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Doctor says ER in a state of emergency

Understaffing at Nanaimo Regional General Hospital's new emergency room is causing staff to burn out and poor patient care, says at least one doctor.

In a video on bcemergencycare.com, Dr. Kevin McMeel, looking tired at the end of an extended shift at the emergency unit at NRGH, says more doctors are needed to keep up with increasing patient numbers.

“My shift started at six in the evening and was supposed to end at 2.a.m. It's now 5 a.m. and I'm standing outside the newest emergency room in the province that we opened in October,” McMeel tells a  camera. “It was built about three times the size of the last one, bigger because we were seeing way more patients ... Despite that we don't have any extra staff.”

McMeel's testimony is one of several B.C. doctors on the site asking the government for $10 million in additional funding to pay for more emergency room doctors.

The government last provided additional funding for ER staffing in 2010, but since then there has been no new money despite a seven-per cent increase in emergency patient visits year over year from 53,534 in 2011 to 57,400 in 2012 at NRGH alone.

Health Minister Margaret MacDiarmid has stated no direct funding for more doctors is coming, though the government has negotiated a $90-million physician master agreement with the B.C. Medical Association. About $20 million of that is slated for new services, which can be used to address emergency room concerns if the association chooses.

Nanaimo resident Sherry Routledge said her 85-year-old mother waited unattended in triage on March 9 for more than an hour after breaking her shoulder in three places.

“It was a total of 2.5 hours from the time she fell to the time she had any pain medication,” said Routledge. “The ambulance attendant actually had to go looking for somebody because there there was nobody in triage. Once we did get some attention, the doctor was great, she did everything she could. It's not the people, they're doing everything they can. It's the system, it's broken.”

McMeel said one shift he arrived for, the emergency room was “a sea of people”.

“The first guy I saw was waiting 5.5 hours, not doing well, sick, I got him into a room, before I could start talking to him, he has a seizure. We should have got to him earlier,” said McMeel.

He estimates the NRGH needs nine more hours of physician time each day to keep pace with patients, the equivalent of three full-time doctors.

He said that because of burn out, a colleague is likely  leaving at the end of May, leaving a potential shortfall of 30 shifts a month not covered by a doctor.

“It's just not working. People are waiting too long and they're not getting they care need ... We need more doctors,” said McMeel.

The B.C. ER Doctors' website gave the NRGH emergency room a failing grade for overcrowding and staffing deficiencies.

Vancouver Island Health Authority administrators, recognizing the challenges, have implemented several new plans and procedures to improve the experience for ER patients, but so far little has worked, according to doctors.

In a statement, VIHA said it values the efforts of emergency staff.

“They provide exemplary care to patients who need emergency care on Vancouver Island,” it said. “We recognize that the emergency departments are under  increased pressure with more patients coming in due to our changing demographics and growing population.”

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