As the Interlake continues to experience a severe paramedic shortage, the provincial government has stepped in to help maintain emergency services and reduce wait times by training and placing emergency medical responders (EMRs) in several communities while it recruits paramedics.
Manitoba Health Minister Uzoma Asagwara speaking at a news conference at the Selkirk Regional Health Centre on July 19
The government funded EMR training and guaranteed employment for graduates, placing 10 EMRs within the Interlake-Eastern Regional Health Authority.
St. Laurent received three EMRs; Ashern, three; Arborg, one; and Lac du Bonnet, three, according to a provincial communications spokesperson. One additional EMR is working in Minnedosa in western Manitoba.
An EMR training program recently concluded in Arborg. The program was offered through a partnership between the provincial government and Winnipeg-based Criti Care EMS Academy, which trains paramedics and EMRs.
Manitoba began losing paramedics around 2018 due to several factors, including delayed contract negotiations, stagnant wages, rising emergency call volumes, burnout during the COVID-19 pandemic and the previous provincial government’s decision not to hire advanced care paramedics for rural communities.
Health, Seniors and Long-Term Care Minister Uzoma Asagwara said EMRs are a “necessary step” the NDP government is taking to address immediate paramedic shortages in rural and northern communities across the province. EMRs will also be able to gain valuable experience on ambulances before potentially transitioning to primary care paramedic (PCP) positions.
The NDP campaigned in 2023 on a promise to hire 200 paramedics to restore emergency medical services in Manitoba’s rural and northern communities.
Under the previous government, Manitoba lost 90 paramedics and “refused” to give advanced care paramedics jobs in rural areas, Asagwara said. The minister added that rural communities asking for EMRs to be reinstated were ignored, which was “devastating” for emergency services in rural and northern Manitoba.
Two and a half years into its mandate, the government says it is building capacity within Manitoba’s rural emergency medical system.
“We have taken a completely different approach. We are now in a place where we’re ensuring these folks (EMRs) are not only fairly compensated, but that they have jobs and are being trained across rural and northern Manitoba,” Asagwara told the Express following a news conference at Selkirk Regional Health Centre last Friday.
“In two and a half years, we have completely changed the trajectory of EMS services in Manitoba. There’s a lot more work to do; there’s a ways for us to go yet to make sure rural and northern Manitobans have the services and are fully operating in the ways they deserve. And we’re committed to delivering that and work with our partners to get there.”
To help accelerate the training and recruitment of paramedics, the province introduced incentives for EMR training. These include bringing training programs to rural communities, providing a $5,000 training bursary and guaranteeing employment upon graduation. In exchange, graduates sign a return-of-service agreement.
Paramedic shortages in rural areas have resulted in ambulances being taken out of service because two paramedics are typically required to staff them.
However, the minister can issue exemptions under the Emergency Medical Response and Stretcher Transportation Act, allowing ambulances to be staffed by a paramedic and an EMR.
Placing EMRs on ambulances alongside paramedics helps maintain emergency medical coverage in chronically understaffed areas while reducing excessive workloads that can contribute to physical and mental burnout among paramedics.
Asagwara said exemptions have already been signed for some communities.
“The idea here is we can get EMRs experience on an ambulance … and then, as quickly as possible, get those folks skilled up to be full PCPs,” said the minister.
“The objective is let’s get folks introduced to the profession, get them some on-the-ground experience, make it as easy as possible for them to fall in love with this as a career and get them the pathway to become a full PCP as soon as possible. There are a good number of folks going into EMR knowing they want to be PCPs. And that’s what we’re hoping for.”
The province worked directly with municipalities to identify residents who would be well suited to become EMRs and who simply needed additional support to enter the profession, Asagwara said. That support included a $5,000 bursary and a guaranteed job after graduation.
“We’re making it as easy as possible for folks to get trained, to know they have a job and where that job is,” said Asagwara, “and, ideally, in a community that they’ve been a part of for many years already.”
Although they do not work to the same scope of practice as paramedics, EMRs are regulated by the College of Paramedics of Manitoba.
According to the college’s website, EMRs conduct patient assessments, take vital signs, provide trauma management and deliver basic care for medical conditions. They may also assist patients with prescribed medications and administer certain medications under specific conditions. EMR training consists of approximately 300 hours.
While Asagwara did not have wage information available, the minister said the province is committed to fair compensation.
“What I can say is we believe in paying our health-care workers fairly and making health care an attractive profession,” said Asagwara.
According to Job Bank, hourly wages for EMRs in the Interlake range from $18.50 to $24, with a national median wage of $24 and a high of $28.84.
A full-time position earning $24 an hour would generate approximately $49,920 annually before deductions.
After gaining experience and confidence on ambulances, the government hopes EMRs will continue their education and move into paramedic roles.
“If you’re an EMR, we want you to be a PCP then an ACP. If you … want to be a nurse, you can go from being an LPN to an RN or RPN. Or you can start out as a health-care aide … and become a nurse,” said Asagwara.
“Our goal is to ensure people can dream big as to what their health-care careers can be, and they can have support every step of the way and be successful. That’s what this EMR program is all about.”
The Manitoba Association of Health Care Professionals (MAHCP), which represents allied health workers including rural paramedics, expressed concern last year about the province’s use of EMRs because they do not work to the full scope of a paramedic.
The union released a scope-of-practice comparison last November based on Shared Health patient-care maps. The comparison showed EMRs cannot, among other duties, insert airway devices, perform ECGs, remove foreign bodies, start intravenous lines, administer controlled medications or prescribe medications required during patient transport.
Asked about those concerns, Asagwara said the province views EMRs as an entry point into the paramedic profession and welcomes MAHCP as a partner in strengthening emergency medical services.
EMR training was introduced in response to requests from municipalities that had been “pleading for a government to take their urgent needs around emergency response services seriously,” said the minister.
“But we cannot accept — and we cannot normalize — people living in rural and northern communities going without emergency response services in their time of need,” said Asagwara.
More EMRs are expected to graduate in the coming months, the minister added.
In addition to the EMRs, one new primary care paramedic will be stationed in Gypsumville within the Interlake-Eastern Regional Health Authority. Four additional PCPs have been assigned elsewhere in Manitoba: one in Erickson, two in Minnedosa and one in Glenboro.
