Katherine paramedics are at breaking point after being forced to work a brutal roster consisting of four consecutive 20 hour shifts for more than a year, despite raising countless concerns with management over chronic fatigue.
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Fearing for patient safety in Katherine, St John Ambulance paramedics have sounded the alarm on ongoing internal issues and cost cutting measures that have seen them making critical, life-saving decisions under duress and exhaustion.
"My biggest fear is that I seriously injure or kill someone," a St John Ambulance paramedic, who wishes to remain anonymous for fear of retribution, says.
"We've been told to manage our own fatigue or drink more coffee, but when you've done a 12 hour shift and then you get recalled at 2am for a job and then at 5am and then have to return to work the next day at midday, it's impossible," she said.
"We could be awake for 20 hours every day with only four hours stand down... this is a traumatic and busy job most of the time, so you need more time between shifts."
After 15 months of seeking help and calling for a change to no avail, three Katherine paramedics have come forward anonymously.
They are part of a group of five paramedics specifically hired by St John Ambulance in 2019 to crew an additional ambulance to deal with a town facing increasing emergency care requirements.
For years, code ones stacked high as a single ambulance serviced a 150 kilometre radius.The days were split into two 12 hour shifts, with the first shift starting at 6.30am and a night crew taking over at 6.30pm.
If a crew was attending an emergency almost 100km away in Mataranka, people in town would simply have to wait.
Enterprise Agreements, backed up by research which stress the need for a break between shifts, stipulate a minimum 10 hour stand down, but the midday roster added in 2019 sees none of the same protections.
"When they implemented this new roster, existing staff said they didn't want to do it, so St John said they would hire a whole new crew," one of the paramedics said.
"Our shift starts at 12pm and runs until 12am, but then we are on call until 8am and have to be back at work at midday," he said.
"There have been times I've been called in my four-hour break because the other crews are busy, and you can't say no to helping someone."
A particularly intense and busy week involved consecutive jobs three nights in a row and just three hours of broken sleep a night, he said.
"It's become dangerous, we're often making big clinical decisions late at night or administering dangerous drugs - it's not fair for the people of Katherine."
Erina Early, secretary of the United Workers Union, says she has been battling upper management on behalf of the paramedics for over a year.
"My biggest concern is the health and wellbeing of these paramedics. They deserve better," she said.
"[Katherine] has an exceptional team, but if they are fatigued it could really impact patient care."
She said St John Ambulance has ignored numerous complaints from staff in a bid to improve their bottom line.
"In their fatigue policy [St John Ambulance] says paramedics should drink more coffee," Ms Early said.
"The roster is irresponsible. It is how [St John] is cutting costs. This is how they are managing their funding."
The paramedics are calling for an additional crew to service the station operating on a razor thin margin, and for a specific fatigue plan to be written into their contract.
"There have been times when we have been told we don't care about the community if we say we need to go home, but that is so far from the truth," one of the paramedics said.
Burnt out, she said she is unsure if she can continue on without critical reforms.
Craig Garraway, acting director of St John Ambulance Services says the wellbeing of staff is of "highest priority".
"St John NT currently operates two crews seven days a week in Katherine, from midday to midnight, with an on-call component from midnight to 8am. The on-call crews are based at home and are only required to respond to emergency situations," he said.
"In the past 12 months, the on-call crew in Katherine has been called upon 65 times to respond when the active night shift has been unavailable.
"The utilisation of an on-call crew is a common practice in regional and remote locations in Australia and is similar for other health professionals. This roster model is also currently used in Alice Springs."
He said the service is "proactively" working to address the issues raised by the paramedics, despite their claims they have long been ignored.
"The wellbeing of our staff is our highest priority, we are currently reviewing our service delivery models to ensure we have the correct procedures in place to train and support staff to manage fatigue for their own and our patients' safety and wellbeing," he said.
"[We have] been in discussion with the Katherine crew regarding support procedures should they be required to work additional hours and/or face issues of fatigue.
"Provisions for working on-call are currently covered under the existing Ambulance Enterprise Agreement (EA) and continue to be discussed as part of the current EA negotiations."
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