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Deaths in NS emergency rooms reach six-year high, doctors point to ‘bed blockage’ – Winnipeg Free Press

Deaths in NS emergency rooms reach six-year high, doctors point to ‘bed blockage’ – Winnipeg Free Press

ST. JOHN’S, NL – Doctors in Atlantic Canada say too many emergency room beds are occupied by patients who do not need urgent care, and that “bed blocking” is leading to high numbers of emergency room deaths.

Dr. Mike Howlett, president of the Canadian Association of Emergency Physicians, says ideally, patients would be treated in the emergency room and then transferred – perhaps to a long-term care facility or back home where home care is arranged. But that community support is becoming increasingly rare, leaving patients languishing in the emergency room, where research shows they are more likely to get sicker or even die.

“What we really need is a decision by governments that makes it a priority that these patients do not stay in the (emergency room) as long as they are, because we know it kills people,” Howlett, who is also an associate professor at Dalhousie University, said in a recent interview.

Paramedics at Dartmouth General Hospital in Dartmouth, NS, on July 4, 2013. THE CANADIAN PRESS/Andrew Vaughan

Paramedics at Dartmouth General Hospital in Dartmouth, NS, on July 4, 2013. THE CANADIAN PRESS/Andrew Vaughan

“By failing to address the problem, governments and planners are systematically promoting a level of service that virtually guarantees that people will be worse off.”

Figures from the Nova Scotia Health Authority show that the number of deaths in emergency rooms reached a six-year high in 2023: 666 deaths compared to 558 the year before. That’s an increase of more than 19 percent.

The French-speaking Vitalité Health Network in New Brunswick recorded a slight increase, with 216 deaths last year compared to 208 the year before. The province’s Horizon Health Network did not provide complete figures for last year.

The number of deaths in Prince Edward Island’s emergency departments decreased from 48 in 2022 to 35 in 2023.

Newfoundland and Labrador saw a slight decline from a five-year high of 326 in 2022 to 297 in 2023. Last year’s figure is still higher than previous years and during the peak of the COVID-19 pandemic.

“The numbers are too high,” said Dr. Stephen Major, president of the Newfoundland and Labrador Medical Association.

Like Howlett and the other doctors who spoke to The Canadian Press, Major said the numbers need to be analyzed more closely and presented in more detail to get a nuanced picture of what is happening in emergency departments. But he agreed that the numbers point to problems, particularly with bed occupancy.

Major is a family medicine physician in St. John’s and worked in the province’s emergency departments for more than 20 years before taking a break last year.

“There have been times when we’ve had 30 patients admitted and maybe three to five beds are free to rotate people through,” he said. “We see the patients in a chair, in a corner, we put the patients where we can see them because they need care.”

Major said patients also arrive at emergency rooms much sicker than they should be. They don’t have a primary care doctor, and so their illnesses go undetected and untreated, he said. He suspects some people wait as long as possible before calling 911 or going to the emergency room because they know they’ll have a long wait and may not get a bed.

He said doctors felt morally violated and felt they were working in an environment that was unsafe for their patients. “When I go into the clinic, I should be able to do my job and give patients what they need. But when I’m trying to treat people in a hallway, on a chair or in a toilet – then I’m trying to give them every possible care, but it doesn’t make sense that we’re forced to work that way.”

Dr. Robert Martel, who has worked in Nova Scotia’s emergency rooms for decades and now occasionally sees patients, said treating people in hallways or bathrooms is emotionally exhausting for emergency physicians.

“I think doctors have become jaded because they just don’t see any change,” he said in an interview. “I was talking to a colleague the other day and she said, ‘It’s scary to walk into the department because I know what I’m going to face, and it’s just heartbreaking to leave with what I left behind.'”

Matthew Murphy, chief data officer for Nova Scotia Health, said the health authority is working hard to improve patient flow through the province’s emergency departments.

He said his data was consistent with doctors’ hypothesis that the higher number of deaths was partly due to patients coming to the emergency room much sicker than before. This was due to a shortage of primary care physicians and the general health of the population in Canada’s Atlantic provinces, which was older and sicker than in the rest of Canada, he said.