Despite a $37.5 million expansion to Eagle Ridge Hospital’s (ERH) emergency department, much of the new space is frequently shuttered. There’s simply not enough staff to operate.
On May 24, a group of physicians from ERH and Royal Columbian Hospital (RCH) penned an open letter addressed to the community, stating they are at a “breaking point.”
Over the past 18 months, there have been shifts at ERH where physicians have become “incredibly concerned” for the safety of patients, according to one physician, speaking on behalf of the group.
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“Eagle Ridge hospital is the main concern,” they said. “We’ve been on the brink of closure a couple of times.”
The letter details severe shortages of hospitalist physicians and emergency nurses, leading to long wait times, overcrowding and patients leaving without receiving treatment.
Administrators are not providing solutions and even reprimanding advocates who speak out about unsafe work conditions, according to the letter.
More than 100 medical professionals have sounded the alarm in recent weeks.
ERH consistently has some of the longest wait times in the Lower Mainland, routinely operating at more than 100 percent capacity.
“We’re regularly seeing wait times of six, seven, eight hours a day,” the physician said.
The hospital sees around 50,000 patients a year, and has experienced a 27 percent increase to inpatient days since 2012, according to FOI releases.
The expansion to its emergency department was completed in July, 2022, adding 20 new treatment spaces, four isolation rooms for infectious diseases and two new resuscitation areas for trauma patients.
But tripling the square footage did not not relieve the staffing constraints, according to the physician, who said they often only use just one-third of the space.
“You’re under-resourced. You know before you walk in the doors, there’s multiple ambulances lining up outside. You walk into a waiting room that is packed to the gills with patients, in every nook and cranny of the department,” the physician said.
They said the department is experiencing a “critical shortage” of registered nurses – last week, the department was down to four nurses out of 12.
An ERH meeting held on May 31 regarding ongoing shortages caused many of the registered nurses to leave in tears over the lack of patient care, according to the physician.
In the coming days, a new care model will be implemented, essentially doubling the amount of patients assigned to each nurse, the physician said.
Additionally, over the next week, there will be multiple days where only one registered nurse is scheduled to work in the emergency department.
The hospital is scrambling to implement “stop-gap” measures in the meantime, pulling nurses from other hospitals and agencies, or offering overtime in order to meet the minimum requirement to operate, according to the physician.
The physician said these stop-gap solutions are inadequate, as the new nurses are frequently unfamiliar with working in emergency departments.
“It’s a very different type of care that they’re providing. It’s a very different skill set,” they said.
Exacerbating the crisis is the shortage of hospitalist physicians, who admit upwards of 80 percent of the patients to ERH.
This was the “tipping point” for ERH and RCH physicians, according to the physician.
Hospitalist physicians are responsible for patients in need of ongoing care prior to and following their assessment by the emergency department.
ERH has multiple shifts where there are no hospitalists scheduled, causing other nurses and physicians to pick up the slack, the physician said.
A well-functioning emergency department should act like a relay, where one team passes the patient forward to the next level of care so more patients can be treated, according to the physician.
This compounding staffing shortages are causing a “log jam,” they said. “We lose functionally half our nurses to care for incoming patients.”
Adding to the problem are a lack of inpatient beds, and the implementation of a new computer system for electronic medical records.
The rollout of the new system was implemented in mid-April, which was known to slow down care, according to the physician.
The group sent a letter to the Fraser Health administrators asking for its delay.
“We didn’t even receive an answer. We’ve mostly been met with silence,” the physician said.
And the nursing shortages at ERH have been anticipated for years; the pandemic only inflamed the problem, according to the BC Nurses Union (BCNU).
Leaders of the BCNU rallied outside the hospital in February, stating the critically-low staffing levels were resulting in negative health impacts on the nursing staff.
Some nurses were being pressured to work over 24 hour shifts by Fraser Health, organizers said.
“The pandemic has exposed the situation, it has exacerbated it, but the pandemic did not create this crisis,” said Adriane Gear, BCNU vice president.
The group of physicians sent copies of the letters to the mayors offices in Port Moody, Coquitlam, Port Coquitlam and New Westminster, requesting them to lobby the province on their behalf.
The Dispatch reached out to Fraser Health for a response to the letter but did not receive a response by deadline.