Homeless amputee claims he was ignored in hospital ER

CBC News has found another homeless aboriginal amputee forced to wait hours for care at Winnipeg's Health Sciences Centre emergency room.

Rob Courchene went to the ER in his wheelchair just a few weeks ago with a bladder infection, in need of a catheter.

Courchene said he was forced to wait nearly seven hours while his blood pressure rose and he began vomiting.

"[I] felt like I was going to collapse — a rapid heart beat, blood pressure was going up. And that's how I felt.  And I started giving them attitude and they started neglecting me," he said.

Courchene said he got upset with nursing staff because he was scared. He had soiled himself in his wheelchair and other patients had started to complain.

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"Really scared," Courchene said. "I was worried for my health."

The situation was a haunting reminder of what happened to Brian Sinclair, a 45-year-old homeless double-amputee who died in the Health Sciences Centre's (HSC) ER waiting room on Sept. 21, 2008, after sitting for 34 hours without receiving care.

He had gone to the hospital for a blocked catheter and a urinary tract infection.

A lengthy judicial inquest into Sinclair's death and how he was treated began last month and is on break until October.

Ugly culture in the ER

Incidents in the ER are not always clearcut, particularly when it is a revolving door of people — sometimes violent, sometimes high or drunk, and many repeatedly coming in — said a former nurse who worked in the emergency department at HSC.

It makes for some tough in-the-moment assessments.

"Sometimes when you're out at triage, you might get the same patient back three times in a day," said the nurse, who CBC is not identifying and who concedes an ugly culture exists in the ER.

"So what happens is you think they're drunk, but maybe they fell over and hit their head, right? So you've got to do CT scans. One guy I know had three CT scans one weekend — a drunk."

A few months ago, Brian Sinclair's cousin went to the ER after suffering a seizure. But Karen Flett was also high on sniff.

She said she was brushed off when she showed up for care and left the ER. She returned hours later when she began vomiting.

"I got mad and said, 'I'm not going to die like Brian Sinclair here,' she said she told staff.

"I guess I got them mad when I said that to them."

She was escorted to a room by security guards and locked in there until she was seen by a doctor. She believes she was the target of discrimination because she is aboriginal and an addict.

"We may be sniffers but we're not that low," she said. "They make us sound like the lowest of the lowest. We're not low."

Not bed-worthy

According to the former nurse, racist terms are commonly used to describe chronic ER visitors.

"Not bed worthy," she said. "All that means is, 'Brian Sinclair comes in? He might be NBW. He ain't worth a bed, he's just a drunk.'"

 And if there was a number of drunks "it would be like a big joke," she said, describing "Catfish Corner."

"That's where you line up all the drunks in their wheelchairs, to stick them away so nobody else would have to deal with them," she said.

"We called it Catfish Corner."

Both phrases were unofficially coined in the ER and used among the nurses, she said, adding she does not know if that's still the case.

A spokesperson for the Winnipeg Regional Health Authority confirmed the phrases were once used but are now deemed "disrespectful" and staff are instructed not to use them.

They were examples of a toxic culture fueled by the "chaos" of nursing staff chronically overworked and chronically under-supported, the nurse said, describing nights where one minute she'd be coping with an accident victim whose "brains were falling out of his head" to a teenaged girl having a heart attack in the waiting room.

The WRHA made efforts to combat the ER racism with cultural diversity seminars, but the former nurse said the training must be improved.

Learning about the history of the powwow doesn't help staff understand why a chronic ER visitor does not take their medication, she said.

The racism in the ER is a systemic and far-reaching condition that is also reflected far beyond the hospital walls, she said.

To this day, she said, Sinclair's death is evidence of that.

"You take a poll of 5,000 people in the city right now and they're going to blame Brian for his predicament. That is racism."