SJA MFR Changes - PETITION CLOSED

Reducing our abilities for apparently no good reason essentially turns us in to "bandaid brigade" that other organizations already joke about in describing us. In time where SJA is professing our skills and professionalism, reducing our capabilities plays right into the hands of competing organizations for the public event FA funds.

Going backwards while everyone else goes forwards. No benefit to patients or the care they receive at all.

As a long-standing physician member of the organization, I am disappointed to hear from the first aid leaders of a reduction of scope. In particular, if the limitations on certified health care providers, requiring them to lower their scope of practice to first aid only is accurate, then I fear that nurses, physicians, paramedics and others will never participate in the provision of care at SJA events. I personally, as an Emergency Physician, will not come out to a SJA event in a clinical role if I am held to a MFR level of care. That's not what I do.

I would oppose most of these new restrictions, particularly the restriction on carrying ASA, and Glucogel, and the new lack of training for Glucose testing. Having a young sister with Type I diabetes, and knowing other familys who have children with this condition, I can say that most would be very reluctant to place their child in the care of a Medical Responder, who will not only be unable to test and report the severity of a low, but will not even have their own supply of fast acting Glucose. At this point it becomes simpler and safer for the parent to treat their own child.

These changes are disappointing in an organization where recently we have been discussing the advancement of our scope of practice to provide BETTER care to our patients and expand our event coverage with more skills available to our members. These changes will not result in better patient care and for the purposes of insurance we will be reduced to watching certain patients deteriorate and in essence die as we stand by unable to give medications or perform life saving interventions that are required in the emergency situation. These changes will give St John Ambulance a bad reputation in the medical world and will hinder the already fragile, yet growing, relationship we have with BC Ambulance service and other local medical professionals. In the last few years medicine has advanced more than it has in 200 years and with these alterations to our patient care we are not going in the same direction as the rest of the world and we are bringing this organization down from within as it will be pushed out of public contact once organizers start to realize that they can get the same care with Standard First Aiders on site.

These changes to the MFR scope of practice are fairly significant and definitely require some justification. I wonder if Rogers Arena will be keeping us around if we are unable to use a stretcher to extricate patients from the floor to a gate for BCAS. The consequences of this move to decrease our capabilities in the field will directly impact patient outcomes, and is contradictory to the St. John Ambulance mission statement as well (I.E. by providing community service with members that are less trained, we are effectively reducing the safety of people at those events). The St. John Ambulance website also claims that it's 'Vision' is to be the premier community service organization in Canada. This is obviously a step in the wrong direction if that is to be our goal. I'm eager to hear the reasoning behind many of these changes, and until a valid argument is presented that shows this will be in our patients' best interest, I'll remain fervently opposed to these reductions to our scope of practice.

With all these changes to restrict our volunteer's scope of practice, what is going to set SJA apart from other organizations that also provide first aid to public event? How can we continue to provide superior patient care if some of these changes are leaving our hands tied behind our backs when critical interventions are needed? I do not agree with these changes, and I further disagree with the fact some of these changes have already taken place without justification to and prior consultation with the members!

I am extremely disheartened by the new AMFR roll out. It is not even equivalent to the old AMFR1 but is a step backwards from where we used to be. As a paramedic this is morally disheartening and the thought of discontinuing my participation with SJA definitely crossed my mind. Knowing other paramedics who also volunteer with SJA, they had the same thoughts: "Why bother continuing with this organization when all we can do is practice to such a reduced level?". We are going to lose many highly skilled and valuable volunteers in this organization if something isn't changed. Having spent so many years trying to promote and have the public acknowledge us as not just merely a "bandaid station" it looks like we are moving back in time. More importantly I think is the effect of the organization as whole. SJA is exceptional to other organizations in its professionalism and also the high level of care we can provide. With this scope obviously shrinking, I can see other organizations taking over many roles and duties we cover. Other organizations are pushing to increase their standards of care, to further their organization. Why are we taking steps backwards? It makes no sense. I believe with this change, the organization as a whole is setting itself up for failure. Perhaps the bigger questions is WHY are so many practices restricted, including practices such as NPAs, stretcher use, spinal immobilization etc being removed? What is the reasoning behind it, is it a valid reason? We use stretchers and deal with spinal patients in many duties and it is a vital skill to have. As well, why do we no longer teach such basic skills as use of tourniquet when it can mean a life and death sitaution for a patient? Others includes the simple use of glucose, what is the reasoning behind all this? Is patient care not our main goal? I ask that these questions be answered, and for the organization to truly consider the impact this will have on not just the volunters and p

these changes are a step in the wrong direction....St. John Ambulance 'Saving Lives'? More like 'Saving Fewer Lives'

I think an announcement with rationalization for the changes would have helped people better understand these changes. Removing some do make sense (use of traction splints, KEDs), while removing others does not (spinal immobilization, stretcher use, ASA for acute coronary syndrome). Also, the restriction in health care professionals operating under their own license and malpractice insurance is a major step back. RNs and MDs offer a huge selling point to potential event organizers, as well as provide a higher level of patient care. They are also a source of leadership and can share their knowledge and experience to other members. Making these changes will cause most of these professionals to leave the service. This will impact both volunteer recruitment and retention, as well as demand for services in the community.

I find it very difficult to see conflict of interest in the same agency. One is that we are supposed to in line with LCOR and instruct the public to administer ASA for heart and stroke, administer sugar to a diabetic and then tell AMFR that is not the "scope of practice". This must place St John in a legal situation if it tells the public to do one thing and tell its members it's not to be done. The lawyers will have a field day. If the AMFR new standards are fixed I recommend that all Standard manuals be pulled; and LCOR told that we are no longer participants. I also feel that at least 1/3 of the trained AMFR will leave the Brigades and we can kiss our major donors goodbye.

I do not believe that we should go backward in our MFR protocol. A member / common person with standard level would do more than what we (St John) could do in new MFR scope of practice. For a long time, we were told that the MFR should / would be close or at the same level to the EMR. If the new scope of practice stay as it is (lower than standard level), why are we providing first aid service to less than standard. We should do more than standard and be very close to EMR level. It is a stepping stone to the EMR / paramedic.

As a PCP student who is about to license soon, and a member of the Brigade for years, I find these changes to be unacceptable and detrimental to our patients and to our members. Brigades will dissolve quickly if this continues to go on, and SJA will lose its foothold in Canada. Sja in Canada already does some of the least patient care in the Commonwealth, and this goes against the values of both the organization and the Order.

I'm already having these discussions with Charles. The unfortunate problem is that it comes from NHQ and we don't have a direct line. This going backwards is going to alienate and ultimately send away many of our volunteers. They come for the experience and knowledge and this will severely restrict our ability to recruit