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An 'alleged letter' in the dark of night

One of the more interesting moments during Tuesday's televised leaders' debate was the exchange between Premier Williams and NDP leader Lorraine Michaels, where he challenged her on "alleged" anonymous letters that were received "in the dark of night". The premier went to great pains to assure her and the rest of us that there is not a climate of fear within the public service.

I have my own opinions on that. After all, this is the same premier who threatened to sue some local bloggers, and actually floated the idea of removing free speech from the House of Assembly.

Well, last night, I received a letter from a disgruntled health care worker, a nurse in the emergency room (ER) at the Health Sciences Centre (HSC). This is not an "alleged" letter it's quite real though the writer has insisted on anonymity for fear of losing their job. And yes, it was received in the dark of night.

This person recites numerous problems within the ER and says that all of them have been brought forward to management, but where changes have been made, they have been ineffectual. "But if I went to the media and said, Listen to this,' I'm suspended and probably fired," the writer says.

I am posting the full text of the letter here, with just a few minor edits to remove identifying details, because it is, frankly, shocking to read. If you've used our emergency care system and it felt like things were held together with string, duct tape and seven Hail Marys, well, perhaps that's because sometimes it is.

This blog has limited readership; media are welcome to bring this material to a wider audience, as they see fit. Here's the letter:

Lorraine Michaels wasn't wrong about fear of being suspended by Eastern Health. If you speak publicly, you'll get suspended. It has happened before. Danny just got on the wrong tangent with her. As for Eastern Health, they have their media department to do their talking, and when they do it makes me laugh. Example, when the ER was short staffed and closing beds, a rep is on TV saying it'll be a 4-6 hour wait for non urgent cases. It's like that most of the time on a normal day. People waiting 12 hours for non-urgent stuff isn't uncommon. No nurse in there wants to stay there, they are all trying to find other positions and get out, it is a terrible job based on an utterly crappy layout of the ER, short staffing, abuse from the rest of the hospital, rampant verbal abuse and frequent physical abuse from the public (nurses have been assaulted) and just plain being overloaded in many, many ways.

I appreciate the hard work of everyone in the system and know everyone is frustrated the ER is just one of many departments upset.

As nurses we are taught to be a patient advocate. The patient can't speak for themselves and so we speak up. To do so at Eastern Health will get you in deep shit. If I went public with the ER stuff for example, I'd be in trouble, even though to say all this is a benefit to patients who deal with the ER (patient advocate). I have very little good to say about Eastern Health myself, but I will say the ER has some great just utterly overworked staff.

But, yep, speak out, in big trouble. You DID NOT HEAR THIS FROM ME BTW

Oh, two recent ER tidbits. One nurse had a wheelchair thrown at her by a patient who became irate when told about a wait time (a drug seeker as I was told), another nurse went home at end of shift crying as she was so busy she could not spend any time with a dying patient who was all alone in the ER. This stuff is just wrong, but a properly built and staffed ER would help. I don't begrudge the Janeway getting funds to help kids, but maybe some fundraising would help the HSC. You can go to the Janeway ER after midnight pretty much any time and it is dead quiet, meanwhile the HSC ER is constantly on the rocks. The joke you'll hear at the HSC sometimes is to call the Janeway the Hospital for Six Children.

By all means, make sure the Janeway helps the kids to its utmost, but when I've seen people bring in elderly family in the hopes that something is wrong cause they can't tend to them at home, then leave them in the ER saying they can't take care of them anymore when the elderly person is medically cleared to go home, I find all the Janeway fundraising leaves a bitter taste in my mouth. The leaving of elderly people that happens sometimes, that is a direct symptom of no long term beds, and they can linger in the ER for up to a week while social work tries to figure out what to do with them.

People waiting in the ER for beds for 2-3 days after being admitted upsets me too. Those stretchers are occupied and therefore unavailable for ER patients, so that slows things up, and as well the ER nurse has to do ER work PLUS floor nursing work for the admitted people. Nowhere else in the HSC will this happen. Of course when it gets to crisis level, as it often does, just pick the " healthiest" ones and put their stretcher in the hallway.

You have two hospitals to take care of 120,000 people. There are 22-28 stretchers in the HSC ER, and the HSC ER gets all the traumas and most referrals from the rest of the province, because if you are outside St. John's and have a compound fracture, need a bypass, need neurosurgery, for 3 examples, you go to the health sciences. That stuff comes to the ER's too. So the HSC is the main referral centre and the trauma centre for the entire province, and it all rolls through the HSC ER. Plus in addition offshore accidents and such also come through there, and some outside ambulance services won't go anywhere except the health sciences (I could go on about that farce!).

So it's busy, and needs big time help. And that is only one department.

But if I went to the media and said, "Listen to this," I'm suspended and probably fired.

I've been frustrated for years now regarding the ER, for many reasons. It is terribly busy, and while busy more gets thrown at you.

Did you known that many floor nurses (not all of them, but a lot of them) refuse to take patients from the ER as they are busy? It is a constant battle to get patients up to the floors as nurses say they are busy with routine work. If a patient is coding or some emergency is going on, then fine. But I and every other ER nurse have been deliberately delayed for reasons involving routine work or a nurse saying her colleague is on break, or by the most popular tactic, not answering the phone (caller ID in the hospital system so you know what area is calling). I have called the floor and waited forever for an answer, then hung up and connected through the communications desk (different id on the phone) and had it picked up right away. This is very frustrating as you are usually trying to do this while an ambulance has someone on a stretcher in front of the desk waiting for a spot to put them, and that spot is taken up by someone you can't get out of there. Constant problem. The ER can't tell ambulances or the person who comes in with a heart attack or some other critical problem to wait because we are busy. I know that may not sound like much really but it is one area of disrespect from the rest of the hospital that interferes with patient care and shows no respect for a person waiting to get to their admitted bed.

One great example of this happened when a family member was getting upset at the length of time it was taking to get their loved on to the floor. We told them, We keep calling and get no answer.' (For us the faster patients get out of the department the better, it frees up stretchers). The patient's family member knew the bed and floor assigned to their loved one and unbeknownst to us went to the floor to find out what was up. The family member said they went up and found the nurses at the desk not doing anything, busted them basically. True story. Again, I won't say floor nurses aren't busy, they are, but it is very common to put off the ER until routine work is done, and that is very unacceptable.

Some docs, mainly plastics (plastic surgery, for example people who have had finger and such reattached, tendons reattached, really fine sewing stuff) have used the place as a clinic and told their more simple cases to go to ER and they would see them there, and then evaluate, sew, etc the patients. This takes away the stretchers from ER patients while this totally inappropriate use of the ER goes on. It too has been addressed but still happens.

All of the problems have at one time or another been addressed by the usual channels (reports, manager meetings, etc), but the result is nothing happens or if something happens it either stops working pretty fast or is just ineffective from the start.

I could give many, many examples of the state the place is in. I will say that while all this goes on, a person critical gets in right away, though many times this involves a lot of shuffling of patients and very hard work by staff, plus the long waits people less serious complain about. Less serious can range from simple stuff like colds to people with broken ankles or appendicitis, to name a couple of things. This is the triage aspect btw.

If you want to write something I guess that's fine, but no personal details about me. The Docs don't seem to get in trouble, and I'm glad they have recently spoken up about problems. Maybe the ER docs should speak up.

(Name withheld)

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Recent comments

  • Charles
    July 27, 2010 - 14:53

    To me the problems are not surprising, but the detail is shocking. Having been to ER and plenty of visits to the HSC, I can sense and appreciate the pressure health employees are under. Wait times can be very long for non-critical situations. However, despite the stress they're under, in my opinion, they perform very professionally. But I guess they cover it up well. I completely emphatize with this person's terrible situation. Under Paul Martin, wasn't there supposed to be a $15 billion health pot, to be released over a period of some years? What has any new health money done? Everyone will suffer when health care employees are not properly treated and respected.

    If more health care workers are not hired to better manage the work loads, then those giving care will need it themselves.

    I am not part of mainstream media, but I have a blog site and for what it's worth, will add a link post there to direct some more people to this letter.

    I hope this gets much more public attention. The timing is right, an election is on