“Mike has become an important part of our team and everyone is so supportive of him – he even gets hugs in the hallway!” Donna Jouan-Tapp, Manager of Island Health Community Health Services in Duncan, is referring to Mike Wright, a BC Ambulance Service community paramedic and former Island Health chief power engineer at Nanaimo Regional General Hospital.
A paramedic for the past 20 years, in March 2018 Wright was appointed one of Cowichan’s two community paramedics (the other is Georgia Nelson who serves areas in and around Chemainus). The positions were created by BC Emergency Health Services to improve access to health care in rural and remote communities, including Lake Cowichan and a wide span of surrounding areas where Wright spends the majority of his time.
“A huge part of my job is about fostering relationships and building trust with both patients and Donna’s team,” he explains. “I’m not here to replace anyone or do something that’s already being done. Rather, I work collaboratively with Duncan Community Health and others to add value to a system that’s in place and give people access to primary health care more quickly while keeping them in their homes for longer.”
One of Wright’s biggest champions has been Jouan-Tapp, who was already familiar with the benefits of a similar community paramedicine program in Saskatchewan where she previously worked. Here in B.C., community paramedics focus on patients in areas that are sometimes underserved and have aging populations living with chronic and complex diseases, and work to bridge health service delivery gaps identified in collaboration with local health care teams.
“Community paramedicine is a huge benefit to Island Health and to the areas of the Cowichan Valley most removed from our central core,” says Jouan-Tapp. “Mike is our eyes and ears in the community. It takes us an hour to get to some of these places so when you have that extra resource out there, getting to know the clients and the community and connecting with our team on a daily basis, it’s just so fantastic.”
“It took a while to get some traction but thanks to Donna’s support, her staff gave me a chance. I shadowed her folks for a while and we got used to each other,” says Wright. “Now when I walk into this building, I feel like I am part of the team. I have a huge amount of respect for these people.”
Historically, ambulance services have been primarily reactive with paramedics responding to medical emergencies. Community paramedicine is considered a more proactive approach to health care, with community paramedics regularly visiting people, including end-of-life patients, in their homes to check in on them, make assessments and report back to primary health care providers while also offering a host of other services including a wide range of community health promotion initiatives.
“During a blood sugar clinic I offered in Lake Cowichan, one gentleman was surprised to realize that his blood sugar reading was four times higher than it should have been,” says Wright. “Another time, at a CPR clinic I provided to a local health care auxiliary group that met at a nearby legion, I noticed the building didn’t have an Automated External Defibrillator. I spoke with auxiliary members and they decided to donate an AED - I then conducted an AED familiarization training exercise with them and legion staff.”
Wright notes a deep commitment to the health and well-being of his clients, often taking their calls after hours and on weekends. In addition to the trust he’s built with Jouan-Tapp’s team, he’s also dedicated to fostering relationships with other health care partners such as doctors, mental health clinicians and pharmacists.
“I provide that one on one patient care with people in their homes and see myself as a conduit between the patient and other providers who can’t be there in person,” he says. “For example, if I visit a patient and see fluctuations in their blood pressure, I can pick up the phone and talk with their family physician directly. I have built such a good relationship with doctors – there is so much trust.”
Jouan-Tapp agrees that the trust Wright has earned over the past year plays a major role in the success of the community paramedicine program in the Cowichan Valley.
“Because our documentation practices are separated between two agencies, the verbal feedback that Mike provides our staff about our clients is critical,” she says. “That’s where you get the rich conversations and true information sharing. Together, we are supporting our shared clients in the best way possible with the right person at the right time in the right place for the right reasons. It’s a great partnership.”
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