St. John's hospital in double overcapacity for nearly 3 months, reveals health authority

Newfoundland and Labrador's largest hospital is experiencing chronic overcapacity issues, a statement from Eastern Health revealed on Friday.

For nearly three months — from June 20 until Thursday — the Health Sciences Centre in St. John's was continuously in double overcapacity, according to a statement from Eastern Health. 

Registered Nurses' Union Newfoundland and Labrador president Yvette Coffey says when single overcapacity is declared, each in-patient unit at the hospital has to take one extra patient from the emergency room, even if not enough beds or staff are available. Coffey says it's a situation that often leads to patients staying on stretchers in hospital hallways.

"With double overcapacity, which seems to be the norm these days, each unit has taken two patients, whether or not they have nursing personnel to care for those patients or whether or not they have bed spaces," said Coffey.

Between March and June of this year, single overcapacity was in place at the Health Sciences Centre 25 times, and double overcapacity was called 16 times, Eastern Health said. Before March, overcapacity happened at the hospital an average of four times per week.

In its statement to CBC News, Eastern Health also revealed that since March, St. Clare's Mercy Hospital in St. John's has been in single overcapacity 72 times and in double overcapacity 27 times, compared with an average of three times a month before March.

Emergency in the emergency room

The health authority pleaded for help earlier this week because it only had half the nursing staff needed to work at the Health Sciences Centre emergency room this weekend.

In an internal memo sent to all staff on Thursday, which was obtained by CBC News, Eastern Health said it had an "immediate need" for registered nurses, licensed practical nurses and personal-care attendants to work additional shifts or overtime at the department from Sept. 16 to 18.

Debbie Walsh, a vice-president and chief nursing officer of Eastern Health, called the memo a "voluntary call" and said 14 registered nurses are needed to work the day shift at the Health Sciences emergency room, while 12 are needed for the night shift.

"We started with eight, we are now up to almost the 14 — that's for the day shift. And for the night shift, we were down to six staff … and the numbers are very similar for Sunday," Walsh said Friday afternoon.

"Our staffing complement will be stabilized for this weekend," she said.

The staffing crunch at the emergency department follows an Eastern Health statement from last Saturday, where the health authority said it was facing "unprecedented pressures resulting in long wait times for patients." It also asked patients who were not experiencing medical emergencies to stay away from metro emergency rooms.

Walsh says people should try alternatives such as 811, walk-in clinics or their family doctor before visiting the emergency room.

'Breaking point'

Coffey said she doesn't think the health-care system crisis can get any worse. Out of 54 nursing positions at the Health Sciences Centre emergency department, she said, 19 are vacant.

"It's just reached a breaking point," Coffey said.

Coffey said "out-of-the-box ideas" are needed to solve the staffing crisis. The call for staff to help in the emergency department, she said, was an idea discussed by a committee, which is working to fix problems at the Health Sciences Centre emergency room. 

Often, staff need specialized training to work in emergency rooms, Coffey said, and nurses answering the call on the weekend without that training wouldn't take care of patients who are in a medical emergency.

Instead, she said, they would take care of patients stuck in the emergency room and waiting to be admitted to another hospital unit. Coffey said about 20 to 30 patients are admitted to either the Health Sciences Centre or St. Clare's Hospital every day with no beds available due to a lack of nursing staff.

"My understanding is that these registered nurses, LPNs, PCAs would practise within their scope of practice and would care for these admitted patients who would normally be on the floor anyway," said Coffey.

"This would allow the emergency room nurses to do what they need to do."

NAPE not consulted

Jerry Earle, president of the Newfoundland and Labrador Association of Public and Private Employees, which represents many licensed practical nurses, personal care attendants, and paramedics in the health-care system, said asking staff to fill in for shifts in the emergency room is another sign the system is in crisis.

"It's not somewhere you can go in on Saturday morning and say, I'm here to do a shift.… Emergency services [are] extremely demanding," said Earle. "You don't know what's coming through that door."

Earle said he heard about the call for staff from a family member, and Eastern Health didn't consult them about the shortage.

"That's extremely concerning," said Earle. "We could have helped them with this, if they had come to us."

Earle said a more proactive approach is needed.

"We're running out of Band-Aids. We have a health-care system now that is hemorrhaging and all we're doing is just going around the province, sticking Band-Aids on."

PCs say they won't play politics

Interim Progressive Conservative Leader David Brazil called the situation "alarming" and demanded immediate solutions.

"We're in a critical crisis now when our tertiary-care centre here is at a point now where they're actually reaching out to anybody who may be available to come in and help.… That tells you what's happening in this health-care crisis," Brazil said.

Brazil wants to see a collaborative approach between the provincial government and health-care professionals, and consider solutions such as bringing retired health-care workers back for a limited time, or speeding up licensing processes for newcomers.

"This is one of the times we won't play politics. What we'll play is what's in the best interest of the people of this province," said Brazil.

Health Minister Tom Osborne said Eastern Health's call for help was "proactive," and he promised more incentives to recruit and retain health-care workers. 

"Quite simply, we have to do a better job of recruitment and retention," said Osborne.

"Health-care professionals throughout the province have dealt with the pandemic over the last two years, the cyberattack, they have been working very, very hard and they need additional people working side by side with them to ease the burden, to lift the load, and we are focused on doing that."

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