Ontario emergency patients have been waiting for a record long time to be admitted to hospital, and the situation, according to medical experts, seems to be only getting worse.
The trend is particularly worrying for hospitals because it occurs despite the declining number of COVID-19 cases and because it comes during the year when the severity of emergency departments usually decreases.
More than two years after the pandemic, the waiting time is a sign of how chronically stressful the country’s hospitals are.
“Our emergency departments are under more stress than I’ve seen in my career,” said Dr. Howard Owens, who has worked in the emergency department at Mount Sinai Hospital in Toronto for nearly 40 years and chairs the emergency advisory committee. provincial services.
Have you or a loved one recently spent a long time in an Ontario emergency room? Email CBC News to tell us about your experience.
“The workload of the patients we see is at a record high,” Ones said in an interview.
Nurses in the emergency department at Scarborough General Hospital. Shortage of staff due to illness, exposure to COVID-19 and burnout are among the reasons for the growing waiting times in Ontario emergency departments. (Evan Mitsui / CBC)
The key factors driving the long wait are largely the side effects of the pandemic:
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High percentages of employees who call sick or unable to work because they have been exposed to COVID-19.
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Patients whose diseases are more severe, often because they have delayed seeking treatment during major pandemic waves.
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Hospital wards are being filled to the brim, trying to catch up on lagging operations and procedures, so it is a challenge to squeeze patients into the emergency department who need to be admitted.
This comes in addition to long-standing problems in the system that extend far beyond the emergency room, including bottlenecks in disposal caused by a shortage of long-term care facilities and home care support.
At the heart of the growing waiting time for emergency departments are problems that existed in the Ontario health care system long before COVID-19 appeared and never disappeared: hospitals were so routinely out of capacity that patient care in corridors have become the norm.
Mix everything with what officials say is a record number of ambulance patients and a record number of emergency patients requiring admission, and this leads to a waiting time in the emergency department that has never been seen before. At this time of the year .
The paramedics were photographed in front of the emergency department of a hospital in Toronto on June 15. Health officials say Ontario hospitals are seeing record numbers of patients being taken to emergency rooms by ambulance. (Esteban Eduardo Cuevas Gonzalez / CBC)
IN latest statistics published by Ontario Health show that patients who came to the emergency department in April and were admitted to the hospital spent an average of 20 hours in the emergency department before receiving a bed in the ward.
This figure is the longest waiting time that Ontario published in April. This is 42 percent higher than it was in April 2021, and only a fraction of the record high average waiting time of 20.1 hours observed at the peak of the Omicron wave in January.
While more recent waiting time statistics are not publicly available, administrators and health professionals with direct knowledge of the system say the emergency department situation has not improved since April.
“Emergency departments are on fire,” said Amy Archibald-Varley, a graduate nurse who works in the emergency department of a large hospital in the Toronto area.
“Everyone is working at a very, very high level of sharpness and high stress,” said Archibald-Varley, who also co-hosts the Gritty Nurse podcast. “The emergency department has always been an area where it has developed rapidly… but now we are overloaded beyond capacity.”
Archibald-Varley is one of several people in the system who say the shortage of specially trained nurses is the most acute human resources challenge facing emergency services.
“Really, what we’re just trying to do is keep our heads above water,” she said. “But now is a very, very stressful and very, very difficult time in the emergency department.”
Amy Archibald-Varley is a registered nurse who works in the emergency department of a large hospital in the Toronto area and co-hosts the Gritty Nurse podcast. (Daniel Blancher)
Heavy staffing requirements mean far from the ideal emergency experience for patients. In some particularly overcrowded hospitals, admitted patients are faced with waiting an average of more than two days in the emergency department before receiving a bed.
These patients often spend this period waiting on a stretcher in the hallway or remodeled room, and their constant presence contributes to a kind of blockage in the emergency department.
Paramedics are waiting for someone they have taken by ambulance because there is no nurse available to take care of the new patient.
Catherine Hoy, president of the Ontario Nurses Association, says some emergency departments work without filling a large number of vacant nurses, and the patient-to-staff ratio is rising dramatically.
“I don’t think the people of Ontario really know what’s going on in the emergency department,” said Hoy, whose union represents 68,000 nurses and other health professionals nationwide.
A paramedic examines a patient waiting in the emergency room corridor of Humber River Hospital in Toronto on January 13, 2022 (Evan Mitsui / CBC)
“Our current staff shortage is actually getting worse. There is a burnout. They are sick. They are very stressed, “Hoy said in an interview.
Doctors describe in record words what is happening in the emergency room.
“These are quite difficult, challenging times,” said Dr. Andrew Arkand, chief of emergency medicine at Markham-Stouffville Hospital.
“We see more [patient] figures, more volumes than ever, “Arkand said in an interview.” The severity or level of disease of our patients is much higher than it has ever been. And perhaps the most dramatic thing is that our hospital operates at over 100 percent capacity almost every day. “
As a result, Arkand says patients who need to be admitted stay in the emergency department while waiting for a bed, while staff try to keep up with new patients coming to the emergency department.
“This is at a level we have never seen in the history of our department,” he said.
Dr. Andrew Arkand is Head of Emergency Medicine at Markham-Stouffville Hospital. (Michael Charles Cole / CBC)
Dr. Kashif Pirzada, a doctor in the Toronto Emergency Department, says the combination of short staff and high patient demand leads to unprecedented waiting times for patients and causes severe staff losses.
“Basically, we are stretched like nothing I’ve ever seen in my career, and that goes back 15 years,” Pirzada said in an interview.
“Every wave of COVID causes a wave of acceptance that causes stress on the system,” he said. “It’s a chronic stress that the system just isn’t designed to handle.”
However, doctors urge people to come to the emergency room if they are sick enough to need emergency care. They also say staff are abandoning everything to pay immediate attention to people arriving in life-and-death circumstances, such as traumatic injuries or heart attacks.
“I am very proud of my colleagues … they are doing their best under difficult conditions,” said Ones.
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