N.S. emergency units clog up as patients have nowhere to go because of full beds, experts say | 24CA News

With a renewed scrutiny on Nova Scotia’s emergency departments, specialists say the issues of overcrowding and lengthy wait occasions stem from points elsewhere within the health-care system.

Dr. Robert Martel, who has spent most of his profession as an emergency room doctor, mentioned departments throughout the nation are overcrowded, workers are overworked and assets are stretched. 

He mentioned this case has been a very long time coming for Nova Scotia, as different issues within the health-care system trickle all the way down to emergency departments.

“Politicians and those that were supposed to be making informed decisions really didn’t make the right ones,” Martel informed CBC Nova Scotia News At Six on Wednesday.

“And as a result, we find ourselves in a really bad situation right across the country, and by the time we crawl out of this, there’s going to be a lot of tears shed.”

Tragedy in Amherst

All eyes have been on the province’s emergency departments after the dying of a younger mom in an Amherst, N.S., hospital final month.

On Dec. 31, 37-year-old Allison Holthoff waited greater than six hours to see a health care provider on the Cumberland Regional Health Care Centre whereas she skilled excruciating stomach ache.

Her husband drove her to the emergency division at 11 a.m. AT and she or he spent her time between a wheelchair and mendacity on the ground within the ready room earlier than she was delivered to an examination room. 

After extra time handed, Holthoff went into cardiac arrest. She was resuscitated thrice and later died within the intensive care unit. 

Her dying has spurred requires motion and enhancements to emergency departments.

But Martel mentioned issues in emergency departments are only one piece of a bigger puzzle, as an older and sicker inhabitants requires extra long-term care and acute care beds — one thing Nova Scotia simply would not have sufficient of.

Beds are full

As of Wednesday, hospitals throughout the province had been at a median of 98 per cent whole occupancy, that means nearly all inpatient beds are full. 

Some hospitals had been even above 100 per cent occupancy, together with the Dartmouth General Hospital at 112.8 per cent and the South Shore Regional Hospital at 125.9 per cent.

“The bottom line is, if you have a plugged pipe and [patients] can’t move, it’s unlikely that the waiting room is going to be empty,” mentioned Martel.

Ruth Lavergne, a Canada Research Chair in major care at Dalhousie University’s Department of Family Medicine, agrees with Martel that ER issues replicate all the health-care system.

These issues have Lavergne involved, particularly as individuals with no household physician usually go to the ER with generally severe sickness or accidents.

“Patients in Nova Scotia and across the country are struggling to get care in a timely fashion,” Lavergne mentioned. 

“That’s happening in the community as people are trying to find a regular place for care or get their needs met, and we’re also hearing about really challenging situations in emergency departments.”

She mentioned individuals usually blame others with non-urgent issues for clogging up emergency departments, however the challenge lies with individuals with advanced wants who cannot be admitted. Patients who want additional therapy usually cannot be moved out of the ER into beds in completely different models, and individuals who cannot get a spot in long-term care are additionally filling hospital beds. 

“It’s true that on average in Canada, we have fewer hospital beds per person, but it’s not as simple as that,” Lavergne mentioned. “We often hear about building new buildings, but a hospital bed has to be staffed.”

As of Tuesday, there are 12 doctor positions vacant inside emergency departments throughout the province, two of that are on the Cumberland Regional Health Care Centre in Amherst.

For registered nurses, there’s a median emptiness fee of practically 32 per cent in emergency departments throughout regional well being care centres and the Halifax Infirmary as of the tip of November, in response to information from Nova Scotia Health.

Alyson Lamb, government director of well being providers for the western zone of Nova Scotia Health, mentioned the province is experiencing excessive bed-occupancy charges, much like different methods throughout the nation.

She mentioned the well being authority is specializing in workers recruitment and retention to fill the hole, whereas additionally providing extra digital care and including different roles like paramedics and nurse practitioners to emergency departments.

“Certainly we’ve adjusted our models of care based on the needs that are there. It does make things challenging. We know that [emergency rooms are] congested,” Lamb mentioned Wednesday.

“But what I would say is our health-care providers continue to deliver the very best care they can, in the circumstances that they’re faced with every day.”

Problems with triaging sufferers rapidly

Martel mentioned staffing shortages have additionally exacerbated wait occasions in emergency rooms, particularly as a result of nurses should decide the order during which sufferers are handled, known as triaging.

The severity of an individual’s situation determines how rapidly a affected person is triaged, in response to the province’s Annual Accountability Report on Emergency Departments. In Nova Scotia, emergency departments have set objectives on how rapidly that ought to occur.

Patients with regular very important indicators — respiratory, pulse, blood strain and temperature — and non-urgent circumstances are thought of Level 5, and are anticipated to be handled by a health-care practitioner inside two hours. 

Meanwhile, these affected by life-threatening circumstances who require rapid consideration are thought of Level 1, and may obtain therapy instantly.

Martel mentioned overcrowding has made assembly the objectives of treating sufferers in a well timed method practically unimaginable.

“Time after time, patient after patient, and you triage them at a Level 2 —  which means that they should be seen within a very defined parameter,” Martel informed CBC Nova Scotia News At Six on Wednesday.

“It becomes very difficult for an individual doing triage to put that individual in an overcrowded waiting room, where there might be another 20 Level 2s who can’t possibly be seen in that period of time so the stress on the individual doing triage has become enormous.”

Lamb agrees triaging sufferers is demanding and difficult, however Nova Scotia Health is working with emergency departments to assessment information and align assets in response to volumes.

“Certainly, we’re struggling in the sense you can’t always predict what’s going to come into an emergency department and there will be variation and wait times, but we also know there’s always opportunities for improvement.”