Unrelenting chaos, chronic gridlock in ER misery for patients, health-care staff Health minister to reveal details of treatment plan for critically ill system By: Carol Sanders Posted: 6:50 PM CST Thursday, Nov. 16, 2023

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This article was published 16/11/2023 (1057 days ago), so information in it may no longer be current.

Patients in various levels of distress are parked on stretchers that line the hallways. Someone is moaning. The newest arrival, lying on her side, calls out.

“Somebody … please help me.”

There are no call buttons for the people in the corridors. It wouldn’t matter if there were — the staff on shift are too overwhelmed to respond.

A man who’s been languishing for days soils himself.

Over the course of 15 minutes, six ambulances arrive with more patients who will be moved into the hallways.

A woman is brought in with dangerously low blood pressure. Because there aren’t any stretchers left, the paramedics ask her if there is anyone who can sit with her in case she passes out in a waiting room chair.

Two health-care aides go from patient to patient with requests for help outpacing their capacity. They appear exhausted and weighed down, knowing they’ll never catch up or have the time to care for people the way they would like to.

It’s a snapshot of the miserable, undignified and, at times, hopeless situation in the Grace Hospital’s emergency department this week, as described by a Winnipegger inside the chaos.

The Winnipeg Regional Health Authority has told the Free Press it cannot provide the number of patients there each day, waiting endlessly, uncomfortably and without any privacy on stretchers in the hallways for an available bed at the Grace or somewhere else. The patient-flow problem has worsened in recent months, the WRHA said.

The median length of stay for admitted patients in the Grace ER in September was 24.67 hours, the WRHA said. In October, preliminary numbers show a jump to 33.65 hours.

“We recognize that all Manitobans should expect access to timely, high-quality health care when they need it,” a WRHA spokesman said in an email. “Waiting for hours or days for care in our emergency departments and urgent care centres is difficult, especially if you are sick or in pain.

“From my point of view, it’s terribly demoralizing to see these people who are waiting an unconscionable length of time and there’s nothing you can do to get them in.”–Dr. Doug Eyolfson

“When this happens, patients may have to be cared for in alternative spaces…. Those patients are monitored and cared for the same as all others, with all necessary equipment. This is a temporary measure that is necessitated by the surge in patients presenting to the emergency department.”

More staff are needed in hospitals, long-term care and home care in order to open more beds in hospital wards and move patients out of the ER more quickly, the WRHA said, adding it has taken steps in recent years to address the problem, with “internal capacity management plans,” that provide short-term relief to ensure resuscitation-area capacity remains.

“From my point of view, it’s terribly demoralizing to see these people who are waiting an unconscionable length of time and there’s nothing you can do to get them in,” said Dr. Doug Eyolfson, who works in the Grace emergency department.

The former Liberal MP took to social media, posting Wednesday’s Free Press story about 89-year-old Barney Charach, who’d been waiting six days on a stretcher in the hallway at the Grace.

Charach was still there Thursday. His daughter Gayle Charach was optimistic that the necessary supports would be in place Friday enabling her wheelchair-using father to return to his home in Shaftesbury Park Retirement Residence Friday.

“The main problem is there is not enough in-patient beds and spaces and and long-term care beds,” Eyolfson said. “Some people can’t go home anymore and need a long-term care bed and there’s nowhere to go. Sometimes that takes a week or so to find the bed,” he said.

The current situation leaves him with “a horrible, helpless feeling.”

“(Patients) have problems and they need a treatment bed. You can’t just go out into the waiting room and start laying someone down and feeling their abdomen or undoing their shirt and listening to their chest,” he said.

“You need to see every patient because sometimes it seems like a social issue or a home-care issue and you find there’s some serious medical issue.”

Premier Wab Kinew, who has vowed his new government will fix health care, agreed Thursday that patients shouldn’t have to spend eight days on a stretcher in an emergency department hallway.

“A situation like that shouldn’t happen,” Kinew said, referring to Charach in response to a question at an unrelated news conference.

He said Health Minister Uzoma Asagwara would release details of the government’s health-care plan Friday.

“We know that we were elected by the people of Manitoba to ensure that you can get access to health care closer to home, that you don’t have to wait as long to get the medical procedures and access to health care that you deserve and, importantly, that we improve the morale of those people who work on the front lines of our health-care system,” Kinew said.

Manitoba Nurses Union president Darlene Jackson said there is “a light at the end of the tunnel” with the creation of a provincial float pool of nurses. The union bargained for it in their last contract to incentivize nurses to return to the public system from private, for-profit agencies that are being paid millions of dollars by the government to cover staffing shortages.

“I think that’s going to be very effective once it’s up and running and fully staffed,” Jackson said Thursday.

Meanwhile, nurses are left to cope with the chronic ER patient-flow problem, she said.

“It is extremely frustrating,” she said. “I had a nurse say to me the other day, ‘When I go to work and there’s 32 patients lying on stretchers, and I can’t bring a patient in from the waiting room onto a stretcher, then the wait in the waiting room gets longer and longer. Patients get very upset, and this leads to patients leaving without being seen,’” Jackson recalled. “On occasion we have had some bad outcomes from that.”

Chaotic ERs are no place for long-term care, Jackson said.

“For those nurses in emergency, it’s very difficult because now they’re doing in-patient care on maybe 30 patients, as well as trying to manage the resuscitations and critically ill patients that are coming in,” she said.

carol.sanders@freepress.mb.ca