kicked off in September. The course, which has been two years in the making, is a collaborative effort by a team from Nova Scotia Health Learning Institute for Health Care Providers and QEII Health Science’s Centre Simulation program, along with EHS LifeFlight.

 “The curriculum was designed and developed through collaboration of the Nova Scotia Health Learning Institute for Health Care Providers faculty and critical care paramedics,” says Carla MacDonald, Interim Director, Learning and Education Resources, Interprofessional Practice & Learning. “This type of program will ultimately advance the profession.”

“We are extremely happy to partner with the Department of Health and Wellness and Nova Scotia Health on the development of this important program,” says Colin Flynn, Senior Manager at LifeFlight. “It is providing a sustainable pathway for the critical care paramedic profession in this province.”

There are currently six Advanced Care Paramedics from across Nova Scotia who have enrolled in the four-month pilot project. The program is sponsorship-based, so there are seats provided by both LifeFlight and the emergency department at the QEII Health Sciences Centre. The competition is quite strong, and before they are considered, applicants have to be licensed advanced care paramedics with a minimum of five years’ experience and active licensure in Nova Scotia. This ensures that both the learners and the patients are kept safe.

The inaugural critical care paramedic class: (L to R) Joel Connolly, Ryan Fitzpatrick, Jason Tulk, Matt Dumaresque, Joan MacNeil, Michelle Brown

“The individuals participating are the perfect individuals to be in this pilot program,” says Sean Teed, a licensed critical care paramedic and a Critical Care Paramedic Program Educator with the Nova Scotia Health Learning Institute for Health Care Providers.  “They’re keen, they’re hardworking, they’re intelligent. They take initiative, and have a thirst for knowledge.”

Fagan agrees. “These are strong and experienced advanced care paramedics who I just know are going to do fabulous things as critical care paramedics. They blow me away every day, and I’m humbled every time I’m in their presence.”

“We went through an exhaustive search, with well over 60 applicants for the four spots that were available,” adds Flynn. “We are thrilled with the candidates that were selected.”

Programs at the Nova Scotia Health Learning Institute for Health Care Providers are performance-based, meaning knowledge builds on skill and participants demonstrate their learning in simulations and clinical practice. During the first four weeks of the program, participants spend time learning fundamental concepts, participating in simulation learning, and completing an interprofessional model of clinical experience (which involves six shifts in two weeks). Although the content is housed on Brightspace (an online learning platform), learners and facilitators have been able to meet face-to-face for the clinical while respecting public health guidelines and gathering limits.

“We’ve been able to do some really innovative things,” says Fagan. “For instance, we’ve been able to engage with the library team at Nova Scotia Health, and articulate the online material, which makes it more interactive and engaging. We’ve also flipped the classroom design, so the participants are responsible for the knowledge portion, and then when we meet they are active and engaged, and applying the content to case studies.”

The participants will write their final exam right before Christmas and have a two-week break before going back into their preceptor shifts. But this time, there is a unique opportunity - the participants will switch roles. Those that have been hired for LifeFlight will spend time in the emergency department, and those hired at the emergency department with spend time with LifeFlight. Then, they will finish off the last four clinical shifts to ensure that they can consistently and independently apply the competencies they learned, and begin the transition to practice. This was an intentional design element of the program to allow the paramedics to learn CCP competencies regardless of environment.

 “I feel like we have an opportunity to embrace some new approaches to delivering paramedic education – both from a curriculum perspective and an adult education perspective,” says Teed. “We’re really excited about that, and are looking forward to taking the feedback we get from the pilot program and being able to utilize that for future iterations.”

There’s a tremendous amount of people involved,” says Fagan. “Each brought their own level of expertise, and that’s created the wonderful product we have today. It’s never been one person – it’s been a real collaboration. It’s a gift to be involved in."

“As our mandate continues to grow, we are looking forward to expanding the number of critical care paramedics available to support Nova Scotians,” adds Flynn.

For more information on the Critical Care Paramedic Program, visit the Nova Scotia Health Learning Institute for Health Care Providers website.