Spaces closed in QEH emergency department to manage staffing shortage

At least a dozen beds have been closed in the emergency department at the Queen Elizabeth Hospital in order to manage a shortage of doctors and nurses working there over the summer. 

Officials with Health PEI said 12 beds out of a total of 38 treatment spaces have been closed or consolidated along with two "quiet room spaces," which are used for low acuity cases. 

Corinne Rowswell, acting chief operating officer with Health PEI, said the decision to close the beds was made because of a reduced number of staff working in the emergency department this summer.

When it comes to nursing positions, staffing levels at the QEH emergency department have been reduced from 13 nurses on day shifts to 10 and from eight nurses during overnight shifts to seven. 

The 12 closed spaces are comprised of five respiratory beds and five observation beds as well as two critical care beds, which have now been absorbed into the trauma unit within the emergency department.

The 38 treatment spaces include beds as well as what Health PEI calls fast-track rooms, where people with less-urgent issues can be examined but don't necessarily need to stay. Those spaces are still open. 

Rowswell said that there are a number of vacant positions within the QEH ER over the summer months and closing the beds is one measure being used to address those shortages. 

"There have been some vacancies and as we try to ensure that staff have much needed vacation time over the summer we have implemented a number of measures in order to operate the emergency department safely and with good access to service," Rowswell said. 

"To this point we've been able to manage with the closures as they've been in place."

'People are still coming' 

Officials with the P.E.I. Nurses' Union said they have concerns about the decision. Union president Barbara Brookins said she was told about the closures during a meeting in June. She said while bed closures happen in the hospital occasionally, she hasn't seen them in the emergency department before. 

We want to make sure that people get their leave because they have been working so hard over the last year.— Barbara Brookins, P.E.I. Nurses' Union

"The emergency room is a pretty unpredictable area," Brookins said.

"It's not like you can just put up the closed signs and expect people not to come. Now that the bubble is open, people are coming and we have people accessing the emergency room for a variety of reasons."

Brookins said her concern is that despite beds being closed, people in need of medical care still come to the emergency department, which puts added pressure on the staff who are working. 

"In our eyes the people are still coming, so in our eyes the nurses are going to be working harder, the ones that are there," Brookins said. 

She said patients coming to the emergency department with urgent needs or emergencies won't see a difference when it comes to treatment, but the closures will mean longer wait times for some patients with less-urgent issues.

"It's the ones that are going to come in that may not be as urgent but have no other place to go that the wait times are going to be extended, not just for the absence of physicians but because you don't have areas to put people into."  

Some nurses called back into work 

Brookins said while the closures have meant nurses can take leave this summer, some of them have already been called back into work or have gone onto standby to cover shifts in the emergency department when demand is high. 

"The staff are certainly concerned about having to come back," Brookins said.

"We want to make sure that people get their leave because they have been working so hard over the last year. And last summer vacations were limited as well, so this is the second summer now where a lot of people are not getting what they wanted." 

Rowswell confirmed that some nurses have been called back to work in the emergency department when it's been over capacity or there's a heavy workload. She said all staff are compensated when on standby and given overtime rates when they are called in to work. 

She said Health PEI is monitoring wait times at the emergency department, and confirmed that people with less-urgent issues can expect to wait longer this summer. 

Rowswell also said Health PEI is paying attention to the number of people coming to the ER throughout the summer, and typically those visits do increase during summer months. 

She said Health PEI can make adjustments as needed as the number of patients increases, but for now the plan is to keep those 12 beds closed until Sept. 2.

More from CBC P.E.I.