Staff raise alarm over 'exceptionally dangerous' wait times at St. Boniface Hospital
'We've seen people who die in our waiting rooms and it’s at the point where that could happen,' physician says
Staff working in the emergency department at St. Boniface Hospital say patients are having to wait up to 16 hours before getting assessed by a doctor — a trend they fear will have dire consequences.
CBC spoke to two emergency physicians and one nurse. All three staff members say emergency wait times at the hospital right now are the worst they've seen in their careers, citing a shortage of in-patient beds and staff — particularly nurses — as a source of the problem.
"I saw someone this week that waited 16 hours to see me and it's pathetic," said Dr. Paul Doucet, one of the emergency physicians who is willing to speak on the record. Doucet has worked at the hospital for more than 30 years.
CBC has agreed to withhold the identity of the two other staff members because they fear they could lose their jobs for speaking out.
Another emergency physician said in the last three weeks, he's been routinely seeing wait times of 10 hours or more. He said the issue is caused by a "lack of bed flow" which is causing many patients to remain in the waiting room.
"We have so many admitted patients in our emergency departments with nowhere to move them to because there either are no physical beds to move them to or they're unable to staff the beds with nursing staff," he said.
An emergency nurse said on Sunday night, there were 36 patients in the waiting room who've been there for eight to 12 hours.
CBC asked the WRHA for the average ER wait times at St. Boniface Hospital in the past two weeks. In an email, a spokesperson said preliminary data suggests median wait times across Winnipeg are between two and three hours for July and into August.
"Although that data has yet to be statistically confirmed," the spokesperson said.
Number of factors
The WRHA said many COVID-recovered patients have been experiencing long stays in hospital, making it challenging to admit patients from emergency into in-patient units.
It says patient volumes are also returning to pre-pandemic levels, yet the system continues to operate with pandemic-related processes, such as COVID testing and staff being redeployed.
The spokesperson said staffing in emergency and urgent care over the past several months has been affected by nurses leaving to support critical care units throughout the pandemic.
WRHA says the issue is being addressed by the use of agency nurses, overtime and nurse educators filling occasional shifts, among other measures across the system.
"We anticipate that some of these factors will stabilize as the system emerges from its period of readjustment to the pandemic, and staff return to their regular postings," the spokesperson said.
High burnout, low staff morale
Doucet said morale among staff in the department is at a critical level.
"It's … very difficult for people who are highly trained and motivated and want to work hard and deliver good care when you're not placed in an environment where you can do that," he said.
The other emergency physician said staff feel "just absolute defeat."
"We can't do our jobs," he said. "Just crushed … your mental health suffers because you are watching the system fall apart in front of you."
The nurse said since March this year, eight other nurses in emergency have left their jobs due to burnout and stress.
The hospital's solution to solving a chronic staffing problem is to put in mandatory overtime, the nurse said.
"You come to work for an eight hour shift and the next shift is short staffed. It's determined that you're going to stay and it's mandatory. You have no choice," said the nurse.
The emergency physician said the long wait times and staffing shortage is creating "an exceptionally dangerous situation."
"It's no longer, based on what we're seeing, a question of if somebody is perhaps going to have a bad outcome, but a question of when," he said.
He said with the never-ending influx of patients and the shortage of staff, it's difficult for patients to be adequately reassessed.
"We've seen people who die in our waiting rooms, and it's at the point where that could happen any second of any day, despite everybody's absolute best efforts," the emergency physician said.
The nurse said on a typical night shift, St. Boniface would be short four to five nurses, and two to three nurses on a day shift.
The emergency nurse said nurses from other wards have been pulled from their departments to help with the ER, but they don't necessarily have the same skills.
"Staffing has never been as bad as it's been right now," the nurse said.
"We're bursting at the seams. We're just kind of anticipating something bad happening because of the staffing situation and how awful [the situation] we are in is. That takes a toll," said the nurse.
The Manitoba Nurses Union says WRHA and Shared Health data they were given shows 27 out of 103 positions in the emergency department at St. Boniface Hospital were vacant in June this year.