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HomeMy WebLinkAbout1983-0503.Lamb.84-01-26IN THE MATTER OF AN ARBITRATION Under THE CROWN EMPLOYEES COLLECTIVE BARGAINING ACT Before THE GRIEVANCE SETTLEMENT BOARD Between: Before: For the Crievor: S. Laycock Grievance Officer Ontario Public Service Employees Union For the Employer: M.M. Fleishman, Counsel Crown Law Office Civil <Ministry of the Attorney General Hearings : October 13, 1983 &tiber 27, 19E 3 tkcanber 8,1903 OPSEU (Kenneth Lamb) and The Crbwn in Right of Ontario (Ministry of Health) R. Delisle F. Collom E.R. OXelly Vice Chairman Member Member Crievor Employer i -2- The Griever claims that he was wrongfully dismissed from his ’ employment as a Dispatcher with the Central Ambulance Dispatch Service, Lindsay. The dismissal resulted from the negligent conduct’ of the Griever in handling a request for assistance on ‘June 17, 1983. The Employer seeks to justify the dismissal as the appropriate discipline. The Employer submits the penalty is .appropriate on two bases: First, because of the seriousness of potential consequences flowing from the Griever’s negligence a severe penalty is warranted, or second, the Griever’s negligent act was a culminating incident following a pattern of behaviour which suggests that there is not a good chance of improvement in the future. The Griever was hired June 16, 1980 as a Radio Operator Dispatcher when the Ministry introduced its ambulance service to Lindsay. Prior to this employment the Griever had worked seven years for the Town of Lindsay dispatching both ambulance and fire trucks. When hired into the Ministry the Griever received one week’s training at Oak Ridge during which he qualified for a Restricted Radio Operator’s Licence, received instruction on documentation, and observed other Dispatchers perform their tasks. The following week was spent in Lindsay under the supervision of the Manager, William Sherren, mapping and indexing and coding streets and landmarks. The Manager conducted informal training sessions in the evenings studying medical terminology, anatomy, first aid and the like. In addition some previous calls for assistance were reviewed and considered and instruction was given on the necessity for completeness of documentation. Some 10 - 12 sessions occurred and while attendance was voluntary the Griever attended approximately eighty per cent of the time. The Manager observed the Crievor handling calls and offered advice on a one-to-one basis. -3- The Manager introduced an index card system to be used by the ’ Dispatchers which listed various conditions that might prompt a call; by flipping the index card to the appropriate condition the Dispatcher would be alerted to additional information which would be meaningful to the prioritizing of the call and to questions that might be put to elicit such information. A Training Manual which described and illustrated the various calls from Priority 1 to Priority 4 was supplied; though in draft form, the Dispatchers in Lindsay were advised to follow it. A Memorandum Book was kept in the Dispatcher’s working area and all memoranda were to be signed when read. The index card system suggested certain questions to be put if the call related to breaking difficulties. Conscious?, Cyanotic?, Wheezing?, Numbness in hands or mouth?, Chest pain? The index card stated: Dispatch Priorities: In all cases of severe breathing problems a Code 4 ambulance response is indicated. The Training Manual provided: Priority 4 - Urgent Care This type of call refers to life and/or limb threatenirg situations where time is crucial. Examples: (a) pi Heart attacks, choking, difficulty of breathing, etc. C Eliciting Patient Information Patient information is the strongest factor in guiding the Dispatcher% decision as to priority of a call. Thii informa- tion when properly relayed to the crew will assist in helping them prepare for the situation prior to arrival at the scene. You should attempt to ascertain the following: 1. Illness - some idea of the problem. 2. Injury - nature, cause and part of the body involved. ,\ -4- 3. In all cases of a prompt and urgent nature: (a) Is the patient conscious? (b) Ls the patient breathing? (c) Is there severe bleeding? (d) IS THERE SEVERE PAIN PRESENT? A memorandum from the Acting Manager, dated May 26, 1982, and signed as read by the Griever stated: This is one of the most important aspects in dispatching an ambulance. Therefore, as Dispatchers you are required to obtain more oatient information to helo YOU establish the priority of the call. A vast improvem’er;t is required in this area of ambulance dispatching. Ask more questions of the caller, i.e. (a) Patient% name (b) Patient’s age (c) Location of patient (d) Problem at the scene - ask questions to elicit information. i.e. - Is the patient conscious, etc? A memorandum from the Acting Manager, dated May 27, 1982, and signed as read by the Griever stated: Priority 4 - Urgent Calls - This call refers to life threatening situations whereby time is crucial. Possible loss of ,lirnb or eyesight should be considered as urgent calls. EXAMPLES serious motor vehicle collisions heart attacks choking difficulty breathing patients that are unattended or in a public place and whose injury or illness condition is not known. Eliciting Patient Information - Patient information is the strongest factor in guiding the ambulance Dispatcher% deci- sion as to the priority of the ambulance call. You should attempt to ascertain the following: -5- -5- 1. 1. Illness - some idea ,of the problem Illness - some idea ,of the problem 2. 2. Injury - nature, cause, part of body involved Injury - nature, cause, part of body involved 3. 3. III ail cases of a prompt and urgent nature: III ail cases of a prompt and urgent nature: (a) Is the patient conscious? (b) Is the patient breathing? (c) Is there severe bleeding? (d) Is there severe pain? 4. In cases of multi-vehicle or multi-casualty situations: (a) How many are visibly injured? (b) How many are seriously injured? Determining the Patient’s Status - The Dispatcher will determine the patient’s status by interpreting the patient info received from the caller. It is therefore vital that you elicit complete - and accurate patient information. Another memorandum from the Acting Manager dated May 27, 1982, and signed as read by the Griever stated: Priority Four - Urgent Call Life or Limb Threatening Priority Four is indicated for the following illness or injury: (1) All Motor Vehicle Accident . . . . . ilO) Respiratory or breathing difficulties. m.... IF IN JXXJBT THE AMBULANCE WfLL BE SENT TO THE CALL ON A PRIORITY ‘+. On June 17, 1983 at 1415 hours the Central Ambulance Dispatch Service, Lindsay received a telephone call inquiring about ambulance service for Mr. John Diebel. The Griever took the call. The following is a transcription of the tape recording of that conversation: Disp’r Caller Ambulance dispatch 1415. This is Mrs. Diebel calling from Victoria Place 166...I wonder if it’s posible to have an ambulance take my husband to the Lindsay hospital. He’s having a great deal of trouble breathing, his chest seems to be very full, and he’s very uncomfortable. c -6- uisp’r Caller Disp’r Caller Disp’r Caller Disp’r Caller Disp’r Caller Dlsp’r Caller Dlsp’r Caller Dlsp’r Caller Dis p’r Caller Disp’r Ah, who is his local doctor? Well, it would have to be Dr. Konyer now; he hasn’t seen Dr. Konyer because of a Dr. MacLean’s decease. Oh, yah. Do you want me to phone Dr. Konyer first? WeIl, not really. I was just wondering who his family doctor was. If we were bringin’ ‘em in, we have to notify the hospital. Oh, I see. Or family doctor. And what is the name again, please? Diebel. D-i-e-b-e-l. And your husband’s first name? It’ll be John Diebel. And that’s 166 Victoria @lace? Yes...And there’s an empty lot right beside us. I would suggest you come in there because he’s downstairs in the family room and we can go out the side door. I see. And your telephone number there, please? 738-2486...2486. I would take him in the car except the fact that if you sit him up...he’s...you know... he’s very short of breath, and it’s...the whole chest seeins really full...there’s a rasping sound in there that I don’t really like. Yeh, right. The thing is, we’re going to strip our area complete of vehicles if we take him right away. Ahah. Ah...1 would think...yes...to keep the area covered 1 would say you’re looking at possibly an hour. Oh, dear...Well, that’s not so good. Ah...could you hang on a minute...without indisposing anything? Yes. O.K., fine. Caller Disp’r Caller Disp’r Caller Disp’r Caller Disp’r Caller Disp’r - 7- All right. (Roger 28...58 seconds go by.)...1 think if it’s going to be an hour...we’ll try to do the best we can with the car. Well, if not...if you give us a call back. As I say, we’ll get a vehicle out there...but it will strip our area. Yeh. Well, we’ll try and do it this way, and see how it works out. Aha. If there’s any way, you can ,maybe lean him in the back seat and keep the pillows under him to keep his upper trunk raised. Ya, okay. It may ease it a bit for him. Ya, okay. We’ll do the best we can. Okay. All right. ‘Bye. Mrs. Diebel transported her husband to Ross lMemoria1 Hospital in Lindsay. He was pronounced dead at 1514 hours on June 17, 1983. A very serious error was made by the Grievor. The call clearly should have been coded Priority 4 and an ambulance immediately dispatched. The seriousness of the situation and the severity of the breathing difficulty are clearly evidenced by the transcript. The caller is so concerned that she cannot wait “possibly an hour” but will drive the patient herself. The Griever asked no - questions about the patient’s condition though he agrees that eliciting such information is vital to prioritizing a call. He testified that if the caller had insisted on an ambulance he would have sent one. His testimony and the transcript suggest the Dispatcher wanted the caller to decide whether an ambulance should be sent. That decision was the Dispatcher’s job. 1 -8- The Griever testified that his reluctance to dispatch an ambulance resided in a concern that by doing so he would have “stripped the area of vehicles”. This was also his explanation to the caller. We are satisfied on the evidence that this concern had no basis in fact. The ambulance situate at Bobcaygeon, No. 386, could have been dispatched and would have arrived at the scene within six to eight minutes. An ambulance in Lindsay, No. 381, could have been sent to cover Bobcaygeon. Another alnbulance in Lindsay, No. 384, picking up a patient at Ross Memorial Hospital for transfer to a nursing home, could have been kept in Lindsay to cover Lindsay. The Grievor allowed that this simple maneuver would have accomplished the task without stripping the area but insisted it would not have been appropriate for two reasons. First, it would have meant sending the Lindsay ambulance, No. 381, into a strange area. This does not appear at all satisfactory as the Grievor agreed that he knew the area as well as anyone and the ambulance crew would have been able to gain direction from him by radio contact. Second, keeping the Lindsay ambulance, No. 384, at Ross Memorial Hospital would have inconvenienced the patient that was being transferred as well as the hospital and the nursing home. We are not satisfied that their convenience can be a reason for refusing to dispatch to this emergency. The Crievor insists that he did not refuse to send an ambulance. By express word he did not; by his conduct he did. The Griever was clearly negligent. Does the negligence warrant dismissal? Had there been evidence that the Grievor was an unsatisfactory employee who had been progressively disciplined without improvement we would have no hesitation in upholding the penalty. The penalty is severe but the potential consequences of error are as well. There is however, nothing before us to indicate any discipline directed to him. Granted there was evidence of some counselling of the Grievor by his Manager to improve his performance but there is not so much as . . . .& -3- a warning letter on his file. A dismissal might be seen as having some general deterrent or educational effect on. other Dispatchers but is it just in these circumstances? If it is not perceived as just will it have any effect on others? We are not satisfied that dismissal here is justified and to that extent the grievance is upheld. However, we believe that it would be wrong to order the Grievor’s reinstatement to a dispatching position. He has been a Dispatcher for ten years, has received at least some training and supervision, has been given advice in the form of training manual, memorandum and index card system, and still failed to comprehend his true task when the emergency call came in. We were not satisfied by his evidence at the hearing that he understands tnat task to-day. Accordingly we order reinstatement to another job within the Ministry at a comparable salary. We do not believe however that this is an appropriate case to order compensation for lost remuneration. We will. remain seized of jurisdiction pending any difficulties in implementing the award. DATED at Toronto this 26th day of .Januafy , 1984. R. Delisle - Vice Chairman /Ibw