Ridge Meadows Hospital is one of four hospitals in the Lower Mainland experiencing severe backups in the emergency department due to the increased pressures from the flu season.
Christine Sorensen, acting president of the B.C. Nurses Union, said as of 10:30 a.m. on Wednesday there were 19 patients admitted to Ridge Meadows Hospital, which is currently at capacity. And, she suspects, the number of admissions has increased since then.
“These are 19 people who have been identified as requiring admission to the hospital for an overnight stay, so would be requiring a bed in the hospital. So, those 19 admissions are languishing in stretchers in an emergency department,” Sorensen said.
The concern, she continued, is that hallway care is not adequate.
“It’s not safe. You can’t provide good quality patient care, infection control is difficult to manage, patients don’t have any privacy, they don’t have access to bathrooms,” she said.
The No. 1 thing nurses need to do is wash their hands frequently in between patients and, Sorensen believes, conditions in the emergency department are making that more difficult, adding to the risk for infection between patients.
Sorensen says anyone needing emergency care can expect long wait times.
“I would think that there are lengthy waits in Ridge Meadows and patients and the public should be anticipating this if they go to an emergency department right now. That they may be waiting an extended period of time before they even see a physician,” she said.
Tasleem Juma with Fraser Health says that the congestion in hospitals at this time of the year is planned for. At Ridge Meadows Hospital and other hospitals across the province the influenza season is ramping up and the congestion the hospitals are seeing now is seasonal. More people are heading to the emergency department with influenza and other chronic health issues like COPD, asthma and heart disease.
“But we anticipate it, we plan for it, we increase staffing. We have what are called over-capacity protocols that allows us to use all the beds in the hospital,” said Juma.
This can mean beds in the halls of the hospital as well.
“The over-capacity protocol lets us then utilize all the resources that we have available to us in the hospital to manage that congestion,” continued Juma saying that the number of admitted in the hospital changes all the time.
There could be a higher number admitted first thing in the morning, but by the afternoon there are fewer people because they’ve been discharged or they’re back in the community or in residential care, Juma noted.
“We bring in the extra staff to support the patients. We also then work very closely with our home health staff that come and say this person could be supported appropriately in the community, and would help with that as well,” added Juma.
Over the weekend, patients were waiting up to eight hours to see a doctor at Abbotsford Regional Hospital and lined the corridors of various medical units waiting for rooms. One patient was even placed in a shower room due to the congestion.
“My concern is that on Friday in Abbotsford there were 57 admits and five days later we have 52 admissions. So the problem is not resolving and Fraser Health is not resolving the problem,” said Sorensen.
Sorensen contends that this is not a new problem for Fraser Health. The flu season happens annually and even though all of the admissions may not have a diagnosis of influenza, it is a factor that Sorensen sees every year.
“It contributes to high admission rates every year and we don’t understand why Fraser Health is continuously caught off-guard,” she said.
Sorensen thinks that Fraser Health should better plan for the increased activity in the fall before flu season hits. She also thinks that system flow within the hospitals should be looked at, like how people move into admitted beds and how people leave the hospital.
“I certainly think that the Fraser Health can look at systemic things like, yes, improving community services and other services they may have that people can go to, walk-in clinics, more family physicians.”
But, she added, there is also a shortage of emergency room nurses.
Sorensen says the B.C. Nurses Union has been working with health authorities to increase education and training of nurses who work in emergency, but that Fraser Health and the provincial government need to examine staffing levels and current workloads.
Juma says there are a number of strategies that Fraser Health has to manage the congestion.
“This is part of the ongoing work we do throughout the year to plan for times when there is seasonal congestion,” she said.
Last week Fraser Health put out a public service announcement reminding people to get their flu shot and where they can get it. And that if it is not an emergency situation not to go to the emergency department.
“That ensures that emergency services are available for people who have that need,” said Juma.
“The emergency department is based on a triage system that provides the critical care to the most critically ill first,” explained Juma.
“Which is why when we talk about reminding people if their health concern is a non-emergency health concern then they will wait longer because we have to provide the emergency care to those patients,” she said.
Public health officials urge people suffering from the flu to avoid spreading the viral infection if possible, and if they need medical treatment to visit doctors’ offices or walk-in clinics.
Visitors are also being urged to stay away from residential care facilities if they have respiratory symptoms, or the diarrhea and nausea associated with Norovirus or similar gastro-intestinal infections.
Dr. Perry Kendall, B.C.’s provincial health officer, said most people with influenza should contact their doctors or call the B.C. HealthLink line at 8-1-1 for advice before they head for the hospital.
“Trying to avoid the emergency rooms is good because you don’t really want to spread influenza among vulnerable people or health care workers if you can avoid it,” Kendall said.
Anti-viral drugs can be prescribed for people with underlying heart or respiratory illnesses, and they should arrange that in advance, even if they’ve had the seasonal flu shot, Kendall said.
Most healthy people will recover at home with rest and drinking plenty of fluids.
While hospitals and residential care facilities are coping with dozens of outbreaks, this year’s flu season is not as severe as B.C. experienced in the past two winters.
This season started early with a mix of influenza A and B strains, with influenza B more prevalent now.