As nurses in Abbotsford and Mission continue to warn of serious congestion at hospitals, the provincial government has ordered a review of the Fraser Health Authority.
On Friday, health minister Terry Lake announced a strategic and operational review of Fraser Health to address the regional health authority's habitual over-spending and hospital congestion.
Earlier last week, the B.C. Nurses' Union publicly detailed instances in which patients across the Fraser Health region spent days waiting for treatment at emergency departments. The BCNU has been calling attention to hospital congestion for years.
"The nurses are absolutely distressed, morally, physically," said Linda Pipe, who has served as chair of BNCU for the Fraser Valley region for nine years. "The nurses are done. They're tired, they're exhausted. They're certainly concerned about patient care and certainly concerned about their licences."
Pipe works at both Abbotsford and Mission hospitals and said the situation has become progressively worse during her time.
At Abbotsford regional hospital, the month of October saw an average of 50 to 58 patients that were admitted into the emergency department waiting for beds at any given time, according to Pipe. Some were waiting 5-6 days on a temporary stretcher or chair in the hallway before receiving a bed.
The six-bed adolescent psychiatric unit at the Abbotsford hospital remains closed since the hospital's opening in Sept. 2008. According to Pipe, the facility is used as storage and sometimes as a clinic.
Pipe said that some days, one nurse is looking after as many as 11 patients. BCNU advocates for a ratio of one nurse to four patients for an ideal balance between quality of patient care and cost efficiency.
Mission Memorial hospital has three registered nurses per 24-hour period. When one nurse provides mandatory accompaniment to a patient transferring to another hospital, and another might have to stay with a patient in an ambulance, the number of nurses available to ER patients drops.
"That means that Mission hospital could go up to four hours and longer with only one nurse in the emergency department," said Pipe.
Constraints at the regional Abbotsford hospital impact Mission, Chilliwack, and Hope because other hospitals routinely send patients to Abbotsford for specialized treatment and to handle overflows.
The ratio of patients to physicians and patients to nurses has been steadily declining in B.C. over the last decade. A ratio of 715 nurses per 100,000 patients in the province in 2001 had declined to 584 by 2006.
According to Pipe, one of the causes of overcrowding at Abbotsford hospital are chronic nursing staff shortages. Of the 40 or so nursing positions at Abbotsford hospital, a high number are vacancies that have not been filled, or represent nurses that are on leave for various reasons, such as maternity or work-related incidents.
"Some days, it's almost half of the staff that are off," said Pipe.
The government's budgetary review of FHA is a start, said Pipe. She hopes that front-line nurses are included on the review panel.
"This is nothing new. They have been knowing that this is ongoing for years, and have done nothing," said Pipe.
In a statement released to media across the Lower Mainland, Fraser Health said that it has added more than 1,000 new nurses over the past three years, and has invested over $10 million in specialty education for nurses. FHA also indicated it added new beds, streamlined administrative procedures, and expanded home support, in the last year alone.
FHA was unable to provide a comment specific to Abbotsford and Mission hospitals.
A report by B.C. auditor general John Doyle earlier this year suggested that Fraser Health is consistently under-funded compared to other health authorities. The report revealed that FHA's budget allows for an average spending of $1,585 per resident, half of the amount spent per patient in the Vancouver Coastal region, and less than the amount spent in the Interior, Northern and Vancouver Island regions.
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