Bed shortage so severe it's 'appalling'

LISA PRIEST November 5, 2008 GLOBE AND MAIL

Resting comfortably in his hospital room in the Okanagan Valley, Verne Sadoway couldn't believe his good fortune. When the 70-year-old retired civil servant went to the Vernon Jubilee Hospital's emergency ward in early June, 2008, unable to pass urine, he was quickly assessed. It turned out he required an operation to remove part of the prostate that was blocking urine flow, a transurethral resection. A catheter was inserted and all he had to do was wait - from the comfort of his hospital room. If there was a bed crisis, he wasn't seeing it. But a visit from a nurse six days into his stay changed all that. It turned out that they needed his bed for a patient sicker than he was. "I found out it was an old lady," Mr. Sadoway said in a telephone interview from his home near Vernon. "She was in bad shape, so I felt sorry for her, and away I went."

As he lay in the hallway, people stared as they briskly made their way by him, yet he was also treated as invisible - workers talked one foot from his head. Privacy could only be had if he pulled a green curtain around his bed. A trip down the hall was required if he needed a shower or a toilet. "After the third night, I said, 'I've got to get out of here, I've got to get some sleep,' " said Mr. Sadoway, who spent 11 days in hospital. "... I never want to end up in the hospital for a long time. "The bed shortage in Vernon is so troubling that about 18,700 residents have signed a petition, demanding the province increase funding for acute-care beds, nurses to staff them and operating rooms, according to Antony Stamboulieh, spokesman for the Vernon and District Taxpayers Association. "The situation here has been appalling." For the past two days, The Globe and Mail has reported on emergency-room overcrowding, a situation that has become so severe that the Canadian Association of Emergency Physicians has called on the provinces to implement waiting-time targets. Under those targets, patients should be triaged and admitted or discharged within four to six hours, depending on the severity of their condition, 95 per cent of the time.

The problem, said Alan Drummond, chair of public affairs at CAEP, is that emergency is being used as a patient "dumping ground." Canadians make 14 million visits to emergency departments each year. Not only are the queues for care troubling, but many patients find themselves being treated in hallways because there simply is no bed available. Janice Skot, president and CEO of the Royal Victoria Hospital in Barrie, which has one of the busiest emergency wards in Ontario, said in some cases, patients are admitted and discharged from hallways, having never even made it to a bed. "The number of patients receiving treatment in hallways or overflow units is a significant issue," Ms. Skot said. Chris Cunningham, past president of medical staff at Vernon Jubilee Hospital, said the hospital is often working over 100-per-cent capacity, which is why patients are placed in corridors. "Once you are over capacity, the system slows down," he said. "It's a symptom of a health-care system that is not working, it's sick or ill. ... It strains the whole system and has to compromise patient care at some point."

He noted figures from January, 2008, to April, 2008, that show code purples - where the hospital is in gridlock - were called on 41 days. That compares to 20 days of code purples for all of 2007. Code purple is "a case when there is absolutely no elbow room," said Dr. Cunningham, a family and emergency physician. "And all resources have been tapped."Joanne Konnert, chief operating officer of Okanagan Health Service Area, which includes Vernon Jubilee Hospital, said a new patient tower to be built in 2011 will provide, among other things, two floors for inpatients. "None of us," Ms. Konnert said in a telephone interview, "wants to put patients in the hallway."