Overcrowded Emergency Departments: Toronto Star article

Yesterday’s Toronto Star featured an excellent article by health reporter Theresa Boyle about the current state of Ontario’s hospital emergency departments—overcrowded and forced to store patients in “unconventional spaces.”

On January 28th I had gone to extreme lengths to pretend my bowel obstruction wasn’t serious for many hours before my partner Blair managed to convince me to get into the car. It was sometime after midnight when he said, “You know it’ll jinx it if we drive up the emergency department. It will just pass as soon as we get outside and then we can come straight back home.” It was a clever and necessary manipulation.

When Boyle interviewed me for the article, I described what happened next:

Throwing up, barely verbal and in agonizing pain, she was deemed ill enough to admit. But she waited 18 hours in the ER to get a bed.

Devaney, 37, spent the first part of her wait in a busy hallway where she was hooked up to IV fluids. She remembers the scene as being chaotic. There were lots of people walking back and forth, it was noisy and at one point a shouting match broke out. Police were on hand to break it up.

“It was pretty intense. I felt extremely vulnerable,” she said, recalling how she had to use a plastic bag that she brought from home to vomit into.

She was eventually moved into an ER treatment room where she was given pain medication and spent the rest of her wait.

Despite the commotion and long wait, Devaney was impressed by the doctors and nurses: “Staff were amazing and very comforting.”

The rest of the article contains many essential facts that provide background and context, highly recommended reading. As Trump found out recently, healthcare is undeniably complicated. But as usual, I can’t help feeling there are also some undeniably simple facts that are too often left out of health care commentary. Policy decisions are meted out on bodies. Patients are routinely traumatized and retraumatized by experiences in hospitals that are purportedly designed to care for us. None of this is new. None of this should surprise anyone. When governments look for “efficiencies” I only see humans who are about to endure psychological and physical trauma that they may never recover from. Staff are burning out as they are being forced to mediate completely impossible situations and having to make decisions that no human should ever have to make. I have no idea if I was bumped ahead of someone who actually required care more than I did. I don’t know because I was so consumed with relief that the Emerg nurses teamed up to protect me from the chaos, and took a truly remarkable degree of care with me.

In 2002, when I first wrote about being stored in a Vancouver emergency room closet I was still quite optimistic. That closet was emblematic of a decade of cuts to federal transfer payments and recent deep cuts to provincial health budgets. A better situation was still visible in the not-so-distant past. Now, fifteen years later, I will do almost anything to avoid an emergency room admission.

So when I read that:

…Ontario has among the fewest number of hospital beds of countries in the Organization for Economic Co-operation and Development. The province has 2.3 beds per 1,000 people, fewer than 31 OECD counties. Only Mexico, Chile and New Zealand have fewer.

But provincial policy-makers don’t see that as a bad thing. On the contrary, it’s by design and it’s a point of pride, proof of a highly efficient system.

And that:

Both the OHA and the government accept that the average annual occupancy rates for Ontario hospitals hovered between 91 and 93 per cent between 2012 and 2016.

The oft-cited ideal capacity rate for hospitals is 85 per cent. Anything above that leads to long waits and increased risk of transmission of infectious disease. As well, it leaves little wiggle room in the event of a big emergency.

I wondered how much longer patients and staff can tolerate the political turmoil that repeatedly results in the under-resourcing of healthcare. Fifteen years and five surgeries ago I could never have imagined that this is the discussion we would still be having. I wrote recently about the complete sham that has become community care in Ontario. It’s hard to ascribe any sincerity whatsoever to governments who are still claiming their hospital cuts were for the greater good. The reality just doesn’t bear it out.

About the author: Julie Devaney is a patient activist living in Toronto. She is the author of My Leaky Body (Goose Lane Editions: 2012) and co-editor of MESS: The Hospital Anthology (Tightrope Books: 2014). My Leaky Body was one of Quill and Quire’s Top Five Non-fiction books of 2012. Julie was named a Woman Health Hero by Best Health Magazine in 2011 and has been profiled on CBC Radio’s White Coat, Black Art and The Current, in Chatelaine and the Toronto Star. Her writing has appeared in The Globe and Mail, Toronto Life and numerous anthologies. Julie has given hundreds of presentations at medical schools, nursing conferences and theatres throughout Canada and in the US and the UK using participatory techniques with patients and professionals to formulate strategies for change and innovation in healthcare. Her work at the University Health Network in Toronto has transformed real patient stories into staff training.
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