Doctors of BC wants action plan over violence and overcrowding in emergency rooms

The president of Doctors of BC says there needs to be urgent short and long-term action to combat a growing list of issues in B.C. emergency rooms, including overcrowding and violence.

Dr Charlene Lui says the problems are critical enough that they present a risk to patient care standards, along with staff safety.

Lui said a shortage of emergency room doctors and nurses is only part of the problem.

A family doctor shortage means more people in B.C.’s growing population are showing up at emergency rooms with concerns that could otherwise be treated in a doctor’s office.

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“And then other challenges are that other areas of the hospital are also under-resourced. And if those are under-resourced, then maybe patients tend to need to stay in an emergency room bed longer than they normally would, rather than being admitted up into the inpatient [wards] of the hospital,” Lui said.

“…If patients are occupying a bed when they don’t really need to be in the emergency room because they should be admitted, then the emergency room patients end up waiting longer as well.”

Lawsuit alleges ‘unpleasant, undignified, unsafe’ conditions

They’re also presenting with more complex health concerns, Lui said — meaning that it takes more time and resources to provide those patients with the care they need.

And there’s real concern that some patients are falling through the cracks.

“There are significant concerns about overcrowding, patient safety issues, staffing shortages, and unsafe work environments, and really, most of the sites are either on the verge of not being able to staff a shift, or they’re staffed at a level that presents a real risk to patients,” Lui said.

Lui’s comments come after a lawsuit filed against Fraser Health by an emergency room physician working at Eagle Ridge Hospital and Royal Columbian Hospital.

Dr Kaitlin Stockton alleges in a notice of civil claim filed in the B.C. Supreme Court that “working conditions are unpleasant, undignified, and extremely unsafe for patients”.

She claims that there have been multiple instances of severe, preventable harm to patients as a result of overcrowding and resource shortages — including patient deaths.

‘Gut-wrenching’ violence in BC emergency rooms

Stockton also alleges that Fraser Health has done nothing to remedy the threat of violence in the two hospitals in which she works.

Her lawsuit lays out several incidents in the last six months, including one where a nurse was threatened by a man wielding a machete; another where a large, intoxicated patient kicked a nurse, breaking four of their ribs; and one where a patient’s pit bull attacked and bit an emergency room physician.

Earlier this week, BC Conservative MLA and opposition health critic Elenore Sturko said those incidents were “gut-wrenching” to read about.

“This should be a wake-up call to the premier and the minister. If they don’t take action…honestly, I fear [someone] will be killed in the workplace,” Sturko told 1130 News Radio.

Lui said it’s an alarming thing to think about, but not out of the realm of possibility.

“Could it escalate so much that somebody gets critically injured to the point of death? It could, and that is the scary thing — that we can’t predict what’s going to happen.” Lui said.

Fraser Health and the Ministry of Health have declined to comment on the case, which is before the courts.

“Speaking more generally, it is essential that healthcare workers across the province feel they can raise workplace concerns to their employer,” Health Minister Josie Osborne said in a statement.

The province has repeatedly touted its relational security officer program, which places security officers in some facilities — and which the province says it’s looking to expand if necessary.

Short- and long-term action plan needed: Doctors of BC

Lui is calling for the province to immediately begin working on a provincial emergency department stabilization strategy.

“Because these challenges are happening all over the province, and it’s harming patient care as well as the safety and well-being of our physicians,” she said.

“Also the relationships and communication between health authority leaders and physicians are strained, and we need improved transparency, communication, and information sharing so that we can work together to improve the situation.”

Lui said the province’s physicians need to be consulted and worked with on any actions going forward because they’re the ones dealing with the situation on the front lines.

At an unrelated press conference last week, Osborne said they are working to bring down emergency room wait times and combat staffing shortages with a recruitment campaign targeting US-based doctors and nurses.

She said they’re also building up the primary care system so that people don’t need to go to emergency rooms with health concerns that could be better dealt with by a family doctor or nurse practitioner.