Emergency departments are in a state of crisis, Halifax ER chief says

HALIFAX — The head of emergency medicine for Halifax and the surrounding area says ERs are under the most extreme pressure that he’s seen in his 23-year career, and he says it’s taking a toll on patients and health-care workers.

Emergency medicine is in a state of “crisis” amid a shortage of nurses, physicians and hospital beds, and with a rise in patients with complex needs, Dr. Kirk Magee, chief of the central zone’s network of emergency departments, said in an interview Thursday.

“We all went into emergency medicine because we love to do it and we love a challenge — but we used to have the resources to meet that challenge,” he said.

“Now (emergency department staff) are extremely worried they're going to be put in a position where they're not able to manage the expectations or even the needs of patients and their families.”

Magee, reached on the phone following an overnight shift at Halifax's QEII Health Sciences Centre emergency department, said that often he and his peers must tend to patients in hallways and closets. Wait times can be “extraordinarily” long, he said, adding that patient care is not as good as it could be. 

“This is not the care that we wish to provide; it’s the best we can do,” Magee said. “But we know that in a well-resourced system we would be able to do much better, and that’s really tough.”

He said the pressure ER staff are under has resulted in stress and long-term exhaustion that have driven many to reduce their working hours or leave the profession. “I've never seen the morale among physicians and nurses and other health-care professionals so low.”

Magee said that in order to make meaningful change and improve the situation in ERs, the province must address a number of different problems. The government, he said, should increase access to primary and walk-in care; add more hospital beds; hire more nurses and physicians; and increase the availability of community-health and home-care resources. 

“This is a complex problem and there’s no one thing that’s going to make this better,” he said. 

Data released Wednesday shows that deaths in Nova Scotia emergency departments were up 10 per cent in 2022 from the previous year. The data, obtained by the Nova Scotia NDP through a freedom of information request, shows that 558 people died in emergency departments across the province in 2022, up from 505 in 2021. 

The figures, which cover Nova Scotia’s four health zones between 2017 through 2022, show that last year’s death toll was the highest during the six years under study.

On Dec. 31, 37-year-old Allison Holthoff died after a seven-hour wait at the Cumberland Regional Health Centre emergency department, in Amherst, N.S. In response to Holthoff’s death, Elizabeth Smith-McCrossin, the Independent member for Cumberland North, shared on social media a letter she wrote to Premier Tim Houston calling for urgent changes to the Cumberland hospital ER, which is under renovation. 

Her proposed plan includes establishing a temporary walk-in clinic adjacent to the ER, placing a health-care worker in the hospital waiting room to monitor patients, and upping the number of nurses working in the emergency department.  

On Thursday, a relative of a Cape Breton woman came forward to describe how Charlene Snow left an emergency room in Sydney, N.S., after waiting seven hours and then died from a heart attack about an hour after she reached her home in Donkin, N.S.

The woman's daughter-in-law, Katherine Snow, said the 67-year-old left the Cape Breton Regional Hospital on Dec. 30 after giving up on seeing a doctor about flu-like symptoms and jaw pain.

Katherine Snow said family members have since been told Charlene didn't realize she had hemopericardium, a condition where blood accumulates behind the heart. She said the family believes the death could be linked to overcrowding of the hospital system and lack of staff.

The Snow family has created a website that shares their story and is now attracting allegations of inadequate care.

On Friday, the office of federal Health Minister Jean-Yves Duclos issued a statement expressing condolences to the Snow and Holthoff families.

“No one should have to go through what they are going through,” the statement said. 

“We share deep concerns about the significant challenges that our health system is experiencing and we remain ready to collaborate with provinces and territories to … improve health services for all Canadians. We are committed to improve health care in Canada so that everyone can get the care they deserve.”

Earlier in the day, Nova Scotia's Opposition Liberals called on Premier Tim Houston to convene an emergency session of the legislature to deal with the emergency-care crisis.

Liberal Leader Zach Churchill issued a statement saying Houston has used emergency debates to deal with less-important issues, including pay raises for legislators and electricity rates.

“But nothing is more important than the lives of Nova Scotians,” Churchill said. “This needs to have the full attention of government.” 

Nova Scotia's Progressive Conservatives were elected to govern in August 2021 after Houston led a campaign that focused on improving the province's health-care system.

This report by The Canadian Press was first published Jan. 13, 2023.

— With files from Michael MacDonald

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This story was produced with the financial assistance of the Meta and Canadian Press News Fellowship.

Lyndsay Armstrong, The Canadian Press