Over-capacity surge at HSC emergency ‘scary,’ nurses union leader says

The Manitoba Nurses Union is warning that the strained situation in Health Sciences Centre’s adult emergency department since Sunday is unsustainable and ‘extremely scary.’

The ER was overwhelmed, with several patients requiring urgent surgeries, advanced levels of care and admission to hospital throughout the day, a Shared Health spokesperson said Tuesday.

“In response to the higher volumes, an over-capacity surge for resuscitation capacity was declared,” the spokesperson said, adding the system worked as intended to respond to increased demand.

“Calling a surge is a standard and proactive step that allows care teams to adjust staffing, create more space, and ensure patients requiring urgent care continue to receive it safely.”

It might be “standard,” but the system can withstand only so much strain, said MNU president Darlene Jackson.

“It can’t go on for very long, I can tell you that, because it’s not safe. And, for nurses, it is extremely scary,” she said.

“It sounds like they had more patients needing resuscitation and needing that area than they had beds and staff for, so they just doubled up.”

The situation continued into Monday, with a large number of high-acuity patients, additional staff brought in to address the increased volume and a surge response for resuscitation beds in effect, the Shared Health spokesperson said.

“Those are individuals who need intensive care and really need close monitoring and it sounds like nurses are pushed way beyond where they should be,” Jackson said.

By midday Tuesday, the HSC’s ER was jammed, with 43 patients waiting for an initial assessment by a physician, 56 who’d been assessed and a 10-hour wait time.

Jackson said she heard her members experienced much the same situation at St. Boniface Hospital’s ER recently.

“It’s getting to be a real issue in our ERs where we’re seeing more and more critically ill patients, and there just is not the staff to care for them,” she said, adding an aging population is only partly the cause.

“The wait times have a big impact on people not seeking care sooner. Someone is ill and really needs to see a doctor, and they’re like, ‘I don’t want to sit in an emergency department for 12 hours — I’m too sick for that.’

“And then what happens? They become critically ill and need that care immediately.”

The province should be prepared for ER surges that are expected every winter, said physician advocacy organization Doctors Manitoba.

“Manitoba has designed a floodway to accommodate one-in-700-year floods, and yet our hospitals are not planned to accommodate annual surges in patient volumes that predictably occur every winter,” spokesman Keir Johnson said.

“Our hospital and (personal-care home) beds fill up, patients back up in the ER, resulting in prolonged, unreasonably long wait times for incoming patients. This is a longstanding issue in Manitoba, and in many places across Canada.”

Doctors Manitoba has called for hospitals to be designed with more capacity to accommodate routine surges in patient volumes. He said the organization is encouraged to see progress in the last few years to open more beds and add more home care-capacity.

“However, this is not nearly enough to meet the needs of our province,” he said.

Lengthy ER waits will be reduced only when people aren’t stuck “languishing” in hospital beds waiting for home care to become available so they can leave and open up space, Jackson said.

“It’s also a workload issue, because those (home-care) nurses are carrying massive loads and they’re canceling patients on a regular basis in that program just because they don’t have the staff to meet the need.”

She estimated the number of home-care clients has risen by about 30 per cent over the past 12 or so years, but the number of people to care for them has not kept up.

The MNU, meanwhile continues to grey-list the HSC, a designation that discourages others from working at the site because of safety concerns.

“They have done a lot to fix safety at HSC but there are still some things that need to be done,” Jackson said.

The hospital has police officers on site 24-7 and has deployed weapons scanners at the entrances.

“What we’re asking from them is a letter of understanding that says as soon as grey-listing is lifted, we won’t see these things pulled back,” she said.

“We don’t really want to see them backslide on things, but we also don’t want to see them not fulfil promises. We want them to give us a time limit on when they’re going to do what they couldn’t do right away.”

carol.sanders@freepress.mb.ca