Overcrowded Grace Hospital emergency room 'at the breaking point,' nurse says
Volumes sometimes triple the ER's bed load, leaving patients in hallways and staff exhausted
When Jan Wynn was told her father, a patient at Grace Hospital in Winnipeg, was being moved from a treatment area, she was thrilled.
But when she didn't hear an update for a while, she went straight to a desk at the emergency department.
"It turned out I walked right past him and didn't even see him because he was right there in the hallway," Wynn recalls.
The medical staff said, "'It's not ideal; it's not good — he's in the hallway.'"
While the pandemic isn't straining hospitals to the same degree as before, the diagnosis for Winnipeg's health-care system is troubling and, in some cases, worsening. Wait times increased in March at every hospital, patients are waiting in ERs for days for an inpatient bed and chronic staffing shortages are widespread.
Hallways lined with patients
Grace Hospital has been particularly challenged. At any given time, as many as 20 patients are waiting in the hallway, said a nurse at the ER, who requested anonymity for fear of reprisal.
"There are no call bells on the walls. There are no oxygen on the walls there," the nurse said.
"It's not an adequate place for them to be."
Patients have to be kept in the hallway because the emergency department, suited for 31 beds, is sometimes treating as many as 90 patients at a time. There are more than 80 patients in the ER multiple times a week, the nurse said.
And dire staff shortages are not helping.
In recent weeks, leaders at the Grace are "grasping at anything" to fill vacancies, the nurse said. The Winnipeg Regional Health Authority (WRHA) — which operates Grace and several other hospitals in the city — has asked public health nurses to pick up shifts at the ER "potentially for several weeks."
A leaked schedule shows only two to four nurses staffed the unit some nights, while 10 or 11 nurses worked on day shifts.
In the last six months, the nurse is aware of at least nine colleagues who left jobs at Grace ER, burnt out and frustrated by the mandatory overtime.
The same nurse has noticed a spike in very ill patients arriving at the hospital. Those issues, coupled with staffing issues, have left the emergency department swamped.
"Emergencies departments are supposed to be used for [a patient] coming in; you get whatever you need done, and then you're moved on to ICU or you're moved onto a ward so the rest of the care can be completed. So they're healthy enough to go home and rehabilitated," they said.
"But when you don't have anywhere else to move them, they're getting stuck in the emergency department.
"It's many things all bunched into one. It's kind of been brewing for a long time, and it's at a breaking point, I feel."
A few of the wards that should absorb ER patients have closed because of a lack of staff, the nurse said. "There's nowhere to ship them to."
As many as 90 patients are being treated in Grace Hospital's emergency department, which is suited for 31 beds, the nurse said. The number of patients fluctuates in the 80- to 85-person range multiple times a week.
In late April, Jan Wynn's 90-year-old father spent seven hours in that hallway.
While waiting with her father, she made a point of pulling up a chair and snuggling herself as close to her father's hallway bed whenever someone walked past.
She knew she was taking up space, but Wynn felt she needed to be there.
"I didn't want anybody to forget that he was there," Wynn said.
Advocating for her father's care
"I didn't want to yell at anybody or get mad or be obnoxious, but I wanted to make sure that people knew I was there. I just sat there and kept offering to buy people coffee and asking, 'What's going on? What's going on?'"
She recalls another patient who didn't have the strength to shout that he needed water. Hearing his quiet pleas, Wynn called over a nurse on his behalf.
"It's just a really sad place to be, and I'm not allowed to help anybody because of COVID or whatever. I couldn't get anybody a cup of coffee or water." Wynn said.
NDP health critic Uzoma Asagwara said it is disheartening to hear the lengths Wynn had to go through.
"Certainly it raises concerns that if she wasn't there, what might have happened? What about the many folks who are in emergency rooms or urgent cares and they don't have a loved one who's there to advocate on their behalf?" Asagwara said.
"Her experience is not the experience that Manitobans should have when they're accessing ERs in our province."
Asagwara has been hearing for many months about the staffing shortages. The Union Station MLA said the blame falls squarely on the government for not acting quickly enough before the vacancies became a crisis.
A provincial spokesperson called the health care of Manitobans the highest priority of the government.
The WRHA said in a statement that such issues at the Grace, and elsewhere, are stemming from a surge in the number of patients. "This is an ongoing issue that did not develop overnight, and we are committed to addressing the situation and ensuring safe and effective care to all who need it."
The health authority said it is working on a number of initiatives to improve patient flow, such as spreading out patient volumes across the city's hospitals.
Wynn, who applauded the health-care workers for their hard work, chose to speak out after reading a news story in which Manitoba Health Minister Audrey Gordon described the moving of patients to hallways and staff lounges as short-lived.
"They're trying to reassure the public that this is OK. And what I saw in my little stay, it's not OK."
Since then, her father has spent the last week at St. Boniface Hospital and Wynn said it has been a superb experience.
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