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Abusive behaviour taking toll on IWK’s emergency staff in Halifax, says department chief

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Nova Scotia is reintroducing some public health measures amid the spread of the Omicron COVID-19 variant, the province's chief medical officer of health Dr. Robert Strang announced on Monday. Mandatory physical distancing in public settings, the reduction of gathering sizes and mandatory masking are some of the measures being brought back, with the distancing requirement to return Dec. 17 – Dec 13, 2021

The IWK Health Centre in Halifax has revealed in an Instagram post that emergency department staff have been subjected to abusive behaviour and language, including personal threats, from people coming to access care.

In a statement posted Tuesday, IWK said that its “emergency departments, in particular, are facing growing pressures and staff and doctors are doing the best they can to respond to patients’ needs in a timely manner.”

“If you are coming to an emergency room for care, you may expect longer than usual waits,” reads the statement.

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Dr. Katrina Hurley, chief of the IWK’s emergency department, said it’s been difficult for both staff and the public after a long year dealing with COVID-19.

“It’s been difficult because of fear. It’s been difficult because of restrictions. I think many people are experiencing difficulties accessing care, and it may be leading more patients than usual to our department,” Hurley said.

She explained that during COVID-19, the volume of people coming to the emergency went down considerably and so the wait times weren’t very long.

But since the beginning of July 2021, the IWK’s emergency department has been seeing a number of patients that is “over what is seasonally normal.”

“We don’t yet know what that pattern is going to look like going forward. We normally experience a significant bump in the winter months. So I don’t know if our bump is early or if this is going to be a sustained pattern that we’re going to see for many months,” Hurley said.

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In the meantime, she said the staff’s goal is to provide timely care to the sickest patients and try to understand what’s driving the disrespectful behaviour of some of the people trying to access emergency care.

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“Sometimes people have waited a long time and they may be hungry, thirsty or tired or worried about another child that they need to pick up,” Hurley said.

“And so it comes down to making a connection and trying to understand what’s driving the behaviour and if we can provide food or water or warm blanket or some information that might alleviate that stress we’ll try to do that,” she added.

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For the vast majority of days, Hurley said the emergency department has not been working short-staffed, but it’s hard to predict how many people are going to walk through the door.

“Some days we might try to be overstaffed thinking today is the day or there will be a big number, and then it might not be that day. So when it comes to emergency medicine, it is very tricky to predict in that way.”

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But it has become really hard with people yelling at staff, despite the efforts of the emergency department to meet patients’ needs, so for the first time, the IWK made the choice of putting the post up on social media asking people to be more kind.

“I think it’s partly that staff are also experiencing stress. And I question, maybe our resilience is not as high as what it normally would be, or maybe it’s worn down over the many months of dealing with this,” Hurley said.

“But I think that it’s really hard when you’re trying your hardest. And then someone’s yelling at you.”

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In conversations with nurses, Hurley said because the nurse is the person who meets people at the front, they end up getting the brunt of those complaints.

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“They’re the person who’s going to hear all the different complaints from people in the waiting room. And you know, they didn’t get into this business to not help people. … And so when they’re not able to meet those needs or feel like they can’t meet those needs, it can be quite demoralizing,” she said.

As staff members try to navigate these stressful situations, Hurley said they are finding a lot of support in each other and discussing the pressures among themselves and in meetings.

“I think the IWK making a post like that — I think staff also feel supported by that. They feel validated that and I think that in itself is important. And maybe it reaches the public, and maybe it results in a moment of acknowledgment or gratitude,” Hurley said.

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