Emergency departments facing extreme pressure in Sask. and across Canada

Limited beds, reduced staffing and low morale — all in an environment that cannot control what comes through the door — are just some of the issues plaguing emergency room departments across Canada.

Many ERs have adopted drastic measures to stay afloat, like closing early or temporarily shutting down.

Dr. Mike Howlett, president of the Canadian Association of Emergency Physicians, said there are two main issues currently affecting care in emergency departments.

"Crowding of people in hospitals has reached a very serious level," he said. "And related to that is a decreasing physician and nurse workforce."

Although Howlett agrees that COVID-19 has helped expose the precarious situation in hospitals, it is not the only thing to blame. 

"COVID by itself is not the only cause, nor it's not the only thing creating stress in the system," said Howlett. "It's just created a situation where it's more obvious."

ER doctors say crisis has been a long time coming

Dr. Brian Geller experiences the systemic pressure first-hand through his work as an emergency medicine physician in Regina. He said there needs to be a "fundamental shift" in how care is delivered.

"We've had a health-care human resource crisis in Saskatchewan for 40 years now. And I would argue that any crisis that goes on for 40 years is not a crisis anymore — it's a system that's actively being maintained," he said.

Geller said hospitals are badly short on health-care providers, including human resources, physicians and nurses.

"We need to move away from massive institutional care out into the community and re-emphasize the importance of primary care," said Geller.

Howlett agreed that long-term solutions are needed.

"We need to increase the community resources available," said Howlett. "It needs to be able to be responsive right when [patients] need it and not delayed like currently happens, often days and weeks."

Shortages in other health-care departments creating ripple effect, hitting ERs hard

ERs aren't the only hospital areas with a lack of beds, but people experiencing medical emergencies are particularly vulnerable when beds aren't available.

Howlett said ER beds are often used by patients waiting transfer to other hospital departments or to community care. These patients are taking up room because there isn't room in the specialized care units they require, or in community care facilities.

"We have difficulty getting them out into the community because community care and primary care has not kept pace with the aging of the population in Canada," said Howlett.

"We have more people in their seventies, eighties and nineties who are increasingly frail and have complex health needs. So it's just that much more difficult to find community resources for them."

Geller said that this is an issue in Regina hospitals as well, leaving those who need emergency services susceptible to long wait times and frustration.

"When our beds are full of patients waiting for placement either in the community or in another acute care facility, or in a long term care facility, then we don't have room for the people coming in to the emergency room," said Geller. 

Geller said this leads to long wait times in the emergency department, sometimes as long as long as 14 hours — an entire shift for nurses.

Doctors hope premiers and prime minister will work on long-term solutions

Geller is concerned for the impact the situation is having on his emergency room colleagues.

"What's top of mind is that they have 70 plus patients in a 30-bed emergency room, and have people who have been waiting for 10 hours for care that ordinarily wouldn't wait that long," said Geller. "You feel hampered in your ability to do your job, and that's mentally and morally defeating."

Howlett said this issue is affecting hospitals across the country.

"I am not aware of any department head or local hospital that is not having to deal with this same issue," said Howlett.

Both doctors are hopeful that long-term solutions can be established at the premiers' meeting in Victoria this week.

"They need to pay very close attention to working together and not at cross-purposes," said Howlett.