Nurses at Red Deer regional hospital say patient safety concerns are reported every day as the facility faces nonstop patient overcapacity and persistent under-staffing.
Members of United Nurses of Alberta Local 2 report that Central Alberta’s largest hospital operated well above capacity every day in December and so far in January while the emergency department has consistently been unable to meet its baseline staffing levels on most shifts.
Alberta Health Services said that for about 13 hours on Saturday the hospital diverted some patients who needed higher care due to capacity challenges. Two Central Zone patients were diverted to Calgary.
The UNA said problems started at the hospital Friday when a patient became critically ill in the waiting room of the emergency department while awaiting treatment.
Sue Beatson, UNA Local 2 president, said bare minimum staffing and overcapacity that led to Saturday’s diversion is unfortunately nothing new.
“Nurses, in regards to care and patient safety, have been sounding the alarm, especially in the emergency department, for well over a year,” Beatson said.
AHS said its facilities, including Red Deer’s hospital, remains very busy due to surging respiratory illness in our communities – but AHS continues to provide care to all who need it.
“Red Deer Regional Hospital Centre is using a range of measures to help manage patient demand, similar to those used in other hospitals across the province at peak times. They include discharging patients with appropriate home supports, managing surgery patients at home instead of in hospital as appropriate, and balancing admissions with other sites in the Zone,” said AHS in a statement on Tuesday.
“One of the ways we have been working to address capacity concerns is through transferring a patient who is medically stable but still requires further care to another healthcare facility. Patients who are awaiting placement in continuing care may not necessarily require an acute care space, and could also be transferred out of RDRHC to wait for placement in their location of choice.”
The UNA said wait times in emergency over the weekend were as long as 18 hours. Up to 80 per cent of the patients in emergency were admitted but lacked safe beds elsewhere in the hospital.
Beatson said there’s always extra patients in non-traditional beds in overcapacity spaces, like patient lounges, that lack call bells, oxygen and suction outlets.
“Those spaces are not set up to house patients, and really now because of the crunch, there are very few patients that aren’t acutely ill when they come in. You have to be pretty sick to get a hospital bed.”
AHS said challenges with available bed spaces or capacity in hospital are not new issues.
“Our hospitals are able to accommodate patients over 100 per cent of normal capacity at peak times. No matter where a patient is seen at the hospital site, they will always receive the appropriate treatment.”
Beatson said nurses have reached a tipping point and the hospital is starting to lose a lot of nurses which further exacerbates the shortage.
“People can’t continue to run at that level of stress. How do we provide what we know we need to provide for our patients given the situation where you can’t? It’s a moral dilemma.”
She said the Red Deer hospital also doesn’t seem to fit into provincial staff recruitment programs that focus on Edmonton, Calgary and rural facilities.
AHS said the Red Deer hospital has been working to resolve staffing challenges in the emergency department, including the hiring of new nursing staff. AHS is working with government to build our nursing workforce overall, including signing new collective agreements last year for registered nurses (UNA) and licensed practical nurses (AUPE).
Nurses say AHS needs to take specific measures now to ease the crisis in Red Deer while long-term solutions are sought. Those include:
• Returning base staffing requirements to the levels of two years ago.
• Ensuring two triage nurses are on duty in the daytime as part of the basic staffing requirement, and a waiting-room duty nurse to ensure patient safety.
• Ensuring addictions and mental health nurses are on site as part of the basic staffing requirement.
• Staffing and extended hours for the hospital’s minor treatment area.
• Hiring additional appropriately qualified agency nurses on a temporary basis to ease the day-to-day staffing crisis.
• Pausing surgeries in Red Deer while the admissions crisis continues.
• Discontinuing the use of overcapacity spaces as regular bed spaces.
• Keeping a surgical unit that is now closed on weekends open 24/7.
AHS said it appreciates feedback from its employees as it considers all solutions to provide relief to its workforce and continue to deliver healthcare services to patients.
“AHS is making improvements that are focused on our most urgent priority areas – improving EMS response times; decreasing emergency department wait times; reducing wait times for surgeries; and, developing long-term reforms through consultations with frontline workers. These steps are focused on reducing system pressures and improving patient outcomes.”