Paramedics bring a patient to the emergency room at Toronto Western Hospital on July 14. Fred Lum/The Globe and Mail
Hospital emergency departments in Canada have long struggled to provide expeditious care. But now, more than two years after the start of the pandemic, many are showing signs of going haywire, with long wait times and, in some cases, closures.
Before COVID-19, most Canadians waited up to 3.9 hours in an emergency to see a doctor for an initial assessment in 2018 to 2019, according to the Canadian Institute for Health Information. By comparison, the expected wait time to see an emergency doctor was nearly six hours at Foothills Medical Center in Calgary at one point earlier this week and 11 hours at Children’s Hospital of British Columbia.
In Ontario, patients visiting emergency rooms waited an average of 2.1 hours to see a doctor this May and spent an average of 20.1 hours waiting before being admitted, according to Health Quality Ontario. Meanwhile, many rural emergency departments across the country have experienced closures or reduced hours, including at least three in British Columbia communities that temporarily closed due to staff shortages in May. Most recently, the emergency department at the Perth, Ontario hospital has been closed since July 2nd. In Fredericton, a man reportedly died in a hospital emergency room this week after waiting hours to receive care.
Earlier this week, the federal government traded charges over responsibility for health funding with provincial and territorial leaders who met in Victoria. Provincial and territorial leaders said the federal government was not paying its fair share and urged it to increase its transfer payments. Ottawa has said it will increase its share of the funding if provinces and territories increase their own contributions and commit to financial responsibility for their spending.
Beyond solving the funding issues, improving health care in Canada will not be easy. While high rates of staff burnout and illness have contributed to hospital staffing shortages, some have also pointed out that a lack of primary care physicians and community support is causing patients to seek care in emergency rooms because they have nowhere else to turn. .
In 2019, about 4.6 million, or 14.5 per cent, of Canadians aged 12 and over did not have a regular health care provider, according to Statistics Canada. And it’s getting harder and harder to find a family doctor. The College of Family Physicians of Canada said in a recent open letter that there is a crisis in family medicine as many of its members are burned out, overworked, frustrated and demoralized. More are retiring, the college said, while fewer medical students are choosing to enter family practice.
At a time when health care in Canada is more fragile than ever, The Globe and Mail spoke with five Canadians from across the country about their experiences with health emergencies.
In GTA:
Ian Collins expected he would have to wait to receive care when he visited the emergency room at North York General Hospital in Toronto earlier this month. But he did not expect how long and miserable this wait would be.
While seeking treatment after an injury sustained during chemotherapy, Mr. Collins said he spent approximately 13 hours in a waiting room and another 10 sleepless hours on a stretcher in a busy emergency room corridor. When a bed finally opened up for him, he found himself in one that was placed in an alcove for storing bedding.
Ian Collins expected he would have to wait to receive care when he visited a Toronto hospital emergency room earlier this month. But he had no idea how long and miserable this wait would be. Giving away
“It’s not conducive for me to get well when I’m in an auditorium in the middle of the night with some woman yelling obscenities about whatever’s going on with her and people walking by,” he said, explaining that he was worried not to get sick in this high traffic environment because he has low immunity.
Since he was diagnosed with lung cancer in April, Mr Collins, 52, said he had been waiting a lot for appointments, once as long as 4 1/2 hours.
During his visits to the Princess Margaret Cancer Center in Toronto, he often hears overworked nurses begging each other for overtime or forgoing breaks. He wonders if that’s what led to his injury in the first place.
On July 1, during chemotherapy, his intravenous cannula slipped, allowing the drug to go into his skin instead of into his vein, causing a burn. A nurse instructed Mr. Collins to seek help if the swelling he suffered worsened. When that happened, he called an oncology nurse, who told him to go to the emergency room. The initial visit was brief; Mr. Collins was in and out of the ER within about 90 minutes with a prescription for antibiotics. But when his arm continued to deteriorate, he went to the emergency room again at 11 a.m. Tuesday.
Although it took an hour and a half to see the first doctor who tried to admit him with concerns that he had an infection, it was 11 a.m. Wednesday, a full 24 hours after his arrival, before he was given a bed. He was discharged the next morning when his arm improved.
The experience was “quite traumatic,” he said. He’s annoyed with politicians for failing to keep their promises to end hallway medicine and for not adequately compensating nurses.
“The big thing I took away from this is how hard nurses work and how I really feel they’re mistreated by the government,” he said.
– Wensey Leung
In Quebec:
The first impression wasn’t the best: Ji Yoon Han had only been living in Montreal for a few hours before she ended up in one of the city’s overcrowded emergency rooms.
It was the evening of June 30th and she had just flown in from Toronto to start a new job. At the hostel she stayed in before moving into her apartment, she cut her knee while getting out of the shower.
Bleeding profusely, she made a tourniquet out of a Toronto Blue Jays T-shirt — a “symbolic” break with her old hometown, she joked. Soon she would receive an invigorating introduction to her new one.
Ji Yoon Han outside his home in Montreal on July 15. Khan recounts how she ended up in one of the city’s overcrowded emergency rooms when she first arrived in the city. Christine Muschi/The Globe and Mail
After taking an Uber to the city’s CHUM mega-hospital, she arrived around 1:30 a.m. on July 1. In the crowded waiting room, she made a slip that was soon covered in her blood and tried to remember her French numbers as they were called over the intercom. “I must have looked really pathetic,” she said.
A triage nurse took her information, put gauze on her wound, and warned her that the ER was busy and understaffed, so there might be a long wait. It would turn out.
After 30 minutes, she was called to check in, which involved filling out paperwork for another 30 minutes so the hospital could bill Ontario for her care.
At around 3am, Ms Khan, 27, noticed she was bleeding through her gauze, prompting her to be taken back to triage for another thick dressing.
When she was finally called into the examination room, 30 minutes later, she was only the second person to leave the waiting room since she arrived two hours earlier. A man in a wheelchair told her he had been there since 6 p.m
Still, there was more waiting to come. She looked at her phone every five minutes to kill time and drain the battery.
A doctor came and stitched her up after about an hour. He then waited another hour for his tetanus shot from a nurse. But she admitted she was one of the lucky ones: she had made it and was patched up.
On her way out of the emergency room, five hours later, Ms. Khan saw many of the same faces she had seen earlier in the morning, including the man in the wheelchair, now in his 12th hour of limbo.
“One thing that was very memorable to me when I came out was that the crowd in the emergency room was exactly the same,” she said. “I felt almost survivor’s guilt.”
– Eric Andrew-Gee
In Alberta:
Graham Mosiman didn’t need a morning alarm on June 19. The “excruciating, screaming upon waking” pain coming from his shoulder was enough to get him out of bed at 6am
Graham Mosiman had put his shoulder back in place because the nearby urgent care center wasn’t open and the wait time at the emergency room was hours. JASON FRANSON
The 29-year-old was no stranger to the painful sensation throbbing through his upper arm. About 15 years ago, while refereeing a hockey game, he dislocated his left shoulder and tore the labrum, which is a rubbery tissue attached to the edge of the socket that works to hold the joint in place.
“Since then, my shoulder has dislocated so many times that now it has a groove where it can slide out of its socket more easily,” he said. Sometimes he can return it to its place by leaning against a wall or even by checking his body on a hard surface. But his usual methods weren’t working.
He searched for urgent care clinics in Edmonton. It was a Sunday and the only clinic he could find didn’t open until 3 p.m. “I can’t tell you the level of anger and pain I felt,” Mr. Moziman said.
His options were limited, so he checked the wait time at the emergency room in town, even though he felt it wasn’t the right place to get hurt. They varied between five and six hours. He briefly considered driving to Stony Plain, about 40 minutes west of the city, but decided it would be unnecessarily painful to drive—especially since his car has a standard transmission.
The pain was excruciating, he said, so much so that he had been sedated during previous visits to urgent care centers as they moved his shoulder back into place. He felt like the only option left was to go it alone.
“It was a matter of me literally sitting on my couch and doing like little, painful, minor movements to try to push my shoulder back into place…
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