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Pressure has shifted from ICU to ER at Sturgeon hospital, says nurses' union

Orissa Shima, a nurse at the hospital and president of the local nurses' union, said staffing is relatively stable in the ICU, but pressure has shifted to the emergency department.

An additional ICU bed was needed at the Sturgeon Community Hospital said Orissa Shima, a nurse at the hospital and president of the local nurses' union, in response to the province's recent announcement about the addition, but staffing remains an issue for the hospital in other areas.

“We are critically short-staffed in our ER similar to other ERs across the province. It’s to the point they are closing assignments routinely due to lack of staff. Wait times are beyond what is safe, and they are now trying to secure high-priced agency nurses to deal with this shortage,” she said.

On May 13, the province announced Alberta Health Services (AHS) had opened and staffed 19 of the 50 permanent intensive care unit beds, with the remaining 31 beds expected to be opened this fall.

During the announcement, Premier Jason Kenney said Alberta had the second most expensive health-care system in the country and the lowest per-capita number of ICU beds available in the country. He said ICU bed numbers had never been increased in AHS’s 12-year existence.

“The second most expensive system with the lowest number of ICU beds, that did not serve us well through the COVID crisis, because during various peaks, we were at risk of running out of ICU capacity.

“We had to pause and release surgeries in order to create the surge capacity that we needed to provide critical care to COVID-19 patients,” he said.

That is why, said Kenney, Budget 2022 had $100 million slated for the ICU beds.

One of those 19 beds announced by the province went to the Sturgeon Community Hospital.

Kristi Bland, media relations for AHS, said in an email there are currently seven funded ICU beds at the Sturgeon Community Hospital, including the bed recently announced by the province.

Bland said there were times throughout the pandemic the Sturgeon ICU surged to eight beds.

“Typically, we aim for 90-95 per cent occupancy in our ICUs, allowing us to always accept the next critically ill patient. We adjust staffing when occupancy is low and bring it up when occupancy is high,” she said.

In a press statement, the province said with these beds there are now 192 adult general ICU beds across Alberta, and AHS has filled 250 positions to support the new beds. Before the pandemic Alberta had a total of 173 ICU beds.

The province said AHS will be boosting ICU capacity to 223 beds across Alberta, which will be funded through a $300-million investment by the province over the course of three years, said the May 13 press statement.

Shima said the bed at the Sturgeon recently announced by the province had been operational throughout the pandemic, but was staffed “with temps and agency nurses until recently they posted permanent positions.”

“Staffing is now relatively stable in our ICU,” Shima said.

Shima said the pressure on the hospital has shifted from ICU to ER. 

“The volumes in ER are up. Patients are coming in sicker. Pressures in EMS result in pressures to ER. We have patients who get admitted who wait days in ER for a bed on the ward, adding more pressure in ER,” she said.

Bland said AHS is experiencing significant pressure on the health-care system, particularly in the emergency departments and with EMS.

These pressures are due to high volumes of seriously ill patients and the impact of COVID-19, she said, “which includes an increased number of patients requiring hospitalization, limited admissions to some hospital units due to infection-control requirements, and increased staff absences,” continued Bland.

Bland said emergency departments are seeing an increase in patients with influenza-like symptoms and in patients seeking care after deferring it over the last two years.

“This has meant emergency department wait times sometimes reaching winter peak levels, including at Sturgeon Community Hospital. Specific measures fluctuate on a given day and site,” she said.

Bland said AHS is encouraging people to seek other levels of care if they are not experiencing a medical emergency. 

The health-care system has always been subject to spikes in volume — especially in the winter — and these spikes can lead to overcrowding and delays, said Bland. She said this situation is not an Alberta-only problem. This is happening in jurisdictions across Canada, she said.

“We hope to see relief soon as the level of COVID-19 circulating begins to drop,” said Bland.

Shima said the province needs real solutions to address the lack of health-care workers. 

“Anyone who has spent time in [an] ER can see how strained it is,” said Shima.

“It’s not just nurses that are needed. But we need to recognize we are short health-care workers, and we need to actively recruit and try to retain the staff they’ve burnt out,” she said.

Bland said AHS understands that working in times of overcapacity can be stressful and tiring for staff.  AHS has been focused on filling front-line vacancies.

“In the past two years, AHS has added 230 paramedics and over the pandemic, AHS has filled more than 2,000 vacancies for registered nurses,” she said.

Within 12 months of the 2021/22 graduating year, AHS hired 1,188 RN/RPN grads.

“This means, to date, we’ve hired almost 90 per cent of the 2021/22 Alberta RN graduates,” she said.