Hallway patient numbers 'shocking' but most hospitals over capacity, nurses' association says

A vice president with the Ontario Nurses' Association calls the number of people who have been treated in the hallways of a Brampton hospital "shocking," but says most Ontario hospitals are operating over capacity and the situation will only get worse as flu season approaches.

• EXCLUSIVE: Opposition slams Wynne government over 'hallway medicine crisis'

An internal memo written by a top executive at the William Osler Health Centre and provided to CBC Toronto by the provincial NDP outlines how over a one-year period, more than 4,300 patients received care in the hallways of Brampton Civic Hospital.

Vicki McKenna, a registered nurse and first vice president of the Ontario Nurses' Association (ONA), said Tuesday that the capacity problem is not new and is only getting worse.

"Certainly the numbers are shocking, but those are Brampton's numbers and we know that almost every hospital in Ontario has been running over capacity for some time now," McKenna told CBC Toronto Tuesday in a telephone interview.

"We've been talking to government and employers about over-capacity for over 10 years and the situation has only increased."

The news out of Brampton Civic, she said, "is really just one example of what's happening in Ontario hospitals."

McKenna could not discuss exact figures from other health facilities. However, she noted that it doesn't matter if over-crowding is affecting a hospital of a few-dozen beds or a few hundred.

"If you're talking about a 30-bed hospital, maybe the number's not as big but the effect is the same, that there's people in hallways that lack privacy, lack the proper environment around them to be cared for," McKenna said.

"And for our nurses on the front lines in these hospitals, what they're telling us is that … in many cases there isn't additional staff added when there are patients placed in the hallways or in lounges or in auditoriums or in offices."

While some hospitals have plans to deal with over-crowding, many do not, she said.

'Excessive noise and reduced privacy'

The internal memo obtained by CBC News showed that between April 2016 and April 2017, 4,352 patients were treated in hallways at Brampton Civic Hospital, with lengths of stay ranging from 40 to as many as 70 hours. The memo was written by Joanne Flewelling, interim CEO of William Osler Health System. It is dated July 20.

"Hallway patients experience excessive noise and reduced privacy, which negatively affects their overall patient experience and quality of care, and may extend their overall length of stay," Flewelling wrote. 

According to McKenna, research shows that patients who spend any length of time in hallways end up staying in hospital longer, and their risk of complications, such as infections, is higher because they are not being treated in the proper environment.

Nurses also tell her how both patients and their families feel when they are dealing with serious health problems without any privacy.

"These people are in hospitals because they're sick. They need hospital care; they need good nursing care," McKenna said. She added that often, when more patients enter the system, it does not usually lead to a corresponding increase in qualified staff to take care of them, such as nurses.

'I couldn't sleep'

Jamie-Lee Ball spent five days in a hallway at Brampton Civic Hospital in March. She was suffering from abdominal bleeding, but due to over-crowding was placed in the neurology ward. Her gurney was right near the nurse's station, so she had to listen to the hustle and bustle day and night. The overhead lights were never dimmed, and she had to share a public bathroom meant for visitors to the ward.

Because some patients on the ward were suffering from dementia, "code whites" were often called, which is the call for help when a patient is potentially violent.

"I couldn't sleep. I didn't have anything to eat for three days because of the disorganization of just trying to find out where I should be," Bell told CBC Toronto on Tuesday.

"Not being able to sleep, it was a lot. It was really hard to heal."

Her sister had to bring her a pillow.

"To think that this is going on in Brampton where we have a lot of resources," Ball said.

She has also had to be at Brampton Civic seven times over the last month, and each time she says she heard a "Code Gridlock" called, which occurs when there are no available beds. In the memo obtained by CBC Toronto, a "Code Gridlock" was declared for 65 days in the first four months of 2017.

'We need beds'

In a statement issued to CBC News, a public relations manager with the William Osler Health System said the agency is working with the Central West Local Health Integration Network (LHIN), which administers funding to local hospitals, and the ministry "to address Brampton Civic Hospital's current capacity and access challenges.

"At Osler, our team is dedicated to ensure timely access to care within one of the busiest ED environments in Canada. Like many Ontario hospitals, Osler hospitals have seen an exceptionally high number of patients in its Emergency Department (ED) over the last number of months, and staff and physicians remain focused on providing safe, quality care during these extremely busy times."

The ONA, meanwhile, recently launched a public awareness campaign about overcrowding at hospitals, warning that it can take an average of 30.4 hours for a patient to be moved from the emergency room to the right hospital bed.

McKenna said that the provincial government's recent pledges to increase acute care hospital beds across the province by more than 1,000, as well as additional funding for home care and other health services, is "welcome.

"However, that's going to take time to put in place and that isn't going to address all of the situations that are occurring really quickly."

Asked what she would like to see happen, Ball said the solution is simple.

"Do something!" she urged politicians. "We need beds. There's no other way to argue it. We need beds and we need them now."