'Every bed is full': Saskatoon doctors at a loss in the face of jam-packed ERs

Emergency room physicians in Saskatoon are becoming all too used to repeated apologies to patients for a system they say isn't functioning as intended.

Dr. James Stempien says every shift presents a new set of challenges that rarely existed five to 10 years ago.

Rather than showing up to an emergency room, seeing a doctor and then being admitted to an appropriate ward of the hospital, more and more patients are being admitted and treated in the emergency room, linen rooms or hallways because there is nowhere else for them to go.

The practice known as boarding, or bed block, has intensified in the last few months in a time when hospitals are busier than ever.

"About 10 years ago, boarding occurred, but it wasn't to the point where it obstructed care," Stempien, the provincial head of emergency medicine for the Saskatchewan Health Authority said.

Stempien routinely works shifts where 100 per cent of the beds in the emergency room at Royal University Hospital are used by admitted patients. Stempien admits no one is getting optimal care because of the overcrowding.

Something as simple as discussing injury history with a patient can't be done efficiently because there isn't a place to speak privately. He says going to the waiting room to treat a patient has become common.

"It's been to the point where every shift you come on anticipating that sort of situation where almost every bed is full," he said.

Stempien and other emergency staff are growing tired of trying their best when they know there are better ways to help people. He remembers treating one elderly man with extreme abdominal pain in a chair in the waiting room, feeling his stomach as others in the crowded room looked on.

"My fear is, am I giving the best care I can with every patient? With this overcrowding I think it's very difficult to do that. You have to push yourself to do that," Stempien said.

In recent months, hospitals in Regina and Saskatoon were flagged by the fire department for violating fire codes because of overcrowding. Last week, City Hospital's ER was disrupted for an evening because of staff shortages when multiple doctors called in sick. (, 

Emergency physician Dr. Brittany Ellis can't remember a time when it was so hard to access emergency rooms in Saskatchewan.

"These are the sorts of things that lead to potentially patients leaving without being seen because they've been waiting in waiting rooms that are full," she said.

"We're all just trying to do the best we can and care for patients the best we can."

According to the latest information from the Organisation for Economic Co-operation and Development (OECD), Canada ranks among the worst of the 38 member countries with 2.0 acute care beds per 1,000 population, narrowly beating Chile and Colombia. Stempien says Saskatchewan has fewer acute care beds than other provinces.

Ellis said many patients who come to the hospital are in declining health, and the lack of optimal care isn't helping. But finding solutions is difficult because of how far-reaching the problem is.

Many patients don't have a family doctor and present to the emergency room instead. Seniors are experiencing gaps in their healthcare and are often in need of supportive or long-term care beds that also aren't available.

Paramedics are caught up in the chain reaction as well because they have to wait with their patients in hospital hallways until they are offloaded, preventing them from responding to other calls.

"I feel great moral injury with the fact that I can't do what I know I should be and could be doing," Ellis said.

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"I'm concerned when my family members get sick. I've thought about not doing things because I don't want to end up in our emergency departments."

The province is planning to build and open a 24-hour urgent care clinic in Saskatoon(), but Ellis says a more community-minded approach to alleviate multiple areas of healthcare is needed, mainly better access to primary care and community care -- services that could be moved out of the hospital.

Stempien feels other areas of hospitals could assume emergency department responsibilities to avoid eight-hour or longer waits by patients.

"It's safer for them in a hallway upstairs than it is in a back hallway in the emergency department," he said. "I'd like to see the dissemination of risk rather than all the risk of being on the shoulders of the emergency department."

Whether it be a policy change or an overhaul to healthcare that could take months or years, Stempien and Ellis are hopeful the province can make necessary changes before more staff leave the profession under intense levels of burnout, leaving emergency care in a worse position than it already is.

"Emergency departments were not designed to have patients in them for prolonged periods of time," Ellis said.