Hope can’t help but die in emergency room’s limbo

Opinion

Hey there, time traveller!
This article was published 21/03/2024 (562 days ago), so information in it may no longer be current.

If hell exists, I’m pretty sure it’s a lot like being a sick patient in the Grace Hospital Emergency Department.

You’re left to suffer for days in pain, waiting for a bed that may never come, in a space that offers no sliver of privacy or solitude, being cared for by people who are simply too busy to provide basic care. Case in point, a patient’s IV alarm sounded for an entire shift.

I was recently brought in with sepsis and dangerously low blood pressure. I was heading into septic shock territory. This wasn’t my first time at the sepsis rodeo. I felt terrible. I was writhing. My heart rate was thrumming past 150 beats per minute. I was in desperate need of anti-nausea and pain medication. I did receive it, almost six hours later. It was a sign of things to come.

They never did get any of my orders quite right. My medication? Nope. My IV fluids (I run continuous hydration)? Nope. They never would, my entire stay. Scheduled medication was always late. And medication I had to ask for, like my injections of the painkiller hydromorphone took up to three hours to get. I’m allowed hydromorphone every two hours. Waiting three hours in severe pain is awful and tantamount to torture.

Wound care was a joke. There was simply no time for that.

The skin around my jejunostomy stoma — my small bowel feeding tube, which drains bile and needs frequent cleaning and dressing changes — was further destroyed by sitting wet in copious amounts of bile for several hours.

They wouldn’t clean or put cream on it. When they did anything, they just slapped on new dressings, but not the correct ones. Some staff ignored it completely. By the time I got back to Deer Lodge, it was three times worse.

It will take weeks to fix the damage around my stoma. It’s like a chemical burn and the skin is all excoriated.

Even getting my foley bag (urinary catheter) and ileostomy bag (I have no colon) emptied was an ordeal. And I couldn’t get proper nutrition because the emergency department wouldn’t administer the IV nutrition I am on.

Because they weren’t following my usual fluid orders, I was dehydrated the entire time and getting next to no calories from the dextrose solution since the rate was too low. In some ways, the department was causing me harm.

A crack in my central line was likely how I got sepsis. The central line goes into a big vein to your heart, so if bacteria gets in there, you get sepsis, and fast. Sepsis is a life-threatening response the body sometimes mounts to kill infections.

So, yay, the emergency department staff didn’t kill me. I should not be rejoicing in this fact. But they didn’t leave me in great shape either.

Staff at St. Boniface Hospital later replaced my central line. When I returned to Grace, I had been moved from a room to a curtained area that was cramped and noisy. It had also been reconfigured to accommodate more stretchers than it was originally designed for. It was like human Tetris trying to provide bedside care.

People are burnt out. You can tell they want to do a better job, but can’t. There’s too many things stacked against them. To address the critical issues affecting our emergency departments, Manitoba’s health-care system needs to focus on five key things. You’ve read and seen them before, but they are worth repeating: Reduce wait times; improve patient flow, particularly when no beds are available; ensure staff workloads are manageable and safe; improve morale and working conditions; and fix employee shortages and retain existing staff.

None of these things are impossible. They require planning, resources and money. There also needs to be a timeline for getting things done and accountability for making sure these issues are addressed.

What made me most angry, and brought me to tears, was seeing frail elderly patients crammed into hallways on stretchers waiting for beds for days. The most vulnerable are the biggest victims in this mess. They should expect to be taken care of in their later years, not abandoned in a hallway.

I cried and begged my Deer Lodge nurses not to send me to Grace when I was tanking. Even though I knew my life was in danger, I was more afraid of the emergency department than septic shock. I know that sounds insane but you don’t want to step foot in an emergency department right now if you don’t absolutely have to.

We shouldn’t be scared to seek care. The emergency department is a place where we should feel safe. It’s coming on six months with a new provincial government. I don’t care about photo ops. We need a plan. We need action. It will only get worse, if changes don’t come soon.

People have been patient. But that patience is wearing thin. It’s Code Blue in our emergency departments.

Shawna (Shoshana) Forester Smith is a 41-year-old chronically ill, disabled Ojibwe writer and health-care advocate who lives on a chronic care unit at Deer Lodge Centre. Shawna worked for years in the head office of the Winnipeg Regional Health Authority and has a master’s degree in health leadership. She also has spent over 14 years being a patient with all kinds of experiences, including being on life support. She recently spent three days in the Grace Hospital Emergency Department. She has started a petition (change.org/ERcodeblue) based on her experience.