'No physician wants to look after patients in a hallway': Fredericton ER doctor calls for urgent solutions to overcrowded hospitals
Dr. Yogi Sehgal says he’s giving people ultrasounds while they’re sitting in waiting room chairs and discussing medical information with patients while they’re on stretchers in hallways because the emergency department in Fredericton is too full to put them anywhere else.
The overcrowded situation has been a problem for some time, but the emergency department doctor at the Dr. Everett Chalmers Regional Hospital says it’s been particularly challenging this summer and is only going to get worse with back-to-school and respiratory illness season on the horizon.
“I feel bad for the patients. It's terrible for them. I feel terrible going to see a patient in a chair saying, ‘Okay, you’ve got a kidney stone. I have literally nowhere to put you. Can I do an ultrasound in front of all these people?’ in a chair, which is really hard to do, sitting in a chair to do an ultrasound of somebody's belly,” he said in an interview with CTV Atlantic. “Most people are like, ‘I totally would rather do that than wait another hour to find a room.’ But I just hate doing that. I feel like morally that's just inappropriate.”
Dr. Sehgal updates people on his social media about some of the challenges the emergency system is facing. Over the weekend, he wrote directly to decision-makers, urging them to come up with immediate solutions to move out people who shouldn’t be in hospital.
He even wondered if calling a state-of-emergency might help with some of the bureaucratic obstacles, but acknowledges the situation doesn’t fit the criteria.
“I wasn't really looking for a state-of-emergency declared. I'm just trying to think outside the box of what we can do in the immediate interim, because this is going to get worse in the next few weeks when kids start to go back to school and all the respiratory illnesses start to spread around that,” he said. “But are there things we can do tomorrow? Putting in tents, putting in temporary housing facilities for people that don't need to be in a hospital but can't be on their own at home, that's the sort of in-between kind of population that we need to look after.”
In a report released earlier this month, Horizon Health reported ALC patients – mostly seniors waiting for long-term care – occupied 34 per cent of its hospital beds between April 1 and June 30.
Their goal is to get that number to 20 per cent by 2026.
"Currently we remain at very, very high operational capacity, at 100 per cent plus capacity every day, with approximately 35 per cent of our beds being held by patients that do not require acute care," said Horizon’s CEO Margaret Melanson on Aug. 8. "And so we do have partnership with the Department of Social Development and Department of Health towards strategies to address this. However, at this time I can tell you this does remain a significant challenge for Horizon."
She said they were looking at solutions "as we head into the fall period."
That same report also noted due to successful recruitment efforts, there are just 30 travel nurses left working in the system – and they’re due to end those contracts at the end of August.
But that’s also something of concern to Dr. Sehgal.
“I can't see them functional without travel nurses right now. There's just not enough staff,” he said. “Every shift pretty well, they're calling for help. Can we get this shift covered, that shift covered, this shift? There's usually several a day. It's not just one, it’s almost every day.”
He says he knows of things happening behind-the-scenes by Horizon Health that will help in the future, but those measures are still years away.
The physician is hoping by speaking out, administrators and politicians might be willing to think about more urgent solutions.
“I've said this to people all the time, but ever since I've got to New Brunswick, I really find that the first answer to anything outside-the-box is, ‘No, you can't do that,’” he said. “And I really feel like we should be changing that to, ‘How can we make that happen?’”
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