Missed medications, falls and patients languishing in hallways for days at Grace ER: nurse

Some patients at the Grace Hospital emergency department have experienced harm due to staffing shortages and backed-up patient flow as calls to increase the number of nurses have been ignored, according to a nurse who is sounding the alarm out of her duty to protect patients. 

"They aren't getting their medications in time, they're not getting fed frequently enough, they're not getting bathroom breaks or changed," the nurse said, who has agreed to speak to CBC on condition of anonymity for fear of losing her job.

The nurse says staffing shortages were bad after the consolidation of Winnipeg hospital emergency rooms in 2019, but the pandemic has turned it into a full-blown crisis. 

"The average person out there doesn't realize how bad it is at the hospital and how in a [health] crisis, it may not even be safe for them to come to the hospital," said the nurse.

The number of COVID-19 patients is forecasted to keep rising, and the peak is not expected for another two to four weeks, said Dr. Jazz Atwal, Manitoba's deputy chief public health officer in a press conference on Friday. 

The nurse has seen patients come in for simple things, and end up getting sicker in the overrun ER at Grace, which has resorted to treating patients in the hallway.

She says she's seen patients in the hallway go without water for so long that their blood pressure drops.

"[They] probably haven't had any fluids and now we've caused [them] to be dehydrated. It's heartbreaking," said the nurse. 

She has witnessed patients miss doses of heart medication which leads to their heart rate going out of control.

"They require a cardiac-monitored bed and more interventions to slow their heart rate back down. It's common," she said. 

"We're seeing falls all the time, horrible falls. So then that patient has to stay with us longer because they require X-rays, and then, if something is broken, then they need to see orthopedics," said the nurse. 

She's not the only one to report the Grace ER is overrun. In a letter released by the NDP a few weeks ago, an unnamed woman described her 93-year-old mother's five-day stay in the ER as "torture." 

"During these five days, many patients were packed into this hallway. They were mostly in pain, many immobile, and all afforded little care, water or food. The exhausted, overwhelmed staff did the best they could, but it wasn't nearly enough for the number of stretchers in that claustrophobic, overcrowded, over-lit hallway," reads the letter.

She says mistakes were made in her mother's care including neglecting to test her for COVID-19 until her fourth day. She said she did not blame the nurses, one of whom told her she had worked 20 hours straight. 

All unintended events which occur in a hospital that result in injury, death or disability are classified as critical incidents under Manitoba's legislation.

The province does not report critical incidents until at least a year after the occurrence.

Lack of COVID-19 testing creating backlogs

One of the other reasons for the backlog at the Grace Hospital is because there is no in-house COVID-19 testing capacity, according to the nurse. 

She says they are waiting six to 12 hours to get test results because the samples are transported off-site for analysis. 

"That's an entire day with that room blocked. And that blocking of patients … it's a snowball effect. So then you have more patients waiting in the waiting room. We are pushing more patients out into the hallways. And then because we're just seeing such high volumes, we're running out of space in the general hospital," said the nurse. 

The Winnipeg Regional Health Authority, which oversees the Grace Hospital, did not comment on why there is no on-site COVID-19 testing at the Grace but it did say proper care is being provided.

"There is no evidence to support the claim that patients who come to the ED at Grace Hospital are not receiving the care they need due to staff shortages or other COVID-19 safety measures," said a WRHA spokesperson in an emailed statement. 

'A perfect storm': MNU

The Manitoba Nurses Union says nursing shortages are not just impacting care at the Grace Hospital. Nurses at Health Sciences Centre and St. Boniface Hospital are also being pushed to the limit. 

"This absolutely is a perfect storm. We have a critical nursing shortage. We're in a pandemic and we are basically overwhelmed," said Darlene Jackson, the nurses' union president.

Jackson says she has never seen nurse shortages this bad in her 40-year career as a nurse and union executive. 

"There's many, many, many vacancies across this province. We know that we're close to 20 per cent vacancy rate in almost every facility in Winnipeg," said Jackson.

She's heard from nurses in the province who are putting in extreme overtime: one who worked 24 hours in a row, another who worked three 12 hour shifts with only one 15-minute break.  

"Nurses are stretched so thin and patient loads are so demanding that that ability to be able to be there, and provide those basics for your patient, is lacking at this time," Jackson said.

The nurse says she and her colleagues have been telling management about the effects of the nursing shortage at multiple staff meetings. 

Management told them there is "no money" to address their concerns. 

The Winnipeg Regional Health Authority says there are currently a number of nursing vacancies in the emergency department at Grace Hospital, but recruitment is active and ongoing, and the vacancy rate has begun to drop in recent weeks. 

It says its staffing the department with workers from other units, agency nurses, overtime, and "as a last resort," forced overtime.

The nurse says she used to love the Grace emergency department because it had such high standards.

"To see those standards be stripped away and to see patients harmed by that, crushes your spirit," said the nurse.  

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