FAILED CURE: 5TH IN A SERIES

Backed-up ERs lead to 'hallway medicine'

July 2, 2008

Comments on this story (0)

Petti Fong
WESTERN CANADA BUREAU CHIEF

NEW WESTMINSTER, B.C.–Scott Anderson felt a twinge in his side recently, pinpricks of pain that within a few breaths became unbearable gut aches.

Anderson, a dump truck driver and father of two, thought he could walk it off. It wasn't just manly pride; he wanted to avoid going to Royal Columbian Hospital, a facility with one of the busiest emergency rooms in British Columbia.

"I heard the stories, right? Everyone has these stories about how bad the ER is at RCH, so I put off coming," said Anderson, 42, showing off the scar on his belly. "But when they saw the shape I was in, I got rushed through."

On the day pain forced Anderson to seek help, he arrived at Royal Columbian's emergency room shortly after 4 p.m.; the triage nurse saw him 90 minutes later.

His appendix burst and, by 10 that evening, Anderson was on the operating table.

"There were a lot of people inside in the ER and I thought it would take a long time before anyone would get to me," said Anderson. "But they know what they're doing and when they saw the shape I was in, I got in quicker than people who were there ahead of me. I don't know how it works, how they figure it out. But they do, somehow."

Royal Columbian Hospital, in the Vancouver suburb of New Westminster, is the province's second-busiest hospital. It's so crowded the fire department has been called out twice to force hospital staff to move people around.

Brian Westell, the fire department's chief fire prevention officer, said inspectors have no choice but to respond when calls are made regarding overcrowding.

Fire safety inspectors have gone to the hospital's emergency room and asked staff to move patients away from doors and fire exits when too many patients and their family members crowd the department.

Westell said it's the fire department's responsibility to respond to all calls about overcrowding and potential fire hazards. But he believes the fire department is being used during these anonymous calls for other purposes.

"I feel like it's a political move, trying to get the province to do something about the overcrowding in these hospitals. And apparently it must have worked, because they're doing something, at least temporary," Westell said.

Last month, the province's health minister, George Abbot, told reporters that Royal Columbian has "major pressures" and more space may be added within two years.

The government has come under fire by opposition critics and some nurses and doctors who work in the facility for closing down St. Mary's, a second New Westminster hospital, in 2003 to cut costs.

Twenty-four emergency doctors wrote a letter to the health minister in February 2007 outlining their concerns about patient safety.

In the last six weeks, seven senior nurses from Royal Columbian resigned, a number of nurses told the Toronto Star.

One triage nurse, who, like others, signed an agreement with the health authority saying she would not talk publicly about the situation inside the hospital, told the Star she had never seen a situation as bad in more than two decades of nursing.

"Hospitals are always busy places, especially emergency rooms. No one wants hallway medicine, but it was what we've had to deal with. And we're now in a situation where we're holding ambulances because there's no room," said the nurse, one of those who resigned recently.

She blames the problem on the position held by both the health authority and the provincial government: that a bit of care is better than no care.

"That's been the biggest issue. We've been normalizing an abnormal situation," she said.

Royal Columbian is not only a tertiary care centre in the area, it also is a major transfer station for smaller outlying hospitals. On top of that, the hospital is a major trauma centre and has a renowned cardiac care facility.

"We're seeing people who've been shot and stabbed here from around the Vancouver area," said another nurse during a break outside of the hospital (she also asked not to be named because of the agreement she had to sign with the health authority).

Much of the Vancouver area's growth over the last 15 years has been towards the east in the direction of the Fraser Valley, where New Westminster is located. By 2015, the region that Fraser Health Authority oversees is expected to increase by 18 per cent.

Betty-Anne Busse, executive vice-president of Fraser Health Authority, said there have been some successes in strengthening primary health-care systems, so there is not such a reliance on emergency care.

Toronto Star

Editor's Picks