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Overcrowding sparks crisis in hospital's ER, nurses say

Feb 25 2012

Overcrowding at Royal Jubilee Hospital's emergency room has reached crisis levels, registered nurses say.

Nurses called their union representatives Friday, fearing for their patients' safety and their own licences as a peak of 34 patients admitted to the ER were waiting for a bed, said Adriane Gear, south Island representative of the B.C. Nurses' Union. "Nurses are very fearful for their licences because they can't adequately care for the patients."

There are too few nurses and not enough beds, she said.

The nurses say Royal Jubilee is often overcrowded, although Vancouver Island Health Authority could not offer exact numbers Friday.

Lynnda Smith, a registered nurse and union steward, said: "Nurses see this as a crisis."

Gear said Friday's patients included one with immunity problems who could not be isolated and another with a probably contagious gastro-intestinal infection who had to share a crowded space.

One woman asked nurses for help, but eventually wet herself, Gear said. No dignity was afforded her, Gear said. "She was very upset; this is not good enough," Gear said.

At its peak on Feb. 21, there were 100 patients in the ER department, Gear said. "There literally wasn't any physical space for them. You couldn't sit them down or lay them down."

Royal Jubilee and many other VIHA hospitals are busy, VIHA spokeswoman Suzanne Germain said.

The emergency department was busy Friday, "but certainly not in a crisis," she said.

The problem in the emergency room was compounded by a higher-than-usual number of staff off sick — the department was short by one registered day-shift nurse and three night-shift nurses, Germain said.

"Our staffing services [have] been working full tilt to get replacement staff in, including on overtime," Germain said in an email.

Royal Jubilee's emergency department has 17 stretchers and up to 12 overflow beds, according to the union.

If more patients are admitted and there are no in-patient beds, they are "just tucked away" in trauma rooms, examination rooms, corridors and crannies — "wherever there is a space," Gear said.

"No one would question the BCNU's concerns and I believe everyone wants to ensure that the patients that come through our emergency rooms are receiving good, quality care and in a timely manner," said Michelle Stewart, spokeswoman for the Ministry of Health.

Adding more beds will not address the underlying issues behind the demand for acute services, Stewart said.

"Health authorities and the ministry know we need to shift our focus to enhancing community services, and keeping our seniors healthy and at home longer, in order to reduce the heavy reliance on acute care," Stewart said in an email.

At a time when other ministry budgets are shrinking, the Health Ministry is getting more than $447 million in additional funding this year and an additional $1.5 billion over the next three years, Stewart said.

To help ease the pressure on Royal Jubilee between five and seven patients were diverted to an overflow ward at Victoria General Hospital in View Royal.

The nurses' union said overcrowding has been an issue since last March, when the hospital's patient care centre opened.

Nurses are quitting because they cannot cope with providing what they feel is substandard care when they are understaffed and emergency departments are overcrowded, Gear said.

There are 136 beds sitting empty in the care centre with no funding to operate them — 68 beds on the fifth floor, as well as 34 beds on both the fourth and seventh floors, according to the union.

"In light of the lack of funding directed at health care, it's only going to get worse," Gear said.

VIHA said there are more beds at Royal Jubilee now since the care centre opened. VIHA never intended to open the care centre at its maximum capacity "as it was always intended for future capacity to open in future years," Germain said.

ceharnett@timescolonist.com

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