Health-care workers are sounding the alarm over “exploding” emergency rooms in Ontario, as hospitals face increasing pressure from patient volumes and the province suffers from a shortage of nurses as a result of the pandemic.
A combination of factors has left patients sitting in emergency rooms for longer periods of time before being treated, according to data collected by Health Quality Ontario, a provincial agency.
In April, a patient had to wait nearly two hours before an initial assessment with a doctor in an emergency room, compared with an hour and 18 minutes in 2021. That same month, patients spent an average of 20 hours in an emergency room before being admitted to hospital compared to a 14-hour wait this time last year.
“It’s absolutely horrific. There are not other words to describe it,” said Angela Preocanin of the Ontario Nurses Association (ONA).
“We have hospitals in the GTA that are running at 60 per cent staff and a 300 to 400 per cent capacity.”
The ONA contends there are several reasons behind the crunch in provincial emergency rooms, including capacity issues that existed before the pandemic, a steady admission of COVID-19 patients, and a shortage of nurses and family physicians who continue to work virtually and refer patients to hospitals instead.
Dr. Kashif Pirzada, a Toronto emergency room physician, told Global News patients have walked into the ER looking for specialist referrals and other non-urgent reasons that add to the crunch.
“You have people who have issues that are urgent to them. They’re not exactly emergencies but they’re just falling through the cracks,” Pirzada said. “Someone who has a joint issue, they can’t see anyone about it. … They come to us for help.”
The resulting backlog, the ONA said, contributes to the kind of hallway health care that plagued the hospital system before the pandemic — patients being treated in non-traditional areas of hospitals, such as storage rooms and auditoriums, while paramedics face difficulties offloading people in need of urgent care.
“Patients can’t be transferred into beds because there are no beds on the floors, so on the units they open up patient lounges, and they start caring for patients in the lounges,” Preocanin said.
“The emergency rooms are exploding. It’s absolutely horrible.”
France Gelinas, who served as the NDP’s health critic before the election, said the long wait times add to a patient’s pain and discomfort and create other challenges in emergency rooms.
“We’re human beings. We need to sleep, we need to eat, we need to go to the bathroom,” Gelinas told Global News.
“None of this is easy in the emergency department. It’s not made for that.”
Of particular concern, the ONA said, is the ever-growing ratio of nurses to patients. The association said in some cases a single nurse could be caring for up to 30 patients concurrently, up from a typical 1:5 nurse-to-patient ratio.
“There is no place in health care for one nurse to be with 30 patients,” Gelinas said. “You will never be able to provide quality care with ratios like this.”
While the Ford government announced a number of measures designed to retain and beef up the nursing staff in the province, create new hospital beds and build or upgrade hospitals, front-line heath-care workers are calling on the province to create an immediate strategy to tackle the current situation.
It used to be that flu season would come once a year, in January and February, and we would be strained with hallway medicine,” Pirzada said. “Now COVID season comes every three to four times a year.”
Pirzada said that the current system isn’t designed to handle a constant strain and warned that it will lead to more burnout among health care providers, leading to calls for proper planning for an expected surge in the fall.
“The real test will be in the fall when people go back indoors, when we see another COVID season again, another flu season again,” Pirzada said.
“I’m really afraid to see what will happen then.”