Sask. hospital staff call out overcrowding, unsafe conditions in the emergency department

Nursing staff at St. Paul’s Hospital in Saskatoon are calling on Saskatchewan Health Authority (SHA) to act on unsafe conditions in the emergency department.

CTV News obtained a letter to SHA leaders signed by 118 emergency department staff at St. Paul’s addresses overcrowding, unsafe ratios of nurses to patients and the indignity experienced by patients treated in hallways because of the lack of space.

Overcrowding leads to poorer patient outcomes, longer hospital stays and higher mortality rates, the letter says, and physicians have nowhere to properly assess people.

“We have great concerns that someday soon something bad will happen in our waiting room despite our best efforts to work in this broken system.”

With nowhere to treat new patients coming in, staff had to place people in hallway beds, “which are literally just stretchers in front of nursing desks and lined down hallways, with no safety equipment for the patients, call bells or oxygen.”

On Wednesday, the Saskatoon Fire Department said hallway beds were obstructing exit doors in the hospital, in violation of national fire code requirements.

“These deplorable conditions are leading to breaches in confidentiality, lack of dignity, and unsafe care provision due to no space with appropriate monitoring for care required,” the letter says.

“Staff report tremendous moral injury due to the conditions patients are placed in. Pad changes in the hallways while staff try hold sheets around the bed, examinations in the waiting rooms, chest pain patients with no heart monitor to observe their heart, cancer diagnoses given without privacy in the waiting room, sexual assaults with no bed to examine them or provide privacy,” staff wrote.

In an emailed statement, an SHA spokesperson told CTV News that a plan to deal with capacity pressure in Saskatoon's hospitals is coming soon.

"We acknowledge that current hospital capacity pressures create a difficult environment for patients who are seeking care in our emergency departments, and for staff and paramedics who have continued to provide excellent care," the statement said.

"Tomorrow, the Saskatchewan Health Authority will release the Saskatoon Capacity Pressure Action Plan, our plan to alleviate and address the immediate pressures facing hospital capacity in Saskatoon, while introducing measures to meet the current and future needs of Saskatchewan residents accessing health care services in Saskatoon."

In their letter to management, St. Paul’s nursing staff say their baseline bed assignments leave one nurse to care for four, five or sometimes six patients, while studies show safe ratios in emergency departments are closer to one nurse per three patients.

They also point out a disparity in the number of security staff on duty compared to Royal University Hospital (RUH) — five per shift at St. Paul’s compared to 18 at RUH.

Given the high rate of violent crime in the neighbourhood surrounding the hospital, they feel there should equal resources for security at St. Paul’s.

“We work in an area of the city with high rates of violence and crime and frequently find weapons in our department,” the letter said. “Staff are very concerned about this, one even stating ‘I am seriously worried someone will be assaulted or killed one of these days.’ ”

Given the high use of its emergency department, staff say non-acute care like diagnostic imaging should be moved to other facilities.

They’re calling on upper managers to spend time in the emergency department and to hold regular meetings with frontline staff.

“Show us you care and actually understand what is happening on the frontline.”