As Ontario sees staffing shortages amid a well being disaster, emergency companies in London are not any totally different

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As a major health crisis looms in the province with staff shortages and longer waits in emergency departments (ED), emergency services in London, Ontario are also struggling.

Various departments at the London Health Sciences Center (LHSC), Southwest Ontario’s largest hospital, are working at full capacity, requiring staff to mix and match.

Londoner Cassandra Colley-Couse is 40 weeks pregnant with her first child. Her midwife has prepared her for the possibility that she may not receive optional instruction due to the lack of support staff, nurses and doctors, and the city’s ongoing birth boom.

“It’s definitely intimidating and a really scary system right now,” Colley-Couse said.

“When you become human, the last thing you want is to be stressed out and wondering when to see a doctor or if you can access the services you need.”

In a statement to CBC London, LHSC said: “High demand for healthcare services has resulted in 100 per cent occupancy at both Victoria and University Hospital.

The hospital added that summer is the busiest birthing season and it continues to prioritize admissions based on patients’ medical needs.

Mom-to-be Cassandra Colley-Couse says the healthcare system is really scary and intimidating right now. (Submitted by Cassandra-Colley-Couse)

dr Christie MacDonald, head of emergency medicine in London, said her emergency department is seeing increased patient traffic at her hospital site in Victoria and a shortage of nursing staff.

“In the last few months we have had increased volume, sharpness and complexity from our patients. Our wait times in our ER are longer than we would like,” she said.

MacDonald said the hospital is continuing to recruit and train new staff, but with many people leaving the healthcare profession and on sick leave due to COVID-19, there is an increased strain. But she says she’s proud of how hard her team tries to care for the patients.

“The environment in the department is challenging, but our team is really strong and resilient. They’re tired, but they continue to come to work every day and take care of themselves,” she said.

“We’re coming out of a two-and-a-half-year pandemic and haven’t seen the full impact yet, so as a team we’re trying to recover from that too.”

HEAR | Hear more from Dr. MacDonald on London’s ED:

London morning7:07Unprecedented wait times are plaguing hospitals across Ontario

Given the extremely long wait times in Ontario’s hospitals, Dr. Christie MacDonald, London’s Citywide Head of Emergency Medicine, for an update on London’s emergency departments.

Bare Bone Staff and Moral Distress

MacDonald acknowledges how difficult long wait times are for patients, adding that it also frustrates healthcare workers not to be able to support their patients in the way they would like.

Ontario Nurses’ Association negotiation president for the chapter, James Gibbons, echoes these views. Gibbons, who is also a medical-surgical intensive care unit (ICU) nurse, says there is a lot of moral distress among nurses.

“We work chronically too short in the intensive care unit. We don’t have rude nurses doing the work, and not being able to meet patients’ needs has been problematic for nurses in general,” he said.

Gibbons believes an immediate solution to the nursing shortage would be to license and hire more internationally trained nurses to help fill some of the backlog. He says alarm bells were already ringing before the pandemic, and with Bill 124 capping wages at 1 percent for three years, many nurses are looking south of the border for work.

“This tsunami has been occurring for quite some time,” he said. “We had budgets going down every year, we knew there was going to be an exodus of nurses, the pandemic hit and only made things worse.”

A nurse prepares to treat her patients in this file photo dated November 24, 2020. (Jeff Roberson/The Associated Press)

According to Gibbons, the LHSC faces the unique challenge of being the largest hospital serving the surrounding communities. As smaller emergency rooms are forced to close due to similar issues, the pressure on the hospital is increasing, he said.

However, MacDonald says she has yet to see a direct impact of smaller ED closures in her department.

According to Gibbons, the province has not provided any concrete solutions to this problem. Healthcare needs to be a higher priority and more investment in staffing is needed, he said. Gibbons expects things to get worse in the fall as flu season and another wave of COVID hit.

“We must work towards rebuilding the foundation of our healthcare system, which is collapsing. Years ago it was on life support and now it’s heavily loaded,” he said.

“Resources aren’t just building new hospitals, they’re just bricks and mortar. What we need is manpower, we’re in a tougher situation today than any other wave of the pandemic, so we need help to get out of this, we’re already out of manpower.”

Boomerang effect for increased demand

Neal Roberts, Middlesex-London’s head of medical services, says his team is seeing an increase in calls requiring ambulances and delays in offloading patients to the emergency room.

“Paramedics have been wonderful during the pandemic but the reality is they are tired and burned out. It’s a systemic fallout that we’re seeing from COVID and the pressure that’s being put on healthcare systems across the board,” he said.

Roberts says that post-pandemic, there is a “boomerang effect where demands for EDs increase dramatically.” This year he has added three additional 12-hour units and is looking to increase staff where he can.

A Middlesex-London ambulance in downtown London, Ontario. (Andrew Lupton/CBC)

Roberts’ team has advocated a local dispatch, which he believes would provide more timely care to patients, and allow community paramedics to treat and discharge patients on-site, rather than taking them to an emergency room when not needed .

According to MacDonald, her ED is working to route patients differently through the department while they await evaluations and blood work to minimize wait times and maximize care.

Although Colley-Couse is grateful to her team of doctors and midwives, she has heard from other expectant parents who share her concerns.

“It’s a dangerous cascading effect, it’s hard to find a pregnant person right now that feels really safe in our system,” she said.