As Ontario sees staffing shortages amid a health-care crisis, London's emergency services are no different
'It's definitely intimidating and a scary system right now' says pregnant patient
As a major health-care crisis looms over the province with staffing shortages and longer wait times at emergency departments (ED), emergency care services in London, Ont., are also struggling.
Various departments at the London Health Sciences Centre (LHSC), southwestern Ontario's largest hospital, are operating at full capacity requiring staff to scramble.
Londoner, Cassandra Colley-Couse is more than 40 weeks pregnant with her first child. Her midwife's been bracing her for the possibility that she might not get an optional induction due to the shortage of support staff, nurses, and doctors, along with the ongoing birth boom in the city.
"It's definitely intimidating and a really scary system right now," said Colley-Couse.
"When you're growing a human, the last thing you want is to be stressed and wonder when you're going to see a doctor or if you can access the services you need."
In a statement to CBC London, LHSC said "high demand for health-care services has resulted in 100 per cent occupancy at both Victoria and University Hospital. Scheduled inductions may change as we navigate an influx of spontaneous births and staffing challenges."
The hospital added that summer is the busiest birthing season and it continues prioritizing inductions based on the medical needs of patients.
Division chair of emergency medicine in London, Dr. Christie MacDonald, said her ED is seeing an increased volume of patients at their Victoria hospital site and a shortage of nursing staff.
"Over the last number of months we've had increased volumes, acuity, and complexities of our patients. Our wait times are longer than we would like in our emergency department," she said.
MacDonald said the hospital continues to hire and train new staff but with many people leaving the health-care profession and sick calls due to COVID-19, there are increased burdens. But she says she's proud of how hard her team is trying to care for patients.
"The environment in the department is challenging but our team is really strong and resilient. They're tired but they continue to come into work everyday and provide care," she said.
"We're coming out of a two-and-a-half year pandemic and still haven't seen the full impact, so as a team we're attempting to recover from that as well."
'Bare bones' staffing and moral distress
MacDonald acknowledges how difficult long wait times are for patients, adding that it also frustrates health-care workers not being able to support their patients the way they'd like to.
Ontario Nurses' Association's bargaining president for the local chapter, James Gibbons, echoes those sentiments. Gibbons, who's also a nurse at the medical-surgical intensive care unit (ICU), says there's a lot of moral distress among nurses.
"In the ICU we're chronically working short. We don't have rough nurses to do the work, not being able to meet the needs of the patients has been problematic for nurses in general," he said.
Gibbons believes an immediate solution to the nursing shortage would be to license and hire more internationally trained nurses to clear some of the backlog. He says the alarm bells were ringing even prior to the pandemic and with Bill 124, capping wages at 1 per cent for three years, many nurses are looking south of the border for work.
"This tsunami has been occurring for quite some time," he said. "We were running with decreasing budgets each year, we knew that there was going to be an exodus of nurses, the pandemic hit and just made things worse."
Gibbons says LHSC faces a unique challenge being the largest hospital which caters to surrounding municipalities. With smaller EDs having to close due to similar issues, there's increased pressures on the hospital, he said.
However, MacDonald says that she hasn't seen a direct impact of smaller ED closures in her department as of yet.
According to Gibbons, the province hasn't provided any concrete solutions to this issue. Health care needs to be a bigger priority and more investment in staffing is needed, he said. Gibbons anticipates the situation to worsen into the fall as flu season and another wave of COVID strikes.
"We need to work towards trying to build back the foundation of our health-care system which is crumbling as we speak. Years ago, it was on life support and now it's on dire strains," he said.
"Resources isn't just building new hospitals, that's just bricks and mortar. What we need is staff, we're in a tougher situation today than in any other waves of the pandemic so we need help to get out of it, we're already on bare bones in terms of staffing."
Boomerang impact for increased needs
Neal Roberts, chief of Middlesex-London Paramedic Services says his team is seeing increased call volumes requiring ambulances, and delays offloading patients to the ED.
"Paramedics have been wonderful throughout the pandemic, but the reality is they're tired and burnt out. It's a systemic fallout we're seeing from COVID and pressures it's placed on the health-care systems throughout," he said.
Roberts says coming out of the pandemic, there's a "boomerang impact where demands on EDs is dramatically increasing." This year, he's added three additional 12-hour units, and tries to ramp up staffing where he can.
Roberts' team has been advocating for local dispatch which he believes would provide more timely care to patients, along with community paramedics being allowed to treat and discharge patients on scene, instead of taking them to an ED when it's not necessary.
MacDonald says her ED is working to flow patients differently around the department while waiting for assessments and blood work to minimize wait times and maximize care.
Although Colley-Couse is grateful to her team of doctors and midwives, she's heard from other expectant parents who share her concerns.
"It's a dangerous cascade effect, it's hard to find a pregnant person right now that feels really confident in our system," she said.