When Rachelle Cole first heard about the community paramedicine program in 2015, she jumped at the chance to expand the health-care services available in her home community of Ucluelet.
As a third generation Ucluetian born and raised the small community of about 2,000 residents, Rachelle serves as both the unit chief and community paramedic at Station 134 - Ucluelet. Through the community paramedicine program, Rachelle visits patients in their homes and focuses on prevention, health promotion, and primary health, working closely with local health-care teams.
“I get to be the boots on the ground and eyes on the client,” says Rachelle. “It’s all about catching issues sooner, preventing ambulance calls where possible, and making hospital stays shorter.”
Since being trialled in 2015 and rolled out provincially in 2016, BCEHS’ community paramedicine program has expanded to now serve 100 rural and remote communities across B.C., in partnership with regional health authorities and local care teams.
The program has trained almost 170 community paramedics, who have conducted more than 100,000 patient visits to date, along with services such as vaccination clinics, home health monitoring, and health education programs.
Provincial research shows community paramedicine is having a positive impact. The latest program review found a 39 per cent drop in 911 calls made by patients who received proactive community paramedicine services.
After growing up in Ucluelet, Rachelle explored different communities and jobs on her path to paramedicine. She moved around Vancouver Island, Kamloops, and the Lower Mainland, then Chicago and Los Angeles. She ran a small catering company after completing culinary school and a sommelier diploma. In California, she worked as a firefighter, and admired what paramedics contributed on emergency calls. That experience inspired Rachelle to train as an emergency medical technician.
Throughout it all, Rachelle felt drawn back to the West Coast. Eventually she moved home to Ucluelet, and had the opportunity join BCEHS in 2013 and train as a primary care paramedic in 2014. Soon after, Rachelle was promoted to acting and then permanent unit chief for station 134.
Rachelle's says her history in Ucluelet gives her a deep appreciation for the community and its residents.
"I feel very fortunate building the community paramedicine program here, because I already had the built-in-network," says Rachelle, who has personal connections to almost every client she serves, either directly or mutual friends or family.
Rachelle is proud to have been part of many 'firsts' in her paramedicine career so far. In addition to serving in the first cohort of community paramedics, she also helped pilot the first home-health monitoring on Vancouver Island. And, when a new program launched at the beginning of 2021 that enabled community paramedics to administer COVID-19 vaccinations, Rachelle was the first in the province to participate. Working with Island Health, the First Nations Health Authority, and the Nuu-chah-nulth nursing team, Rachelle collaborated to offer vaccination clinics on Ahousaht and Tla-o-qui-aht First Nations traditional territories.
"It's so rewarding to play a role in helping to protect people," says Rachelle. "Anything that helps keep people healthy and safe in our community, I want to be a part of it."
Helping people stay their communities as they get older is one of the many reasons Rachelle is excited about community paramedicine work.
"Here in Ucluelet, it's life literally on the edge of the country – there's one way in, one way out, and we kind of like it this way," laughs Rachelle.
Scenery around Ucluelet and Ucluelet Harbour.
But health care can be difficult to access in remote locations like Ucluelet, particularly for aging residents living with chronic and complex issues.
"Too often, older folks in our community eventually feel that they have to move cross-island, to Victoria - away from their friends, family, grandkids – to where they can better access health-care services," she says.
Rachelle hopes programs like community paramedicine can continue expanding options for older people in rural and remote areas like Ucluelet.
"I'm passionate about how we can keep our aging population in place, in their communities – and how we can grow our health-care services and teams where possible," says Rachelle.
"If we can keep the history and experiences of elders on the West Coast, I think that contributes to a fuller society for everyone. That means advocating for the needs of our aging populations, alongside the needs of families, children, and anyone else who wants to be part of these amazing, beautiful small communities around B.C."
Rachelle’s professional work in community paramedicine inspired her to take up cycling as a hobby, to stay healthy as she gets older. Rachelle represented BCEHS as one of the 21 riders on the 2022 annual Tour de Rock to support the mission of the Canadian Cancer Society Canadian Cancer, where she personally raised almost $65,000 for cancer research.
Fred Montpetit works as a community health and home care nurse in Ucluelet. Over the last seven years, he says community paramedicine has provided vital and complementary services as part of Ucluelet's health-care team.
"Community paramedicine is all about being proactive and hopefully reducing the need for emergency or hospital care," explains Fred.
Fred says he's seen countless examples where a quick check-in from Rachelle has made a big difference to the experiences of their shared patients. "We had one palliative care client who was just terrified of calling an ambulance, because he didn't want to get taken to a hospital," says Fred. "Instead, Rachelle was able to go and sit with him in his home, give what he needed to be comfortable, and build his trust in the whole health care team that we would respect his wishes."
Residents at the Sea View Seniors Housing Society at Forest Glen playing games and enjoying meals together in their community; Amphitrite Point Lighthouse in Ucluelet
Cathy Whitcomb is the administrator for Sea View Seniors Housing Society at Forest Glen, an assisted living building in Ucluelet with apartments for older adults. Cathy says she values Rachelle as a partner who makes sure Forest Glen residents get the right care.
"I know I can always count on Rachelle and BCEHS, whether it's a just a quick text, an in-person visit, or a 911 call," says Cathy. Rachelle has been able to help Forest Glen with services such as regular check-ins and blood pressure testing, and community initiatives like setting up a local warming centre for Ucluelet seniors in case of power outages or emergencies.
"Since community paramedicine started, it's become an integral part to the health infrastructure of the whole West Coast," Cathy explains. "In Ucluelet, we're literally at the end of the road, but I have a great deal of confidence knowing that Rachelle and the BCEHS team are looking after us here."
Learn more about community paramedicine and read the 2021/22 progress report for more about BCEHS programs.