St. Boniface Hospital staff share near-miss horror stories due to critical short staffing

Treaty 1 Territory, Homeland of the Métis Nation, Winnipeg, MB - Manitoba Liberal Leader Dougald Lamont, MLA St. Boniface, called on the PC Government to immediately step up to provide relief and resources to health care workers in the St Boniface hospital, especially the ER.

Lamont said staff at the hospital, who wish to remain anonymous, say the ER is massively short-staffed. While 130 nurses are needed, fewer than 100 are often available. Some nurses have left as they feared they could lose their licenses because they cannot provide proper care.


An ER nurse wrote:

"We are officially supposed to have ~130 nurses staffed in the ER dept. and are chronically understaffed with less than 100. We have the highest turnover rate of RNs in the system. Frequent new hires that stick around for a few months/years and leave due to poor working conditions and are generally paid the same in other areas that are far less stressful. After ICU RNs were given a pay increase of $6/hr (decided by the government and the union without input from union members) - many left for ICU."


Another ER nurse wrote:

"Our triage nurses are exceptional at what they do, we prioritize the very best we can but we cannot possibly predict every outcome and diagnoses from the few minutes we get with each patient. I often feel like my nursing license is in jeopardy due to no fault of my own, but due to the systematic problems in our health care."


The complaints and allegations from health care workers included:

  • Patients being stranded in the ER for days waiting for tests

  • A patient who needed a pacemaker waited for an operation for four days

  • Psychiatric patients spend days in a space intended as a "family room" because no psychiatric beds are available.

  • PCH residents ending up in the ER because their doctors don't assess them and understaffing is so severe at PCHs

  • Family doctors who send patients to ERs for non-emergent tests and scans, because no other options are available.


Lamont said these are all the direct consequences of the Pallister Governments' deliberate decision to keep gutting the health care system.


"Over the five years they have been in power, the PCs have demanded multiple rounds of cuts, freezes, layoffs and closures in health, even as they received $1-billion more a year in transfer increases from the Federal Government," said Lamont. "Pallister has no trouble finding hundreds of millions of dollars to bail out a football stadium, to cut his own taxes, but when it comes to health, he has kept cutting."


Lamont said Pallister keeps falsely claiming that the Federal Government has cut health funding to justify his own cuts. The Federal Government's share of Manitoba health care funding from the Canadian Health Transfer has been rising since 2015. Manitoba has seen total federal transfers rise by over $800-million a year in the last five years.


Pallister has also claimed, without evidence, that the federal government once paid 50% of health care costs, and that the federal share is currently at an all-time low. A review of the federal share of health care shows that health has never exceeded 35% of Manitoba's health care costs at any point since 1975. It is currently about 22%.


"Pallister is pretending to have less money than he has to pretend that he has no choice but to cut. The PCs are not cutting health care because they have to - they are cutting because they want to," said Lamont.


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BACKGROUNDER


STATEMENTS by St. Boniface Hospital Health Care Workers

Waiting Room/Prolonged waits for admission beds:

- "Perhaps we can discuss the day a 104 year old woman waited on a stretcher in the hallway for 6+ hours... and after getting fed up with waiting, ended up just walking out the door"

- "The long wait times in the ER while waiting for an inpatient bed. There was a lady in observation last week for >100 hours. She was in high acuity the 1st day. A few days later she was still in observation, appearing completely deconditioned. Probably hadn't been out of bed this whole time. No physiotherapy in ER. I just don't understand why care can't be transferred to another physician on another ward in these cases."


- "Patients are having long stays in the department causing falls, delirium. Some require sedation and restraints because the system is failing them. These patients then need constant cares (1 on 1's to ensure safety). However, health care aides who are supposed to be 1:1 are now turning into 1:3-1:4 because we don't have the staff"

- "There was a psych patient who was in 'parlour' (multipurpose treatment space NOT funded for current staffing ratios, but frequently used for overcrowding) for 41hrs admitted, acutely psychotic, without even a light switch to turn the light out. The light operates on a sensor and is extremely sensitive so never turns off."

- "I had a man that needed PT/OT (physiotherapy/occupational therapy) due to a stroke that had been in observation for over 72hrs. The son came in to see him and made the comment that he seems to have deteriorated, which was 100% true. I gave him a patient relations card because he was so upset with the system. He was previously Alert & Oriented x 3 ('sound of mind') and was now becoming more confused and less and less able to mobilize."

- "84 yo in complete heart block (life threatening arrhythmia requiring pacemaker), heart rate in 20s in HA (high acuity) for 4 days. I called Cardiology on Friday during the day - after I called asking wtf: "we have no beds. We're going to try to get him in for pacer on Sunday (2 MORE days). FURTHERMORE - The patient had been there for 2 days, was NPO (not allowed food as procedure pending) since Thursday at midnight for pacer next day. When 2:30 pm Friday came and the patient still hadn't gone up, (that's when I called and Cardiology said they would "try" to get him in on Sunday)...so I fed him. And had to bear the burden of being the one to tell him (NOT the cardiology staff or administration) he still wasn't getting his pacer....and then I gave him a patient relations card... because what else can I do?."

- "There was also a MH (mental health) patient in FR (Family Room - room used for MH patients when our psych area is closed due to poor staffing - more on this to follow below) for three or four days. He was suicidal and agitated, was so frustrated about being in there for so long waiting for his admission bed that he lost it, punched the door, broke his hand, had to be sedated, restrained and moved to HA (high acuity)....and still waited another day before getting onto the unit."

- "I've had cardio admits stay in HA for days because they have CPAP (machine used for sleep apnea - considered an AGMP (aerosolized generating medical procedure)) and need a private room. Cardiology didn't have any. Both bed's 12 and 13 were in this situation but our negative pressure rooms were in use. They ended up not using their CPAP in the ER and not sleeping for days. One left AMA (against medical advice) to go home and sleep."

- "I've had a couple situations where palliative patients have had to die in the ER because of no available private beds. I feel so horrible for these patients, we don't have the resources to care for them the way they should be cared for."

- "Last Wednesday, when I was in High Acuity, there was a psych patient who had spent 5 days in the family room (no windows, no real bed, etc) waiting for a bed at HSC. Nurses did their best (offering to take her for walks) but basically this human who was already undergoing psychological problems was kept in that space for an ungodly amount of time due to no beds. Even if you didn't have psych issues to begin with, i think being in FR for that long would result in some..."

- "A patient came in with a Crohn's flare, in observation, with the intention of being admitted upstairs. She had a negative COVID swab, however, was not taken off precautions because of the symptoms she presented with. She lived in observation for days, sat with poop and pee in the commode because people rarely have a moment to change it. Was not permitted to leave the tiny curtained area, had to eat the tiny trays of food plus dry roast beef sandwiches which didn't help her flare up. We ended up finishing her treatment, in observation, a bed was never made available by the time she was eventually discharged by the admitting doctor."

- "I've spent several days at triage this past month. A patient had a fall in the waiting room, moved to a stretcher where she laid in the hallway waiting over 10 hours for a treatment spot. A sick elderly patient deteriorated into an acute delirium, likely due to having to wait in the hall with not enough staff to assist if they needed food/water/assistance to the bathroom. She tried to elope from the department and security had to bring her in from outside to return. She waited over 6 hours in an a-flutter (potentially lethal arrhythmia). Her family had to be called in to try to calm her down - otherwise she would have required medical sedation for her own safety."

- " A woman in her 40s with abdominal pain, didn't know she was pregnant, waited over 6 hours before getting a treatment spot. Was sent emergently to the OR after discovering a ruptured ectopic pregnancy. A man with a ruptured appendix had a similar situation. Last fall, I filled out workload reports for two patients who waited for angiograms for over 4 days in ER, without being brought up to the ward first. They kept being told they'd be next, eventually almost leaving AMA (against medical advice) due to discomfort and frustration. A man admitted to cardiology who spent >125 hours in the department, mostly in observation while his destined ward kept taking other patients up before him as he was someone who could be discharged from ER. After this long stay and assumed deconditioning, he was not assessed by physiotherapy for mobility concerns prior to discharge."


Poor Staff Management


- "Last week the supervisor pulled pre arranged SRT (specialty resource team) staff from our department to go to cardiology for N8 (night 8 shift) "because there was no one to mandate upstairs" and mandated one of our staff instead."


Systematic Flaws outside of the hospital that are dumped on the ER


- "PCH doctors not coming in to assess their patients (at the pch) and/or nurses at PCH being understaffed/poorly supported so they end up calling family to make a decision for what is in the patient's best interest to transport to ER."

- "Family doctors who send patients to ER for non-emergent scans or urgent blood work... But they have no other options! And don't get me started on health links..."