ER doctors declare a ‘state of emergency’

BCER calls for public support for campaign, plan to deal with reduced staffing levels and increasing ER visits.

The doctors who work in British Columbia’s emergency rooms have declared a “state of emergency” in emergency medical services.

Increased patient visits coupled with ongoing staffing cutbacks have created an ongoing overcrowding crisis in B.C.’s ERs.

The British Columbia Medical Association’s section of emergency medicine this week launched a campaign, including a plan to deal with the situation, which is outlined on its website, www.bcemergencycare.com.

The situation is complex, according to the campaign website, but can be boiled down to two basic points: “A failure to hire enough doctors to keep up with patient needs, and a failure to move admitted patients into wards.”

Dr. Jodi Turner, an emergency room doctor at the East Kootenay Regional Hospital, describes how this situation can play out on the front lines of emergency medical care.

“I started working (at the East Kootenay Regional Hospital) 16 months ago,” Turner said. “Within a month, it was announced that staffing hours would be cut back. In 15 months, there has been a significant reduction in doctor hours and a significant increase in ER visits.”

Turner said that in a 24-hour period, there are only four hours where there are two doctors on duty in ER. This “overlap” time is decreasing, as well, Turner said.

“We are currently understaffed by half a doctor,” Turner said. “It doesn’t sound like a lot, but when you’re by yourself and you get ‘slammed’ — with 20 patients waiting and three ambulances coming in at once — it’s pretty bad.”

Since the East Kootenay Regional Hospital also functions as a region-wide referral centre, the on-duty doctor is also often called away to deal with referral duties while patients are waiting.”

The campaign message is that this situation can be fixed. “Doctors have worked on an ER treatment plan for B.C.,based on a model pioneered in Australia and England,” the website campaign states. In similar crisis situations “they were able to turn things around, without breaking the bank.”

The campaign is calling for public support for the campaign. Details on how to do so can be found at the website.

Turner said though she could understand anger or impatience among waiting ER visitors, she has found the patients to be generally understanding and sympathetic.

“Patients are patient and grateful,” she said. “Before the campaign started, as our hours were being cutback, they were asking what they could do to help.

“Well now there’s an outlet.”

In a nutshell, the BCER plan lists five short-term points:

• Increase physician staffing in ERs to reflect increased ER patient visits;

• Make annual adjustments to ER physician staffing to ensure safe patient care;

• Set and enforce standards regarding how long sick ER patients wait for an inpatient bed;

• Continue and expand initiatives that will reduce the number of ER visits that could otherwise be served by other practitioners;

• Hold administrators in Ministry of Health and Health Authorities accountable for meeting the standards set.

And for the long-term, the plan calls for “honest and realistic plans to increase hospital beds to achieve regular hospital occupancy rates that do not exceed 85 per cent.”

As of press time Wednesday evening,  Margaret MacDiarmid, B.C.’s Minister of Health, was unable to comment on the campaign due to a vote in the Legislature.