Ballooning Alberta ER waiting rooms ‘quite regular’ and ‘deeply troubling’

A late-afternoon visit to the emergency department at Edmonton’s Stollery Children’s Hospital turned into an all-night affair for Alberta’s mother, Karen Khurshed, and unfortunately, she’s not alone.

“My son was sick – cold or flu – and he started coughing up blood. And so we thought it was a fairly emerging kind of situation,” Khurshed said.

“He has asthma. Something that was in the back of our mind, ‘Could it be something more serious?’ Yes, something we had to look at.”

She took her two-year-old son to the Stollery at around 17:00 on a Tuesday afternoon – there was standing room only in the emergency department.

“I’m in this waiting room, and I feel this tension from these parents. I feel that way, but I feel everyone else’s stress. And these kids they’re trying to get to sleep on their lap and everyone’s coughing,” she said.

Khurshed remembers feeling relieved to be able to wait in the lobby, with some separation from a crowded waiting room of children and parents trying to find comfort and rest.

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“I’m like, ‘Is it because I’m feeling stressed or is it because everyone’s stressing and I’m feeling everyone’s stress,’ you know? And I kept going back and forth in the waiting room when I went to the washroom, a would get snack, and I’m like, ‘Yeah, we’re all feeling so super-stressed.’

Before leaving for the hospital, Khurshed checked the estimated wait times on the Alberta Health Services website: it was six hours for the Stollery.

“We actually sat on a bench in the lobby and we were there all night. We had to wait a total of 13 hours for a doctor,” said Khurshed.

In the fall, schools in Edmonton and Calgary saw high absenteeism rates. Many schools experienced respiratory illnesses and parents expressed concern to Global News about near-empty classrooms as more children fell ill.

An increase in respiratory illnesses has caused even higher wait times at children’s hospitals in Alberta.

An AHS spokesperson said at the Alberta Children’s Hospital (ACH) in Calgary, there were more than 300 daily emergency room visits, up from about 180-220 before the recent surge.

Pediatric ICUs at the Stollery and the ACH reached 100 percent capacity in mid-November.

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Dr. Sandy Dong, a 20-year veteran of emergency medicine in Edmonton, said the wait time the Khursheds experienced was not surprising given current realities.

Dong said he has more “OMG” moments while working.

“Those OMG moments can be when the waiting room is ballooning. Unfortunately, it happens quite often,” he said.

The ER doctor said that people waiting with undiagnosed problems are the place in the emergency system with the greatest risks.

“They were assessed by a triage (nurse), they had a quick check or a few questions, and they had vital signs (taken). But you really don’t know what the diagnosis is,” Dong said. “You cannot do a proper assessment from the waiting room.

“The longer people wait there, the greater the chance of something bad happening.”

Frontline frustration

An Edmonton paramedic said he doesn’t think Albertans understand how dire the health care situation has become, even with the amount of news stories circulating.

“When people call 911, they have an expectation that (an ambulance) will be there quickly. Maybe it used to be the case, but now it’s not,” he said.

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The paramedic spoke to Global News anonymously because he said speaking out would likely cost him his job.

He said long wait times for an ambulance prompted many paramedics to advise their families to seek alternative means of getting to the hospital.

“If you can just throw them in the back seat of your car and get to a hospital (within) 10 minutes, that might be the better way to go than to wait, because if there’s that much chance, it’s now so unreliable,” he explained.

The longtime paramedic recalls when a dispatch to Edmonton’s bedroom communities like Sherwood Park or St. Albert – 16 kilometers away – struck him as unusual. These days he is sent out as far as Jasper, a 365-kilometre drive.

For the high-acuity calls, the paramedic said he thinks about how to soften the blow of any delayed response.

“Mostly what goes through my mind is preparing myself to be a part of something that is really horrible. I think about how I will react when the family asks ‘Why so long?'”

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An Emergency Communications Officer (ECO) also spoke to Global News on condition of anonymity for job security.

An ECO – commonly known as a 911 operator – is responsible for answering 911 calls, liaising with dispatchers and assisting Albertans on the line.

The ECO who spoke to Global News has been in her role with Alberta Health Services for more than a decade. She said the call volume has increased exponentially.

“Our call volume has increased so much that we just can’t keep up. We fall woefully behind and it’s terrible,” she said. “I have seen calls that have been on hold for more than six or seven hours. It’s a long time to wait for an ambulance.”

The operator explained AHS’s triage protocols for particularly busy periods. “Urgent disconnect” means that calls will be taken but may need to be disconnected. People are told to call back if anything changes with their health.

“Calling someone back to say the patient has taken a turn for the worse is terrible when they wait an hour and a half, and then all of a sudden the patient is not doing well,” she explained, adding said she would sometimes need to give CPR or other mitigation instructions at that point.

“It’s a terrible feeling when you don’t have to do that if we had the ambulance to send.

“It’s hard to tell people that you can’t get an ambulance if you call 911,” she said, her voice breaking. “I never did until last year or 18 months. Now I seem to do it often.”

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Both frontline respondents spoke of their frustrations with staffing levels and said morale was extremely low.

“Sometimes I would go home and think ‘I didn’t do anything good today’ and ‘do I even want to stay in this job?'” she said. “I know this is the right job for me. I enjoy helping people … I just put another foot forward for the next day.”

“I personally don’t need to know the exact result. I know I did my best when I made the 911 call.”

The ECO assumes that people have died while waiting for care.

“In no uncertain terms, it’s the worst I’ve seen in 20 years.”

“Every way we can look at (healthcare), every way we can measure it. It’s never been this bad,” said the paramedic.

“It has been said that the biggest point of stress in the workplace is not being able to accomplish the tasks that are asked of you. And that’s certainly what we’re seeing,” Dong said.

“The volume requires – not getting to the people who come to the emergency department in time – resource constraints, where we do the best we can with minimal or with staffing constraints. And then there is also the moral distress of not being able to provide the best care due to factors that are really beyond our control.”

The Edmonton-based doctor said he saw his colleagues in emergency departments visibly upset.

“It also affects us, because they cannot provide care. And so morale is low,” Dong said. “It’s hard to see colleagues on their edge and on their limits.”

In the end, two-year-old Malix Khurshed was seen by a doctor and “checked out fine,” said mother Karen.

“Thank you. And the staff were lovely. But it’s really, really concerning how difficult it was to get access to health care for him.”