'Everything is not fine': Overcapacity ERs creating longer ambulance wait times

Overcrowded emergency rooms and chronic understaffing are leading to increased wait times for ambulances in Saskatchewan, according to Paramedic Services Chiefs of Saskatchewan (PSCS).

“We do experience it in other hospitals in the province, like Regina, Moose Jaw, the odd time in Prince Albert -- but nothing in the capacity of like Saskatoon,” PSCS president Kelly Prime said.

“A bottom-end wait time would be about four hours, and we've seen up to 48 hours before a patient has got offloaded into [the ER] or into a bed.”

Prime says he’s heard examples of paramedics waiting with patients in back hallways of hospitals for so long that their symptoms have cleared up and the patient has been discharged without ever seeing the ER.

“There's been a lot more get better than a lot more get worse, but it's happened,” he said.

“It's happened where people have crashed in the back hallway, and we have had to wait 45 minutes, hours to get that bed. We've had people go into cardiac arrest.”

Prime says wait times and overcrowded hospitals in Saskatchewan and in Saskatoon aren’t just because of COVID-19.

“In Saskatchewan, we funnel a lot of our transfers into Royal University Hospital, and everything goes to the [ER],” he said.

“It clogs up and it's patients that are orthopedic that are waiting for a bed for surgery for a fractured hip, and they're being transferred just to sit in the back hallway. You're having neurology and you're having internal medicine problems — everything gets funnelled. There's no direct admits to the wards, and it creates a backlog.”

In a statement, the Saskatchewan Health Authority confirmed that high capacity levels and staffing pressures are creating delays in EMS off-loads for inbound ambulances across the province.

“During the week, we have had periods when the RUH adult medicine and surgery inpatient units experienced in excess of 100% occupancy, which creates barriers in terms of admitting new patients from the Emergency Department,” the statement reads.

“We make every effort, every day to ensure we can meet the needs of all of our patients.”

Saskatchewan Union of Nurses president Tracy Zambory says it’s yet another symptom of a broken healthcare system.

“Everything is not fine,” she said.

“[Ambulances] cannot just drop and leave, that's not how it works. They have to sit there and wait, and then someone who has an acute episode in their home or a chronic illness may have to wait hours for an ambulance to come and pick them up and get them into a hospital.”

“We need paramedics on the street,” said Prime. “I don't think paramedics should be in the hospital fixing this problem.”

“We might be a temporary solution, but I'm really extremely concerned that if we are a temporary solution, it's going to turn into a permanent one, and that's very concerning.”

The SHA says it’s responding with a province-wide approach to help support safe emergency room care and EMS coverage levels, working with physicians and operational leaders to consider regional centres close to a patients home for possible care, and delaying transfers for stable patients while timely transferring unstable patients.

Prime says he’s seeing more transfers to Yorkton and Melfort for CT scans and ultrasounds, but it isn’t relieving the pressure from Saskatoon.

“Our crews are getting extremely fatigued. I've talked to many colleagues in Saskatoon. They're fed up with wait times, they're fed up with the offload delays in Saskatoon. That's not what they got into paramedicine for,” he said.

“The rural paramedics, they're fed up with the long days of transporting and then the even longer days of sitting in the back hallway, and then having to worry about their safety of driving back.”