A nurse at St. Paul’s Hospital said the ER is “consistently caring for at least double the amount of people we are safely able to.”
If patient shows up at the emergency department of St. Paul’s Hospital in Saskatoon complaining of chest pain, that’s a symptom of a heart attack until proven otherwise, says registered nurse Stephanie Fehr.
That patient “should be immediately placed on a heart monitor and thoroughly assessed and continually monitored by staff while in our care” — but will probably never get a heart monitor, or even a bed, she said in a recent interview.
At St. Paul’s, the “vast majority of possible heart attack patients” are being treated entirely from the waiting room because there’s nowhere else to put them, Fehr said.
“With the number of patients we are expected to care for without rooms or proper equipment growing every day, the standard of care is abysmal.
Last week, the emergency department at Saskatoon’s Royal University Hospital (RUH) was said to be working at 350 per cent capacity.
By Sunday morning, Saskatoon Fairview NDP candidate Vicki Mowat said it was still at more than 200 per cent capacity.
On Oct. 2, occupational health officer Steve Bilan inspected the RUH emergency room and found overcrowding had led to several illegal hazards and risky situations.
“The emergency room was over capacity,” Bilan said in a publicly-posted report. “It was noted by the emergency room managers that 19 or more admit-no beds puts the emergency room in the black (over capacity) and they were currently dealing with 60-plus patients in that situation.
“Also mentioned that the emergency room has 36 beds/chairs for patients and at the time of the inspection they had over 90 patients in the emergency.
“When asked if there was a plan or protocol in place to help control the situation when over capacity issues arise they said that there was no plan or protocol in place.”
The number of patients on beds and chairs in the hallways, doubled up in triage areas and lined up around the nursing stations was also obstructing movement through the emergency room, and making it harder for medical staff to transport and use equipment like IV poles, blood pressure machines and ECGs.
Bilan said all these situations must be remedied by Nov. 1.
At St. Paul’s, Fehr said the emergency department is “consistently caring for at least double the amount of people we are safely able to.”
That means each triage nurse is consistently responsible for 10 or more patients at a time. When a bed does open up, Fehr said she and her colleagues are left to make their “best guess” at who is the sickest out of a group of very ill people, and who can risk waiting longer.
With so many patients, Fehr said nurses can’t do the “close observation, assessment and care” they are trained to do. This means patients have to wait longer for help and nurses are more likely to miss signs that their condition is getting worse.
“We are the ones that carry this burden (and) have to make these ethical decisions when we have four, five or six patients in our waiting room that we’re very worried about, but only have one bed to put them in,” Fehr said.
“Do you know how high the stakes are in that decision? Do you know the weight of the burden our nurses are carrying every day, when they have to pick and choose who gets that very last bed and who has to risk sitting in a chair? The weight of this has broken us. This is why emergency staff are leaving.”
In hospital hallways, there is no real privacy.
The lights are never turned off; patients can’t sleep. Those who can’t move in bed on their own develop painful bedsores. Wait times are often measured in days, not hours.
Still more patients are left waiting with paramedics who have brought them to the hospital, and who can’t leave until the person in their care has been seen and formally admitted — even though those long delays tie up ambulances and first responders, and the care they can offer from the stretcher bays is limited.
Recently, Fehr said a patient walked into the St. Paul’s emergency department bleeding from multiple stab wounds.
“The only good thing about having 10 paramedic units waiting without beds is that I had extra hands to hold pressure on the stab wounds while scrambling to shuffle someone out of a trauma room so this patient wouldn’t die,” Fehr recalled another nurse saying about the incident.
She and her colleagues are afraid “every second of every shift” that a patient will die a preventable death in their waiting room, Fehr said.
“Emergency rooms are the safeguard of the public. When they’re overloaded like this, and nurses are pushed like this, all our patients are in danger.”
The Saskatoon Star Phoenix has created an Afternoon Headlines newsletter that can be delivered daily to your inbox so you are up to date with the most vital news of the day. Click here to subscribe.
With some online platforms blocking access to the journalism upon which you depend, our website is your destination for up-to-the-minute news, so make sure to bookmark thestarphoenix.com and sign up for our newsletters so we can keep you informed. Click here to subscribe.