A late afternoon visit to the emergency department at Edmonton’s Stollery Children’s Hospital turned into an all-night affair for Alberta mother Karen Khurshed, and sadly, she’s not alone.
“My son was sick – a cold or flu – and he started to cough up blood. And so we thought that was a pretty emergent kind of situation,” Khurshed said.
“He has asthma. Something that was in the back of our mind, ‘Could this be something more serious?’ Yeah, something we needed to look at.”
She took her two-year-old boy to the Stollery at around 5 p.m. on a Tuesday afternoon – there was standing room only in the emergency department.
“I’m in this waiting room, and I’m feeling this stress from these parents. I feel that same way, but I’m feeling everyone else’s stress. And these kids that they’re trying to get to sleep on their laps and everyone coughing,” she said.
Khurshed recalls feeling relief being able to wait in the foyer, with some separation from an overcrowded waiting room of children and parents trying to find some comfort and rest.
“I’m like, ‘Is it because I’m feeling stressed or is it because everyone’s stressed and I’m feeling everyone’s stress,’ you know? And I kept going back and forth into the waiting room when I went to the washroom, would get a snack, and I’m like, ‘Yeah, we’re all feeling so super-stressed.’”
Before leaving for the hospital, Khurshed checked the estimated wait times on the Alberta Health Services website: it was six hours for the Stollery.
“We actually sat on a bench in the foyer and we were there all night. We had to wait a total of 13 hours for a doctor,” Khurshed said.
In the fall, schools in Edmonton and Calgary saw high rates of absenteeism. Many schools experienced respiratory illness outbreaks and parents expressed concerns to Global News over near-empty classrooms as more kids fell ill.
A rise in respiratory illness triggered even higher wait times at children’s hospitals in Alberta.
An AHS spokesperson said at the Alberta Children’s Hospital (ACH) in Calgary, there were more than 300 daily visits to the emergency room-compared to about 180-220 prior to the recent surge.
Pediatric ICUs at the Stollery and the ACH were nearing 100 per cent capacity in mid-November.
Dr. Sandy Dong, a 20-year veteran of emergency medicine in Edmonton, said the wait time the Khursheds experienced wasn’t surprising given current realities.
Dong said he’s having more “OMG” moments while working.
“Those OMG moments can be when the waiting room is ballooning. That happens, unfortunately, quite regularly,” he said.
The ER doctor said having people waiting with undiagnosed issues is the spot in the emergency system with the greatest risks.
“They’ve been assessed by a triage (nurse), they had a cursory examination or some questions, and they had vital signs (taken). But you really don’t know what the diagnosis is,” Dong said. “You can’t do a proper assessment from the waiting room.
“The longer people wait there, the higher the chance of something bad happening.”
Front-line frustration
An Edmonton paramedic said he doesn’t think Albertans grasp how dire the health-care situation has become, even with the amount of news stories circulating.
“When people call 911, they have an expectation that (an ambulance) will be there quickly. Maybe that used to be the case, but now it’s not,” he said.
The paramedic spoke with Global News anonymously, because he said speaking out would likely cost him his job.
He said long wait times for an ambulance have prompted many paramedics to advise their family to seek alternate ways to get to the hospital.
“If you can just chuck them in the back seat of your car and get to a hospital (within) 10 minutes, that might be the better way to go as opposed to waiting, because if there’s so much chance, it’s so unreliable right now,” he explained.
The long-time paramedic remembers when a dispatch to Edmonton’s bedroom communities like Sherwood Park or St. Albert – 16 kilometres away – struck him as unusual. These days, he gets dispatched as far as Jasper, a 365-kilometre drive.
For the high-acuity calls, the paramedic said he’s thinking about how to soften the blow of any delayed response.
“Mostly what’s going through my mind is preparing myself to go be part of something that’s really awful. I’m thinking about how I will respond when the family asks ‘Why so long?’”
An emergency communications officer (ECO) also spoke with Global News on a condition of anonymity out of job security concerns.
An ECO – commonly known as an 911 operator – is responsible for answering 911 calls, connecting to dispatchers and assisting Albertans on the line.
The ECO who spoke with Global News has been in her role with Alberta Health Services for more than a decade. She said call volume has increased exponentially.
“Our call volume has increased so much that we just can’t stay ahead of it anymore. We’re falling behind miserably and it’s terrible,” she said. “I’ve seen calls that have been held in excess of six or seven hours. That’s a long time to wait for an ambulance.”
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The operator explained AHS’s triage protocols for particularly busy periods of time. “Urgent disconnect” means that calls will be taken but may need to be disconnected. People are told to call back if anything changes with their health.
“To have somebody call back to say the patient has taken a turn for the worse is terrible when they’ve been waiting an hour and a half, and then all of a sudden the patient is not doing well,” she explained, saying she’ll sometimes have to give CPR or other mitigation instructions at that point.
“That’s a terrible feeling when you didn’t have to do that if we had the ambulance to send.
“It’s hard telling people that you can’t have an ambulance coming when you call 911,” she said, her voice breaking. “I’d never done that up until this last year or 18 months. Now I seem to do it on a regular basis.”
Both front-line responders spoke about their frustrations with staffing levels and said morale is extremely low.
“I have gone home at times and thought ‘I didn’t do any good today,’ and ‘do I even want to stay in this job?’” she said. “I know it’s the right job for me. I enjoy helping people … I just put another foot forward for the next day.”
“I personally don’t need to know the exact outcome. I know I have given my best when I took the 911 call.”
The ECO presumes people have died while waiting for care.
“In no uncertain terms, it’s the worst I’ve seen in 20 years.”
“Every way that we can look at (health-care), every way that we can measure it. It’s never been this bad,” the paramedic said.
“It’s been said that the biggest point of stress in the workplace is not being able to achieve the tasks that you’re asked. And certainly that’s what we’re seeing,” Dong said.
“The volume demands – not being able to get to the people who come to the emergency department in a timely fashion – resource constraints, where we do the best we can with minimal or with staffing constraints. And then there’s also the moral distress of that comes with not being able to provide the best care we can because of factors that are really outside of our control.”
The Edmonton-based doctor said he’s seen his colleagues in emergency departments visibly upset.
“That affects us as well, because they can’t provide care. And so morale is low,” Dong said. “It’s hard to see colleagues at their edge and at their limits.”
In the end, two-year-old Malix Khurshed was seen by a doctor and “checked out fine,” mother Karen said.
“Thank goodness. And the staff were lovely. But it’s really deeply troubling how difficult it was to access health care for him.”
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