Canada’s ER crisis: Doctors urge governments to stop finger-pointing and find solutions

Emergency room doctors say patients are experiencing “dangerous” wait times in ERs across the country and it’s time federal and provincial governments stop pointing fingers over the “crisis” in health care and instead come up with solutions.

Hospitals across Canada are experiencing a “perfect storm” of pressures that have resulted in overcrowded emergency departments and wait times that can sometimes stretch to up to 20 hours, Dr. Rodrick Lim, medical director and section head at London Health Sciences Centre’s pediatric emergency department told Mercedes Stephenson in an interview on The West Block.

It’s every doctor’s “worst nightmare,” he said.

“The thought of anyone waiting longer than they have to in a waiting room and something happening to them because of that is every health-care worker’s nightmare,” Lim said.

“It’s just something that we don’t want to think about but, unfortunately, there are stories (about this happening) coming across the country right now.”

Front-line workers in hospitals across the country have been sounding the alarm about what they call a “crisis” in their ERs, due to a combination of factors that has forced many hospitals to close their emergency departments temporarily over the last several months.

Significant nursing shortages is one of the biggest concerns, which has led to bed closures in both emergency departments and within medical units in hospitals. This means fewer available beds and personnel to care for patients at a time when hospitals are also seeing a significant influx of sick Canadians. Many have no choice but to go to ERs as they are unable to access primary care thanks to a national shortage of family physicians.

Meanwhile, health workers already burned out from working flat-out during the last two-and-a-half years of the pandemic are now left short-staffed amid a surge in patients due to waves of COVID-19 continuing and an unusually early start to the respiratory virus season.

The situation is particularly acute in children’s hospitals in many parts of the country, including Ontario, where pediatric units seeing an early spike in RSV (respiratory syncytial virus) cases are warning parents of significant wait times.

“It’s a tough situation… We are seeing quite a surge in RSV earlier than we traditionally see it,” Lim said.

“At the current time, there’s a tremendous strain on both emergency departments, inpatient wards and ICU capacity across the country.”

Dr. David Carr, an emergency physician and clinical investigator at the University Health Network in Toronto, says emergency departments are a kind of barometer of the health system, and there are some “alarming signals” right now.

With so many nurses retiring early and quitting their jobs due to burnout, emergency departments are not able to admit patients as there aren’t enough nurses to open the beds needed to accommodate them, he said.

It’s leading to a “cascade” of overcrowded ER waiting rooms, in which physicians have nowhere to see patients.

“We’ve now really shifted to just seeing patients in waiting rooms and in some cases outside of the waiting room because there’s just no physical space,” Carr said.

All 13 of Canada’s premiers argue more federal funding is what’s needed to help their ailing health systems, but Ottawa says it wants to see better results from the billions already flowing to the provinces and territories for health care before increasing health transfers.

Lim says it’s time for the buck passing to stop and for all levels of government to focus on finding ways to ease pressures for health workers and patients alike.

“We’re going to have to really have a serious conversation about health care and the amount of resources that are required and the amount of planning that’s required,” he said.

“The sooner we can have an intelligent, comprehensive conversation around it, the better the solution will be.”

Possible fixes will be complex and need to involve short- and long-term plans, Carr added, including paying nurses more and lifting the freeze on nursing salaries in Ontario.

But long-term initiatives won’t help with the immediate pressures facing ERs in Canada, he said.

“Recognizing foreign-trained graduates and increasing class sizes for health-care professionals will help,” he said.

“But let’s recall, this is not going to help this winter. And this winter is frightening both of us considerably.”