‘Constant sense of impending doom’
Critical incident only matter of time at HSC, say ER nurses
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Summer is “trauma season” in hospital emergency departments and nurses at Winnipeg’s largest ER are already raising the alarm about what they describe as worse-than-ever staffing shortages.
“The public is at risk, and that’s why we’re speaking out, is because patients’ lives are at risk,” one Health Sciences Centre ER nurse said. Three HSC nurses with many years of experience working in the ER were interviewed on the condition their identities not be published, because they fear they’ll be fired for speaking publicly. All three of them brought up the tragic death of Brian Sinclair and said they worry another patient will soon die in the same manner.
Sinclair was an Indigenous man who died in 2008 at age 45 after waiting 34 hours in HSC’s ER. An inquest into his death resulted in 63 recommendations for change, many of which focused on how HSC’s ER is run. Now, 14 years later, nurses are so overrun they don’t have the time or resources to follow all of the protocols that Sinclair’s death proved were necessary.
Patients are waiting up to 24 hours in the ER waiting room, and waiting additional days or weeks for a hospital bed after they’ve been assessed by an ER doctor. The usual per-shift complement of 24 ER nurses has recently dropped as low as 12, and triage nurses don’t have time to regularly re-assess patients in the waiting room like they’re supposed to, the nurses told the Free Press.
“That is one of the greatest fears (among nurses in the emergency department) is that what happened to poor Brian is going to happen to somebody else again. It’s not a matter of if, it’s a matter of when,” another nurse said.
They said HSC has lost roughly 60 experienced ER nurses over the past two years, since the pandemic began. Many ER nurses have either transferred to other departments, moved out of province, or quit the profession entirely. New ER nurses have been hired, but the hospital has lost decades of experience as senior nurses leave.
At 25.8 per cent, the vacancy rate in HSC’s ER is higher than the hospital’s overall vacancy rate (of 20.2 per cent), according to data provided by Shared Health. In a statement, a Shared Health spokesman wrote more than 40 per cent of vacant ER positions are term jobs, “which are often challenging to fill.”
The organization, which oversees the hospital’s operations, pointed to several previously announced government initiatives as ways the staffing shortages are being addressed: adding seats to university nursing programs, allowing undergraduate student nurses to join the workforce, signing a recent contract with the Manitoba Nurses’ Union, and establishing a provincial float pool.
“While the emergency department at HSC and others EDs across the province continue to provide safe, quality care, health system employers are putting significant efforts into ensuring appropriate and stabilized staffing levels, and more timely care for everyone who comes to one of our EDs,” a Shared Health spokesman stated.
The HSC ER nurses are calling for a plan to immediately increase staffing over the summer, when they expect to see increases in traffic collisions, accidents, substance abuse, stabbings and other violence in the city’s urban core. HSC is a tertiary trauma centre and now handles all of the city’s stroke patients in addition to referrals from other hospitals in Manitoba, Nunavut and northern Ontario. The nurses said they don’t have enough resources to properly care for all of the patients who come to the ER — many of whom have worsening conditions because of pandemic treatment and diagnosis backlogs.
One nurse said she goes to work with a “constant sense of impending doom.” Another said she feels more moral distress now than at any other point in her career. All of them said the current reality of working in the ER is worse now than it was last spring, when Manitoba was forced to send critically ill patients out of province, and worse than at other waves of the pandemic.
“We are continually compensating for a broken system, because of the fear of what we know is inevitably going to happen, which is somebody dying in our waiting room or somebody dying when we could have prevented it,” one HSC ER nurse said.
“I don’t have the answers. Unfortunately, I think it will take something truly tragic in order to elicit any sort of change.”
Katie May is a general-assignment reporter for the Free Press.