Central Victorian communities ‘exposed’ as exhausted paramedics spend hours in hospital corridors

Paramedics using one of the state’s busiest hospitals are forced to care for critically ill patients in busy corridors for hours as the health system buckles under strain.

Paramedics at Ballarat Base Hospital are calling for better conditions and resourcing in the busy region amid dire and frequent ambulance ramping.

Exhausted paramedics at one of the state’s busiest regional hospitals are being forced to sit with critically ill patients in crowded corridors for up to half a shift because of Victoria’s battered health system.

As the Victorian Ambulance Union is in a stalemate with the state government over a new enterprise agreement following more than 100 meetings, frontline paramedics are burnt out and demoralised enduring “unsustainable” conditions and normalised overtime.

There are three Advanced Life Support ambulances rostered on in Ballarat on any given evening, manned by paramedics who work 14-hour night shifts.

These are backed up by two Mobile Intensive Care Ambulances.

But paramedic Alex said roughly once a night all of those vehicles were forced to wait for a bed to become available inside Ballarat Base Hospital – a situation called ‘ramping’ – while paramedics continued to care for their patients in busy corridors.

Paramedics Chelsea, Zoe, Taylor, and Tony at Ballarat Base Hospital.

Alex said it was “not uncommon” to do half a shift “on the ramp” and for paramedic crews to be called in from Ballan, Beaufort, Avoca, Daylesford, or Ararat.

If circumstances worsen, crews from as far as Bacchus Marsh or Geelong might be forced to lend a hand, “leaving their communities exposed”.

“Most paramedics in this region have had concerns about this level of staffing and resources for a significant period of time,” Alex said.

Many ambulances in Ballarat bear marks of these protests: chalk messages on the vehicle’s sides and backs read: “Will we be available when you need us?”

“1 ALS ambulance per 40,000 people. How do you like your chances of getting one?”

“Who will look after you if we’re stuck in the hospital corridor?”

“17 hour night shift! Not safe.”

Ballarat paramedics say there is a ‘palpable’ tension about ambulance ramping in the region.

During a recent night shift, Alex spent seven hours ramped, and over a fortnight did nine and a half hours of overtime – overtime which he said was “burning out the workforce”.

His colleague Tony this week spent eight hours ramped with the same patient during a single stint and did not get a meal break for 12 hours.

“It was a really busy night so other crews hadn’t had their breaks as well, so we had to take over their patients so that they could get their breaks, and then we got stuck,” Tony said.

At 11.30am on Monday – a “notoriously awful day” due to an influx of weekend patients – there were 10 ambulances parked at the hospital’s rear, three of which were for non-emergencies like moving patients between hospitals.

One vehicle had been waiting for four hours; the night crew who picked up that particular patient had to be relieved by fresh paramedics, who continued the vigil.

Four other crews at the time had logged at least an hour of ramping, and three more topped 40 minutes.

Paramedics can spend hours ramped with a patient, sometimes half of a shift.

If a particularly critical patient arrives when there are no beds, a more stable patient from the resuscitation area of the hospital is brought out into the hallway to make room, often leaving nurses to care for several patients at a time.

In the past few weeks, one person apparently suffered a cardiac arrest in the corridor.

Paramedic Taylor said ramped patients did not have the privacy and dignity they deserved.

“Our corridor’s actually quite narrow where there’s lots of traffic, so if a patient is undignified in any way, such as they got into a car accident and don't have any clothes on, they don’t have any dignity – there’s no privacy at all,” she said.

“I once had a gentleman that was close to 100 years of age sitting on a stretcher for about 12 hours.

“He was just meant to be an inter-hospital transfer, so that’s directly from one hospital to another.

“They were promised a bed but waited in ED for about 12 hours.”

Paramedic Chelsea returns a stretcher to an ambulance.

The sick or injured meant to be seen within 10 minutes often spend at least an hour without a hospital bed, another paramedic named Jack said.

He said the tension about ramping was “palpable” and 14-hour night shifts were “unsustainable”.

“If you don’t get ramped, you’re looking at easily eight-plus jobs a night,” Jack said.

“You’re constantly just working, working, working.

“And a job, if it goes smoothly and there’s no delays, is a two-hour endeavour.

“Credit to Ballarat Base, they’re doing everything they can with what they’ve been given – there’s just not enough.”

Ballarat’s emergency department entrance.

Zoe has been a paramedic for 15 years and said the number of ambulances on of a night time – one each from Ballarat, Sebastopol, and Wendouree – had not changed.

Ballarat’s population has increased from about 91,000 in 2009 to nearly 120,000 now.

“It’s not the career that we chose,” Zoe said.

“We didn’t choose to stand in corridors for hours on end with a patient who’s uncomfortable and not being treated ideally.

Ballarat Base Hospital.

Some paramedics fear for their own families amid a lack of resourcing.

In late June, video appeared to show at least nine ambulances ramped outside Ballarat Hospital’s intake bay.

Paramedics’ hopes for their enterprise agreement include improvements to the dispatching system and changes to make it more likely they finish their shifts on time.

In Ballarat, Alex said more staff on at night-time and more emergency beds were also needed – and at a faster rate than the city’s growing population.

Grampians Health hospitals chief operating officer Ben Kelly said the emergency department was under high demand due to a rise in winter illness, staffing pressure, and other general ailments.

“All patients presenting to our ED (via Ambulance or through the front door) are triaged carefully and those who are most unwell will be seen to first,’’ he said.

“While we acknowledge that we are not alone in this, and a similar pressure is being experienced across the state, we thank our staff for doing everything they can to limit wait times for our community.”

Ambulance Victoria Grampians regional director Peter Jenkins said multiple teams — in Ballarat including MICA and ALS paramedics, first responders, air ambulance and secondary triage teams — worked together to ensure Victorians got timely and proper care.

The state government said health care across the world had been “heavily impacted and changed as a consequence of the once-in-100-year pandemic”.

“Primary care is harder to access, patients are sicker and staying in hospital longer, and we’re seeing record numbers visit the emergency department and triple-0 calls,” a spokesman said.

“Ballarat Base Hospital continues to treat all Category 1 emergency department patients in the clinically recommended time.”

The government said it had more than doubled the on-road paramedic workforce since coming to power, with more paramedics per 100,000 people in Victoria than in NSW and Australia as a whole.

The January to March 2024 quarter recorded 96,484 Code 1 ambulance call-outs, representing a 4.4 per cent increase compared to the same quarter last year.

A $655m redevelopment of Ballarat Base Hospital now underway will include a new emergency department and an extra 100 inpatient and short stay beds.