What we have here is an emergency

Pam
Pam Frampton
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“An emergency department that is patient focused should communicate to the patients who are waiting, as best they can, what their expected wait time should be.”

— From the provincial government’s

2012 Strategy to Reduce Emergency Department Wait Times

in Newfoundland and Labrador

 

Walking through a corridor in the Health Sciences Centre in St. John’s the other day, I saw a steady stream of beaming couples departing with tiny squirming infants in spanking-new strollers.

A happy sight, to be sure.

It got me thinking that hospitals are like airports — there are plenty of warmly received arrivals, some sorrowful departures and a whole lot of people just sitting around waiting.

Which brings me to the emergency department.

I was there to see my father, who was taken to the ER by ambulance Sunday night and, as a result, did not have to spend countless hours waiting in the crowded anteroom before being seen by a physician.

He’s doing much better now, thanks to the great medical care he received.

But not everyone fares as well.

Spend a few hours in the emergency department waiting room and you will witness human misery in many forms.

It’s a room full of dull-eyed, worried-looking, rumpled people in various states of discomfort.

A young woman sits holding her bandaged hand upright and leans against the wall, trying to sleep.

A young man limps through the double doors and eases himself gingerly into a chair.

A woman lowers her head in her hands despondently, wincing with every movement.

Another woman arrives with what looks like raw burns or fresh bruises across her cheekbones and the bridge of her nose.

The room is painted a listless blue and the air is stale. Despair seems to drift down and settle on the people waiting like dust motes. There is an anxious look about new arrivals, but that quickly morphs into slump-shouldered resignation. The space fills up quickly.

After a few hours shifting in hard seats under the fluorescent lights, we all look like we’ve slept in our clothes. Zombie-like, we stare at our cellphone screens and tap out text messages, some of us oblivious to the sign above our heads that asks us to please turn off our cellphones.

The scattering of magazines is dog-eared and thumb-worn. Someone has torn out a page containing recipes.

The wall-mounted television is set too high up to watch comfortably and the scrolling TV news is a mind-numbing murmur. Only the odd word or phrase penetrates the steady din of snatched conversation.

“Stittsville … grief counselling … young son and daughter … stay-at-home mom …”

Suddenly the dull TV drone is drowned out by a young woman’s loud moans. She is doubled over in pain and her moans soon turn to screams and anguished sobs. People shift in their seats uncomfortably, avoiding eye contact. The young man with her is frustrated by their long wait and his inability to comfort her and pounds on the windows of the information station.

You feel for the people working there, who can only do so much.

You also wonder what will happen to the young woman who is in so much pain, and to the other people waiting for care.

Later in the day, the number of people slumped in chairs remains about the same, though the odd face has changed, replaced by a new one.

At one point, a manager emerges to announce that the ER is over-capacity — that 24 people have been admitted and there are only 22 beds, and that no one else (pending an accident or disaster, presumably) could be admitted.

That news spurs a testy verbal exchange between the hospital employee and a woman who has been waiting to see a doctor since 9 p.m. the night before.

“That’s not my problem,” he says, explaining they are doing the best they can, but there are limits.

It was the emergency department at the Health Sciences Centre, but it could have been at just about any ER in the country. Health authorities in many jurisdictions are grappling with the problem. Long waits and frayed nerves are common.

Last year, in this province, the Department of Health released a five-year strategy to reduce wait times in emergency departments. It’s only a year old so we will have to wait (pardon the pun) and see if it succeeds.

I truly hope it does. Lord knows, it’s a problem that has been studied and tackled and analysed and measured.

Meanwhile, one thing is abundantly clear. Emergency departments are overcrowded, understaffed and under-resourced. And that’s not good for anyone — the employees working under extreme pressure or the sick and injured.

In July 2011, an article on the website Healthy Debate reported on an emergency department wait-time study by researchers in Ontario that was published in the British Medical Journal.

As the article noted:

 

“The study findings imply that when emergency departments are full or overcrowded, processes of care change and quality declines. Howard Ovens, an emergency medicine specialist and director of the Mount Sinai Hospital emergency department, says that the study findings ‘confirm what emergency department staff have always known, that an overcrowded, backed up emergency department is dangerous.’

“Ovens says that ‘doctors will spend less time with patients when there is a long queue, as they are trying to get caught up.’

“The authors of the study also speculated that spending less time with patients can mean time-consuming, but important tests may not be ordered, observation times may be shortened and arrangements for follow-up after discharge may be incomplete.”

 

Emergency departments where people are screaming in pain and have nowhere to lie down, where the wait time extends from one day into the next, and where even people who are admitted to hospital can be left for days on gurneys in noisy, busy corridors because there is a shortage of beds, are simply not working properly.

We need to solve this problem, stat.

 

Pam Frampton is a columnist and

The Telegram’s associate managing editor. She can be reached by email at

pframpton@thetelegram.com.

Twitter: pam_frampton

Organizations: Health Sciences Centre, Department of Health, Mount Sinai Hospital

Geographic location: Newfoundland, Ontario

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Recent comments

  • John Smith
    January 21, 2013 - 09:45

    3.5 billion a year...every year...is what we spend on healthcare in NL. Every 5 years we spend nearly 20 billion dollars on healthcare in NL. We will borrow 4 billion for muskrat falls, a one time expenditure...just for perspective. People are outraged about Muskrat falls, they form groups against the development, saying it will bankrupt the province. Yet, we pour billions into the open maw that is healthcare...and what do we get in return? People go off their heads about muskrat ballooning to 10 billion etc...yet we spend 10 billion on healthcare every three or four years...and not a peep from the naysayers...strange to say the least...if anything is going to bankrupt us it will be feeding healthcare the billions upon billions it consumes evry year...for a population of half a million people...

  • St.Johns Orange Councilor
    January 20, 2013 - 08:58

    The real emergency is the emergency room its self. When all these cuts that are coming happen, just remember that no one in the confederation building will be lacking services, equipment or extra hand to do their jobs. They'll get their raises, perks and more besides, but the people who will be paying for it will get the estimates of it. We have another issue about NL's population growth, or lack there of. our aging senior's. The premier is scared of not having enough people to pay for muskratfalls, so she placed some one in a patronage position to keep him busy until the next election when they can abondon their posts again and leave the issue up in the air. Its not good enough! Government needs a salary cap on themselves, like every other public servant. Think of it this way, the premier can place 10 billion dollars on the next 3 generations of NL'ers on a dam we don't need but we can't waste it on 24 hour snow clearing for 2-3 months of the year, a ferry built in our own province, or an extra doctor in the emergency . How can EasternHealth expect to cure anyone when they can't even cure themselves of not providing a decent and reasonable service. But after these cuts alot of services will be cut out and you can't be judged on a service that you don't provide. Maybe there will be more Government jobs pop up when we get closer to the next election. Its worked in the past!

    • Christopher Chafe
      January 21, 2013 - 08:06

      Ahmmm your logic with MF and the Health Care System crisis is laughable to say the least. You sound as if this crisis has only sprung its head since Dunderdale became premier. Perhaps you need to stop drinking the Orange Crush and realize that the health care system has been flawed for decades.