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This article was published 26/7/2017 (1313 days ago), so information in it may no longer be current.
Guards with a private security firm are acting as the after-hours gatekeepers at one of the city’s largest health care facilities, raising new concerns about patient safety in the wake of the provincial government’s hospital reorganization plan.
Staff with Securitas Canada are now stationed just inside the front doors at Misericordia Health Centre’s Cornish Avenue entrance between 8 p.m. and 7:30 a.m., telling would-be patients that the urgent care centre is no longer open around the clock.
The overnight shift at the urgent care centre was axed after less than two weeks’ notice on July 5. One doctor and one nurse remain on staff overnight to care for patients who remain in the urgent care centre when the doors close — and to respond to emergency situations that might arise within the larger health care facility. The two health professionals are also there to ensure the safe and timely transportation of anyone who might show up "with significant care needs."
But first would-be patients need to get past security guarding the entrance.
“Obviously, our position would be that security guards are not triage nurses." – Sandi Mowat, president of the Manitoba Nurses Union
Security staff have been told to let in patients requiring emergency eye care. The eye centre within Misericordia remains open 24-7.
Patients with other health issues are directed to other city urgent care centres and emergency rooms — unless their health condition seems grave enough to be examined by the lone doctor or lone nurse on staff.
But the discretion as to whether to summon the doctor or nurse appears to be left with security staff.
Critics find it bizarre that untrained workers are in effect performing some of the duties of a triage nurse.
"I think it’s very concerning, certainly from a patient safety point of view," said Sandi Mowat, president of the Manitoba Nurses Union.
"Obviously, our position would be that security guards are not triage nurses, and they certainly don’t have the expertise or knowledge to determine the severity of an illness or injury," she said.
It’s not always obvious how ill a person is based upon their demeanour when they arrive, Mowat said. "My question would be, ‘How does that security guard determine that level of (medical) distress?’"
Security 'providing direction': WRHA
Lori Lamont, the Winnipeg Regional Health Authority’s vice-president of interprofessional practice and chief nursing officer, rejected the notion that security guards at Misericordia are being asked to do triage.
"Not at all," she said. "They are responding to the public as they come in the door and providing direction to them."
Lamont said the security function at Misericordia is similar to what it is overnight at most other health facilities. "They do ask what the person is coming in to the centre for, which is our normal practice in many areas."
“It seems odd to me to have the security person essentially doing triage, particularly when you have a doctor and a nurse there.” –Jon Gerrard, Liberal MLA for River Heights.
Generally, security staff are redirecting patients who arrive late at night to other facilities, Lamont said.
"But certainly in the event that someone comes in in any form of distress the security guard would not be triaging as to what their problem is. They would be alerting staff within the facility to address that," the WRHA official said.
It’s that apparent responsibility, left with security, for deciding what constitutes a serious enough medical situation to require immediate medical assistance that worries critics.
"It seems odd to me to have the security person essentially doing triage, particularly when you have a doctor and a nurse there," said Dr. Jon Gerrard, Liberal MLA for River Heights.
Gerrard said it would be better to have the doctor or the nurse examine patients as they arrive and determine whether they needed immediate assistance. If they were becoming overloaded with work, they could refer patients to other facilities, he said.
He noted the WRHA has already indicated that few patients use the urgent care facility in the wee hours of the morning. One official estimated the volume at one patient per hour between midnight and 6 a.m.
"If they have one person per hour why aren’t they able to see them?" Gerrard remarked.
NDP health critic Matt Wiebe said it is unfair to put a security guard in a position to decide whether a patient’s situation is serious enough to alert a doctor.
"I think it’s a totally dangerous and irresponsible situation," he said, adding that it "could have life and death consequences."
Securitas Canada did not respond to a request for comment on Tuesday.
Misericordia’s urgent care centre is set to close entirely on Oct. 3 as part of the citywide hospital reorganization plan. The urgent care space will become a community-based intravenous clinic.
Wiebe accused the PC government of setting "arbitrary timelines" for the hospital system overhaul, saying it has left the WRHA scrambling to cope with the fallout.
While the Misericordia urgent care was to have remained open around the clock until it closed, WRHA administrators soon found that health professionals at the centre, seeing the writing on the wall, were taking positions elsewhere in the system. That caused officials to cut back the centre’s hours of operation.
Larry Kusch didn’t know what he wanted to do with his life until he attended a high school newspaper editor’s workshop in Regina in the summer of 1969 and listened to a university student speak glowingly about the journalism program at Carleton University in Ottawa.