Ambulance shortage forces mother of Alberta ER patient to drive her to urgent surgery
Review underway by Alberta Health Services over circumstances of patient transfer
Olivia Armstrong is recovering from surgery — as well as a harrowing ordeal of simply getting to the operating table.
At around 4:45 a.m. on June 25, the 21-year-old went to the emergency room at the Red Deer Hospital because of abdominal pain.
"If I stayed still, then it was not as bad. But as soon as I'd move again, it would start hurting bad," Armstrong said.
It took more than six hours before she was able to get an ultrasound.
"It was just frustrating … that it had taken so long, and it could be something serious," she said.
The ultrasound revealed Armstrong had appendicitis and needed to undergo urgent surgery. But due to staffing shortages, the hospital was unable to operate on her. It was another hour before she was referred to a different hospital, 140 kilometres northeast of Red Deer.
What if my mom wasn't there to take me? What if I didn't have an alternative ride?- Olivia Armstrong
Except there was a snag, she was told.
"They came and told me, you need to go to Camrose for your surgery, but we can't take you there. There's no transportation, so you have to find your own way," Armstrong said.
"Wow, is basically what I thought. What if my mom wasn't there to take me? What if I didn't have an alternative ride?"
Olivia's mother, Roxzane, experienced many thoughts during the 1½-hour drive.
"What if something happens along the way? That's very scary… What if we get delayed on the highway?" she said.
Armstrong eventually received her surgery at the St. Mary's Hospital in Camrose and was discharged the next day, but frustrations remain over the whole experience.
"I was still in a lot of pain and it was a very terrible experience, but mine was not so much life-or-death. I feel very bad for the people that are in those situations and can't get the help and support and health care that they need," Olivia said.
Roxzane Armstrong is raising bigger questions over the incident.
"I think we're in a dire situation, realistically … How are we a First World nation with no access to emergency health care?" she said. "It's incredibly frustrating and frightening."
System under stress
Health-care systems in Alberta and other provinces are struggling with a variety of issues after more than two years of responding to the pandemic.
Emergency calls have been soaring in Alberta and many paramedics are off due to illness.
Patient volumes in hospitals are returning to pre-pandemic levels, but there are shortages of health-care workers, while those who are working face burnout. As a result, many services and procedures have been disrupted.
Dr. Mike Weldon, an emergency physician at the Red Deer Hospital, said he and his colleagues have been grappling with nurse shortages, full beds and busy waiting rooms.
The state of the system is crumbling and that's an issue nationwide.- Dr. Mike Weldon
"I remember just going back to the doctor's office after seeing the majority of my patients out there and just putting my hands on my head and saying, 'What are we doing here? Is this really quality care?'" he said.
"That is the most difficult thing for myself and for my colleagues: knowing that people need care and just not being able to bring it to them."
A review is underway after it took an ambulance 30 minutes to respond to a Calgary woman who was attacked by a dog in early June; she died from her injuries.
On June 27, a three-year-old with a head injury was rushed to hospital by a fire truck because no ambulances were available.
"At that moment, the option that we had was to get her up in that engine, and that's what we did," said Calgary Fire Capt. Vern McNeice.
'It's just been incredibly difficult'
For those intimately involved with providing care, it is a glaring reality check.
"The state of the system is crumbling and that's an issue nationwide … it's just been incredibly difficult," Weldon said.
Dr. Kym Jim, an internal medicine specialist, said patients will ultimately feel the impact.
"People will get their care, but it is going to be delayed at times. And delays, unfortunately for some people, will lead to poorer outcomes," he said.
"It is very difficult for us as physicians because we just can't deliver the care to our patients that we have been used to and that they expect and that they should have."
The incident involving Olivia Armstrong is prompting action from Alberta Health Services (AHS) after CBC News brought it to AHS's attention.
"We acknowledge that this was a difficult experience for this patient and her family. We apologize for the stress that this caused, and we are reviewing the circumstances around this patient transfer," said AHS spokesperson Kerry Williamson in a statement to CBC News.
WATCH | Patients in Alberta are feeling the strain of health-care staffing shortages:
'Health care is under strain in every province'
Williamson said in some rare instances, a medical team may deem it safe and appropriate for a patient to take a private vehicle to another facility where they can get timely care, but he acknowledges it is not routine practice.
We apologize for the stress that this caused.- Kerry Williamson, AHS spokesperson
AHS is "working hard to resume" normal surgical services at the Red Deer hospital in the coming days, adding that new clinical assistants will start work at the site this week.
Statistics provided to CBC News by AHS show that in the second quarter of 2022, there has been a 12 per cent increase in emergency department visits provincially compared to the same quarter the year before.
Williamson said AHS has hired 230 more paramedics over the past two years, is creating 100 new permanent EMS positions and has added staff and ambulances in Calgary and Edmonton.
Alberta Health spokesperson Steve Buick said the ministry is following up with AHS to make sure the patient was not put at undue risk, that the decision to send the patient to another site was appropriate and that the patient could have received care in Red Deer if it had been clinically inappropriate to divert her to another site.
"Health care is under strain in every province and in other countries due to the accumulated impacts of the pandemic," Buick said in a statement to CBC News.
"The health-care workforce is growing, but the system faces shortages in many areas in spite of it, in Alberta and across Canada."
ABOUT THE AUTHOR
