ER being used as holding unit, nurses say

Senior nurses have been warning hospital managers about serious problems in the busiest emergency room in St. John's for more than a year, documents obtained by CBC News show.

Senior nurses at the Health Sciences Centre wrote to managers in 2006 and this August about serious deficiencies, including the fact that elderly patients— some of whom were dying— were being held in the ER for long periods of time, before being admitted to hospital rooms.

More than three dozen nurses signed an August 2006 petition decrying "rapidly deteriorating workplace conditions" in the ER, which the nurses said could not "run effectively while nearly half of the working area is occupied by hospital admissions."

More than a year later, emergency room staff filed a letter saying that continuing problems — from heavy workloads that precluded comprehensive patient assessments to breaches of patient confidentiality — were violating the hospital's own policies and guidelines, as well as an independent code of ethics and set of standards for nursing practice.

The staff also said overworked ER nurses cannot provide adequate care for dying patients.

Eastern Health, which manages the Health Science Centre, said in a Sept. 12 written response that several changes have already been made, including the opening of five extra beds to accommodate new admissions.

Debbie Forward, president of the Newfoundland and Labrador Nurses' Union, said the letters reveal a heartbreaking situation.

"Not being able to do that makes it really difficult to leave that unit at the end of the day," Forward said.

"You know that, as an emergency room nurse, you probably weren't able to be there for the patient and their families, like someone should have."

Among the nurses' concerns is that dying patients were left waiting in the corridors of the ER this summer.

Rosemary Barrington, the program director of emergency trauma at the Health Sciences Centre, said the hospital has resolved to do better.

"Out in the corridor would be something that we would try never to do," she said. "I can't say that in all the cases that we had over the summer that we didn't get into that situation, but our goal is to move those patients out of emerg as quickly as we can."

Barrington said the hospital is taking other steps, including hiring more nurses.

Forward said it took courage for nurses to complain to Eastern Health, and now it appears to be paying off.