Interior Health has acknowledged that patients at Kootenay Boundary Regional Hospital (KBRH) have been treated in the hallways in recent weeks after anonymous staff raised concerns over staffing and capacity levels.
“As the regional hospital, KBRH is a busy hospital and there have been times over the past few weeks when patients have received care outside of traditional patient rooms, including hallways,” Lannon de Best, executive director of clinical operations, Kootenay Boundary, told the Trail Times.
“We recognize this is not ideal.”
After receiving correspondence from KBRH staff describing highly-stressful working conditions, the Times contacted Interior Health for responses to workplace experiences the letter-writers clearly outlined.
Specifically, they said the medical, surgical and emergency departments “have been forced to work with only 50 to 80 per cent of their normal staff levels, while being forced to accept 120 per cent above patient capacity levels.”
The letter-writers revealed that in recent weeks this has led to patients placed on stretchers in the hallway with no call bell, and six to eight patients per nurse.
While the letter-writers said they had been in contact with agencies like WorkSafeBC, appealing to managers and speaking to the union, they said, “It’s not enough. Our concerns are being brushed over … workers are burnt out, scared for their job security, and are putting their licences at risk every day. We have had a great loss of hospital staff in the last few years, and if there are not changes made, we will be losing much more.”
To further understand staffing levels, the Times asked Interior Health for context.
The health authority was asked: “What is the nurse-to-patient ratio at Kootenay Boundary Regional Hospital? Is the hospital struggling to employ adequate staff? Which units are affected most?”
de Best began by saying that staffing ratios can change depending on staffing levels and patient numbers in the hospital.
Moreover, he said that staffing levels are impacted by several factors such as vacancies, sick calls and vacation.
“The health care sector is facing human resource shortages and KBRH is no exception,” de Best said.
“This is a challenge every hospital is facing right now.”
As far as hospital capacity, there are 20 funded surgical beds and 30 funded medicine beds; and surge space is available in both areas.
The unit most impacted by staffing challenges, de Best said, is the medical floor.
Regarding patient numbers in the emergency department, de Best said while there is always a physician in the emergency department, there is no defined nurse-to-patient ratio.
“Patient volumes in the emergency department are always in flux,” he explained. “So it is difficult to provide a ratio for the number of staff to patients.”
As well, over the last year, de Best said the average wait time to see a physician in the KBRH emergency room is 90 minutes.
According to Interior Health the staffing ratios at KBRH should be:
Medical: 4-5:1 (Four to five patients to one nurse)
Surgical: 4:1 (Four patients to one nurse)
Pediatrics: 2-3:1 (Two to three patients per one nurse)
Workplace stress
In regards to the mental health and well-being of staff, de Best acknowledged this is a very real problem.
“Interior Health recognizes that many of our staff are tired and experiencing burnout,” he said. “We’ve been facing really challenging and unprecedented times in the last three years and our staff are really impacted.”
Interior Health has a number of psychological health and wellness resources available for workers.
“Staff who have concerns can speak with their manager or site leadership,” said de Best. “Our teams want to hear from staff and how they can help improve things. Staff can also raise their concerns with their union as well.”
The BCNU (B.C. Nurses Union) says the COVID-19 pandemic has dramatically highlighted the serious shortcomings of B.C.’s health care system — a chronic nursing shortage that has existed for years — leading to increasingly difficult working conditions for nurses … Under “Act Now” on the union’s website bcnu.org, the union states, “Critically short staffed and facing burnout, B.C. nurses are struggling to provide safe patient care. When there aren’t enough nurses, patient care suffers.”
Earlier this year, Meena Brisard of the Hospital Employees’ Union (HEU) stated: “Health care workers are facing unimaginable stress fueled by staffing shortages and compounded by the ongoing impact of COVID-19, a toxic drug crisis, another season of fires and floods, and rising costs that are eroding their pay … One out of three of our members are considering leaving health care in the next two years because of the stress they face in their workplaces.”
These statements reflect the stressful workplace environment described by the KBRH letter-writers, and that’s not taking into account a recent jarring crime, when a discharged patient fired gunshots at police outside the nearby Trail ambulance station.
The anonymous staff members did, however, emphasize that there is a way for patients and families to get involved and help make a difference.
“Please help us,” they ask. “Please phone the patient quality care office to make complaints and statements. Please help us stand up for you and your families to provide the care you deserve. Every call helps.”
The Patient Care Quality Office (PCQO) can be reached at 1.877.442.2001 or via email: PCQO@interiorhealth.ca.
Interior Health concurred saying the PCQO is the right avenue for addressing patient concerns if they cannot be dealt directly with hospital teams. The PCQO will gather information about an individual’s concerns and respond to them directly.
(Editors note: Interior Health did ask the Trail Times to set up an interview with Lannon de Best which the Times will follow up with in the New Year.)