It is Sunday morning on October 9 at the Emergency Medicine Communication Center (AMK) at Ullevål Hospital. You get here when you call the medical emergency number 113 from the capital and large parts of the surrounding areas. Normally, 6 employees will receive emergency calls from an area with over 1.7 million inhabitants at this time of day. They must ensure that people get the right help at the right time in a medical emergency. Whether it concerns cardiac arrest, a traffic accident, or someone being shot or stabbed. At 7 o’clock that Sunday, only two employees were on duty to answer 113. There was also a crisis in the duty schedule later in the day. Staffing had been critically low for a few days. Now the management sounded the alarm. Waited almost 17 minutes for an answer. More people are calling AMK in Oslo now than before. The medical operators have a demanding job. They talk to people in crisis. When the exchange is understaffed at the same time, people who call 113 can notice this. Earlier this year, the State Administrator was on an inspection visit. Their report established that the time it takes for people to get an answer when they call 113 is not always reasonable. It is a requirement that 90 per cent of calls to 113 be answered within 10 seconds. news has asked for insight into how AMK in Oslo meets the requirement. So far this year, they have received close to 200,000 inquiries. In 85 percent of cases, people get an answer within 10 seconds. Many of the callers have been waiting for several minutes. Five of them have waited longer than five minutes. The longest waiting time is 16 minutes and 58 seconds. This is the response time for 113 telephones in 2022 (Figures for 2021 are in brackets.) Under ten seconds: 170,106 inquiries (197,725) Between 11 seconds and a minute: 25,832 inquiries (31,994) Between one and two minutes: 3,046 inquiries ( 3815) Between two and three minutes: 378 inquiries (521) Between three and four minutes: 35 inquiries (87) Between four and five minutes: 5 inquiries (8) Over five minutes: 5 inquiries (4) The longest a caller has had to wait in 2022 is 16 minutes 58 seconds. (The longest a caller had to wait in 2021 was 7 minutes and 3 seconds.) OUS emphasizes that there are weaknesses in the numbers collected, and there may be some errors. Source: Oslo University Hospital According to the management at the AMK central, the staffing situation has not improved since the state administrator’s visit in March. – The consequence may be that it takes a little longer before callers get an answer on the phone, says Katharina Lende, at AMK Oslo. Certain times of the week are more prone to waiting than others. In the afternoon and evening at weekends. When there is most activity in society. – What would you say to those who feel unsafe? – They must get answers, and they must get good health care. – They should know that we are working hard to resolve the situation and that we will do what is necessary to ensure that they receive fast and good health care, says Lende. This advertising poster for 113 hangs on the wall at the AMK central office. Photo: Siv Johanne Bjørkly Seglem / news Felt threatened After Sunday with critically low staffing, employees, management and union representatives gathered for a general meeting about the situation. news has spoken to several of the employees who were present. They wish to remain anonymous. They fear consequences. Many of them are frustrated. At the general meeting, the management said that the staffing crisis will be resolved for a long time to come, if the employees take on two extra shifts each. The management also said that if this does not happen, AMK in Oslo may have to reduce the area they cover. Employees can then be moved to other AMK centres. Several employees perceived it as a threat. Katharina Lende is head of department at AMK Oslo. Photo: Siv Johanne Bjørkly Seglem / news – It was not meant as a threat, says department head Katharina Lende at AMK Oslo. – The intention was that we, managers and employees, should sit with the same reality perception of the situation. She understands that employees are frustrated. Holes in the duty schedule After the general meeting, several of the employees have volunteered to take extra shifts. Former employees and employees of the ambulance department have also wanted to contribute. But there are still many gaps in the duty schedules in the coming weeks. – Yes, there are more holes than there should be. Around 120 guards at the AMK central are not occupied for the next three weeks. These are evenly distributed throughout the week. According to Lende, the situation is demanding for those who are at work. – There will be a disproportionately high workload. Nora Tiller Solheim is a medical operator at the AMK center in Oslo. She is a trained nurse and has worked at the AMK center for five years. Photo: Siv Johanne Bjørkly Seglem / NRKNora Tiller Solheim is a medical operator at the AMK center in Oslo. She is a trained nurse and has worked at the AMK center for five years. Photo: Siv Johanne Bjørkly Seglem / news Sick leave at the AMK central is also high. In excess of 10 percent. The trade union at OUS has previously said that they are well aware that there is a high level of sickness absence due to high work pressure. So far, no one has been ordered to work. – Where is the limit for when ordering takes place? – Imposed overtime must be considered when it is not possible to get enough personnel in a short time to ensure a proper emergency notification service for the population. Photo: Stian Lysberg Solum / NTB Proposals for unskilled AMK in Oslo receive many inquiries where there is no immediate danger to life or health. In order to make operations more efficient and reduce the waiting time on 113, the management wanted to turn over all stones. One proposal has been to train unskilled people without health education to take emergency calls. To roughly sort the inquiries. The Directorate of Health has assessed the proposal. They believe, among other things, that such rough sorting can delay the assessment of which health care the patient needs. The conclusion is clear. Temporary salary increase 20 out of 140 positions at the AMK central in Oslo are currently unfilled. Many employees have left here at the AMK central in Oslo in the past year. Photo: Siv Johanne Bjørkly Seglem / NRKMany employees have left here at the AMK central in Oslo in the past year. Photo: Siv Johanne Bjørkly Seglem / news Many are in training after people have left. Solving the staffing crisis is not done in one fell swoop. Hiring takes time. Training takes time. In the short term, management has taken three measures. Bringing in substitutes Changing the rotation so that the employees are evenly distributed among the different shifts Changing the training of new operators so that they can start work more quickly But Katharina Lende believes that the long-term measures are the most important to get the AMK center out of the situation . Among these are increased staffing, new larger premises and a thorough review of the way AMK is organised. In a time of extra strain, the management has also pulled out a “carrot” for the employees. Everyone at the AMK center will temporarily receive a higher salary. The so-called AMK supplement, which is a recruitment and retention supplement, is doubled. – It will double from 50,000 to 100,000 in the period we are recruiting, says department head Katharina Lende at AMK Oslo.
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