Emergency departments across the country are burdened by lengthy wait times but Saskatoon is among the worst.
Timely care and privacy are considered by health care workers to be a luxury in Saskatoon’s overcrowded emergency departments these days. Catheters are being inserted behind opaque glass. Abdominal exams are being performed in hallways. Wounds are being stitched and dressed in waiting-room chairs as patients cry in pain.
And health care workers are having to walk through a maze of patients crammed into corridors, storage rooms and makeshift quarters separated by curtains so thin that family members on the other side have had to hear their loved ones unexpectedly go into cardiac arrest and die. Final goodbyes are said aloud in the crowded area.
These anecdotes were shared with The Globe and Mail by four doctors and a nurse who work at Saskatoon’s three adult hospitals. They say their emergency departments are past a crisis point, but decision makers have been slow to react, which has aggravated conditions that are, at times, putting patients and staff at risk.
Physician Brittany Ellis, who works at all three hospitals, said patients – especially older ones – are developing bed sores, experiencing delirium and losing cognitive and physical abilities because of lengthy wait times.
Stephanie Fehr, a nurse at St. Paul’s Hospital, said she’s scared a patient will die awaiting care. “The distance between decision-making and the reality on the front line is vast,” she said. “We’re barely surviving.”
The beleaguered system has been a hot-button topic during this Saskatchewan general election, with leaders from the two major provincial parties trading political jabs over whose plan will ignite real change. Voters head to the polls on Monday.
New Democratic Party Leader Carla Beck, during last week’s debate, blamed Saskatchewan Party Leader Scott Moe and his government for fracturing the health care system. But Mr. Moe pushed back, arguing that the pressures are not unique to Saskatchewan but are being felt across Canada.
A Globe report, published earlier this month, underlined that emergency departments across the country are burdened by lengthy wait times but Saskatoon – Saskatchewan’s largest city – was among the worst.
Health care workers, union leaders and politicians who spoke to The Globe for that report said the emergency-department crisis has developed over time. They pointed to rapid population growth, staffing and capacity shortfalls, insufficient community health services, patients with more complex ailments and a family doctor shortage for the dysfunction.
The average length of stay for emergency patients at Saskatoon City Hospital waiting for a bed was between 55 and 68 hours between September, 2023, and March. At the city’s other emergency departments, patients waited an average of 29 hours at Royal University Hospital and 35 hours at St. Paul’s Hospital during the same six-month stretch.
Both provincial parties have committed to hiring more front-line workers and dealing with capacity shortfalls, but they differ in their approach. In Saskatoon, the Saskatchewan Party plans to open an urgent care centre – similar to the one that opened in Regina this summer – while the NDP has promised to open the City Hospital emergency department 24 hours a day. It is currently open from 9 a.m. to 8:30 p.m.
Despite City Hospital having to transfer patients to other hospitals for an acute-care bed because of its limited services, it has become increasingly common for patients to be housed overnight in the emergency department, and sometimes for days, as beds aren’t available at other sites.
Chantell Mollenhauer, a nurse at Saskatoon City Hospital, says safe staffing levels and retention should be a top priority for whichever party wins the election.
Chantell Mollenhauer, a registered nurse for 20 years, said there have been times when three-quarters of the department’s beds are filled, leaving just a handful of spaces for patients who show up during the day. In January, City Hospital had to restrict emergency services one evening because of a physician shortage.
Ms. Mollenhauer stepped away from working full-time in the emergency department a few months later because she said it had become unsafe for nurses. She added that while the department isn’t open to the public 24 hours a day, it is already operating around the clock. For the NDP’s plan to work, she said they need to ensure adequate resources are in place, such as safe staffing levels as well as constant access to a pharmacy technician, X-ray services and CT scans.
Listening to health care workers and involving them in decision-making is the cornerstone of the NDP’s plan to revive the health system, said Ms. Beck in an interview. Her party has promised an additional $1.1-billion in health care spending over four years to hire and retain staff, but added: “Money alone won’t fix it.”
The NDP has committed to adding 800 front-line positions over four years in places of greatest need. The NDP said it will also launch an online portal to connect residents to family physicians, modernize the Ambulance Act to get paramedics on the road faster and create an online dashboard to warn the public of unplanned emergency room closings.
The Saskatchewan Party has promised $2.6-billion over four years to build more hospitals, long-term care sites and other health facilities.
Everett Hindley, who is running for re-election and serves as the province’s Health Minister, defended his government’s record. He said his party would forge ahead with its existing plans if it forms government again – including bolstering rural health services to minimize strain on urban centres and increasing acute and long-term care capacity.
Mr. Hindley said they would be open to providing incentives to attract needed health care workers to Saskatchewan’s urban centres, like they have done in rural and remote regions. His party is open to the idea of increasing competition for hospital operations, he said, but wants to see how that plays out in Alberta first.
An analysis is under way by the Saskatchewan Health Authority to examine existing hospital pressures and provide recommendations on ways to increase capacity. John Ash, vice-president of Integrated Saskatoon Health, said the analysis is expected by spring. He said 250 full-time equivalent positions have been added in Saskatoon over the past year, including 106 nurses. He was unable to say how many positions were specific to emergency departments.
The Saskatchewan Union of Nurses (SUN), one of the largest nursing guilds in the province, said many of its members have felt disrespected by the government. As a result, nurses at all stages of their careers are transitioning to casual or leaving hospital work altogether.
Nurse Sara Peters says even though seven to 10 nurses are being trained each month for the emergency department at Royal University Hospital, less than 50 per cent of them stay.
Sara Peters, a charge nurse in the Royal University Hospital emergency department, said between seven and 10 nurses are being trained each month for the department but the retention rate is shy of 50 per cent. On Oct. 1, the department was at three times its capacity, according to the union, which prompted hundreds of nurses and supporters to rally at the provincial legislature for change.
Saskatchewan Occupational Health & Safety investigated and found the hospital was significantly overcapacity and had no plan to control the situation, which the Saskatchewan Health Authority disputes. More than 90 patients were in the department but there were only beds for 36. Occupational Health & Safety said overcrowding impeded staff’s ability to transport equipment and risked their physical health.
Ms. Peters said many nurses realize it is an unsafe situation and she said she is in constant fear that a patient or staff member will be harmed under her watch and put her nursing licence at risk. “I want change,” she said. “I expect change.”
Editor’s note: A previous version of this story contained a misspelling of Chantell Mollenhauer’s name. This version has been corrected.