Overcrowding in ER forces nurses to quit, where should patients go?

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New Westminster: As many as 10 ER nurses have resigned from ER of Royal Columbian Hospital in New Westminster citing overcrowding as the reason. Since February, four were transferred to the cardiac lab and six have either transferred to other units, moved to other hospitals or taken early retirement.
This is alarming situation for the province when the people who are qualified enough to handle an emergency situation are quitting, what will happen to the patients? How the hospital plans to provide emergency care to its patients remains to be seen.
On March 6 at a rally BC Nurses’ Union President Debra McPherson told the crowd “the healthcare system needs more nurses, not less. Patients need safe staffing levels. Without it, safe patient care is at risk.”
Sometime ago, Asian Journal had carried a column in its Feb 14 issue questioning the service patients receive after paying their MSP and medical premiums on time.
Canada is at no. 11 among the OECD countries which is not a good symptom at all. According to the report of Health Council of Canada only 31 to 46 per cent of Canadians, depending on the province, could get an appointment the same day or the next day, not including emergency department visits. Canada is in last place among all countries surveyed in this regard, with no improvement since 2004.
On the current crisis of nurses quitting the Emergency Room, Asian Journal spoke with Jan Downes-Springer, an RN and union steward at Royal Columbian Hospital.

Asian Journal: Why did the nurses decide to leave? Did they voice their problems to the Fraser health or hospital earlier, what was the response?

Jan: Overcapacity has been the number one issue within the Emergency Room at the Royal Columbian Hospital. Overcapacity means having as many as 17 admitted patients in the emergency room because they cannot be placed on the units- they too are full with overflow into the hallways. As well as having admitted patients in the emergency room, there are often as many as 5 patients in stretchers around the nurses’ station on a daily basis.
With overcapacity comes unimaginable workload, exhaustion, burnout and equally as important, a very negative impact on the nurses being able to deliver safe patient care. Nurses are constantly voicing their concerns to the employer by using the processes available to them using their BCNU Collective Language process yet nothing changes.
Nurses are portable and marketable. Nurses have decided that one thing that is still under their control is freedom of choice with respect to where and under what conditions they work and many have decided to exercise that choice as a direct result of their working conditions
I spoke with Emergency Room nurses yesterday and they were unanimous in voicing very low morale and burnout as well as helplessness. Of course, departures in such large numbers (10 or more) will have a profound negative effect on the ones who choose to remain…for now. One very seasoned nurse expressed that she was counting down to retirement.

Asian Journal: What are the recommendations that BC Nurses organization has put forward to deal with overcrowding?

Jan: The BCNU continues to demand that the Health Authority live up to the Collective Agreement with staffing levels for safe patient care. We have put forth following recommendations:
• The Provincial government must provide funding for a rapidly growing and aging population with higher acuity levels.
• Until the Health Authority eliminates congestion, it should have a plan in place for sufficient staffing so that even in the event of hallway nursing and Emergency room backups, the best possible hallway care is delivered.
As well, there is a need for more acute beds
• The Health Authority needs to deliver on the promise of the 5,000 Long Term Care beds and put more resources in the community to support people who are discharged quickly so that they remain safe at home instead of ending up back in the hospital. This is a major contributory factor to the exixting congestion
• The key to the solution is the delivery by the Health Authority on the promise of safe staffing that was negotiated in the last Collective agreement

Asian Journal contacted RCH on their view of this situation. Dayan Muthayan, Program Medical Director Patient Access and Care Transitions, Fraser Health claimed that there is no particular incident that caused this increase in visits to Royal Columbian Hospital. He said, “Our staff are going above and beyond during this very busy time and we are grateful for their continued dedication. We will be meeting with the RCH emergency room team to discuss their concerns, and will continue to work closely with them to identify solutions. We have 220 staff in the Royal Columbian Hospital emergency room, including RN’s, LPN’s, care aides, porters, and unit clerks. In the last few months, approximately 10 nurses have taken new positions in other areas of the hospital, other jobs within Fraser Health, or have retired. It is not uncommon for nurses in larger hospitals, or those who work in unpredictable areas like an emergency department, to move into other roles that might suit their skill sets and interests – or because a position will offer more consistent hours.”