Patient went into cardiac arrest after waiting 4 hours at St. Boniface ER, hospital staff say
Health authority needs plan to address shortage of beds and staff, St. Boniface ER doctor says
Staff at St. Boniface Hospital's emergency room say a man went into cardiac arrest at the Winnipeg hospital Tuesday evening after waiting approximately four hours for care.
ER physician Paul Doucet said the man came by ambulance and was lying on a stretcher after being triaged when he went into cardiac arrest. Emergency staff had to resuscitate him in the middle of the hallway in front of other patients, Doucet said.
The man was moved to a resuscitation room and survived his cardiac arrest, Doucet told CBC.
This incident comes days after hospital staff raised concerns about an overflowing ER and dire shortage of capacity at St. Boniface. There are not enough nurses and beds to accommodate a constant influx of patients, two emergency physicians and a nurse previously told CBC News.
CBC was made aware of the Tuesday incident through multiple confidential sources who work in the hospital. They refused to speak on the record for fear of losing their jobs, and CBC has agreed not to name them.
Doucet, who was on shift earlier in the day Tuesday, said he didn't tend to the patient who had the cardiac arrest, but spoke to colleagues who did.
"It was devastating for front-line health-care providers to see poor outcomes like this that might be prevented if they were better resourced. The nurse who triaged him was very upset," said Doucet.
"People lose sleep, have difficulty with the rest of their lives because of traumatic experiences," he said.
Report filed to patient safety team
The Winnipeg Regional Health Authority says its patient safety team has received a report on the incident.
They're reviewing it to see if it meets a critical incident criteria under provincial legislation, said a spokesperson.
In an email statement, WRHA says it's aware St. Boniface Hospital and other facilities in its system is experiencing ongoing staffing challenges, capacity issues and increase in wait times in recent weeks.
"This issue is top-of-mind for the region and currently represents the most pressing operational issue for WRHA," a spokesperson wrote in the email.
On Wednesday, the health authority called a meeting with emergency and clinical staff. It says it will continue to meet with representatives from medicine and emergency programs to identify immediate actions to expedite the flow of patients out of hospital.
The goal is to alleviate capacity issues for those patients awaiting admission from emergency and urgent care units, the statement said.
'It will happen again'
Doucet said the man should have been moved to the high-acuity area of the hospital after being triaged, where he would have been monitored by nurses and a physician — but all of the space in that area was already being used by admitted patients.
"No matter how many times you reassess someone, if they wait too long without appropriate treatment, you can have bad outcomes like this," said Doucet.
"This individual could likely have done much better if there were sufficient resources within the emergency department to look after him in a timely way."
The incident also happened on an evening when the hospital decided to close its observation unit because of a nursing shortage, Doucet said. The 12-bed observation unit is where admitted patients usually go to wait for further treatment or to be discharged.
Two beds in the high-acuity area were also closed that night.
Doucet said emergency staff are familiar with situations like Tuesday's incident and they will be more frequent if the Winnipeg Regional Health Authority doesn't put a plan in place to address the shortage of beds and staff.
"It happens more when there's a delay in putting patients in the right areas of care, so it's not unexpected. It will happen again," he said.
Overflow is becoming dangerous, says ER nurse
An emergency nurse who works at the hospital said she's not surprised the incident happened.
"I'm shocked that it hasn't happened before now," she said. "I sit at triage some evenings... and you look at the sea of faces, 30 to 40 to 50 people, all of them sick, all of them needing attention," she said.
"And there's not a single thing you can do because there's no place to put them," said the nurse, who spoke on the condition of anonymity for fear of losing her job.
She said she wasn't working on Tuesday night, but she has dealt with similar dangerous situations.
The nurse said one night last week, the hospital was short on cardiac monitor trained nurses — there were two among 18 patients who needed monitoring.
"I was by myself for nine patients, nine cardiac monitored, extremely acute patients," she said. "That is incredibly dangerous. Thankfully, everybody was stable and nobody tanked."
She said because of the staff shortage, she's been working 16-hour days and in a stretch of 16 days, she would work 13 of them.
"I'm good at what I do, I don't want to do anything else, but at the same time, I don't know how much longer I can kill myself trying to serve others," she said.
She wants the public to know that she and her colleagues are trying their best to provide good care.
"Every day you think I'm going to go and I'm going to do the very best I can, knowing that the best you can is nowhere near good enough. It's disheartening and demoralizing," she said.