Overwhelmed ERs a symptom of health-care system collapse, author says

Two veteran medical professionals are warning that Nova Scotia's health-care system is in need of sweeping changes, amid renewed scrutiny of the province's overloaded emergency departments.

Catherine MacNeil is a retired nurse who has written a new book about the race to save medicare in Canada titled Dying to be Seen. She said emergency rooms in the province are like "a house that's in the middle of a hurricane."

"People are throwing sheets of plywood to shutter our windows. They're giving us nails to nail down our roofs, sandbags so our basement won't flood. But what's really going to save that house is to get out of the hurricane, and that hurricane is the collapse of the system in general," she said.

"Emergency services were never meant to be primary care services, to be social, community services. They were meant to be emergency services. And unfortunately the framework around them has collapsed."

The recent deaths of two women in different parts of the province who had waited hours in their local emergency rooms to see a doctor has renewed debate about health-care reform in the province.

Charlene Snow visited the Cape Breton Regional Hospital in Sydney, N.S., on Dec. 30 to seek treatment for a sore jaw and flu-like symptoms.

Family and friends said the 67-year-old eventually left without seeing a doctor, after waiting roughly seven or eight hours. She died less than an hour after returning to her home in Donkin, N.S.

The following day, in Amherst, N.S., 37-year-old Allison Holthoff was driven to Cumberland Regional Health Care Centre by her husband after she began complaining of excruciating abdominal pain. 

She waited to see a doctor for more than six hours and eventually went into cardiac arrest, her husband said. She died in the intensive care unit.

Wait times in emergency departments across the country have increased significantly, said Dr. Mary-Lynn Watson, interim medical site lead at QEII Health Sciences Centre in Halifax. But she said that's a symptom of a much broader issue.

"It's not an emergency department overcrowding problem — it's a system overcapacity problem," she said.

No quick fixes

In response to Holthoff's death, MLA Elizabeth Smith-McCrossin, the Independent member for Cumberland North, shared on social media a letter she wrote to Premier Tim Houston calling for urgent changes to the Cumberland hospital ER, which is under renovation.

Her proposed plan includes establishing a temporary walk-in clinic adjacent to the ER, placing a health-care worker in the hospital waiting room to monitor patients, and upping the number of nurses working in the emergency department.

But Watson said that putting a health-care worker in the waiting room to monitor the status of those waiting for a doctor won't solve the problem since overcapacity is the root of the problem.

On Friday, Nova Scotia's Opposition Liberals called on Houston to convene an emergency session of the legislature to deal with the emergency-care crisis.

MacNeil said it's a crisis that's been decades in the making, with the baby boom generation getting older and human resources in the health-care sector dwindling.

"People were really worried about that 20 years ago, and now here we are," she said.