The Emergency Room

Our family has been cloaked in various sicknesses for the last week, from coast to coast. Most appear to be variations of the flu, or infections of the viral kind.

This all culminated in a visit tonight to the Emergency Room at the Queen Elizabeth Hospital for Oliver. Not because there was an emergency, mind you, but simply because our family doctor was too busy to see Oliver today, and he has been running a fever of 103 for a couple of days. We’re still in the “overly cautious, better safe than sorry” phase of parenting, where the downsides of the eternal waiting room visit don’t yet trump the upsides of a professional diagnosis. So off we went.

I’d be willing to bet that the QEH Emergency Room is the consistently most stressful place on Prince Edward Island. Everyone there is sick or injured. And they’re all being made to wait a lot longer than they think they should, rightly or wrongly (yes, triage is triage, but that doesn’t matter much when you’re in pain).

Like most emergency rooms I’ve seen the inside of, the QEH’s version is decorated in a fashion best decribed as “prison modern.” There are generic, uncomfortable chairs. Old, moldy magazines. A television playing some innocuous channel that nobody is interested in watching. And the room is plastered with various warning signs from floor to ceiling: don’t smoke, don’t use your cell phone, wait your turn, cover your mouth when you sneeze, take a number, stay out of here, and so on.

It is not, let’s just say, a very welcoming place. Add to that the pall of sickness, injury and death that permeates, and the result is a place that serves only to make those forced to wait there more stressed than they started out.

I’m no doctor, but I’ll willing to bet that’s not a good thing, “wellness” wise.

What would it take to turn the QEH Emergency Room from a health gulag into something more welcoming, and, dare I say, pleasant to wait in? It’s never going to be perfect, because people waiting there are still going to be sick and injured. But surely with the investment of a small amount of money and effort, the environment could be significantly improved, couldn’t it?

Surely the benefits — less stress for patients (meaning less stress for staff) and less of a problem with long waits (because they’re not so painful) — would be worth it.

Comments

Steven Garrity's picture
Steven Garrity on March 9, 2004 - 05:29 Permalink

I dread the QEH emergency room (fortunately the only ER I’ve ever been in). I’m not sure there’s much you can do about it, but the last thing you need when you are nauseausly waiting for a doctor is to have kids puking around you. I shudder to think.

Mandy's picture
Mandy on March 9, 2004 - 06:33 Permalink

Well I’m sure I can say I’ve seen more of the QEH emergency room in the last 2 years then most people will in their life time. Sadly, all the nurse know me as soon as I walk in and I’m usually rushed behind those “big green doors”… so I never have to wait on those dreaded chairs for long, if at all.

But with that said, I couldn’t agree with you more. The new purple paint on the walls surely “jazzes” the space up some if I could dare say that. But it’s drab and terribly uncomfortable. I especially dislike seeing poor sick children hanging off their parents because they are too sick to sit up on their own, and the chairs are not for curing up in.

I have to say though, maybe there is a method to their madness. The sad fact of it is, many times the ER is packed to the the ceiling of the same people. People who are there not because they are “really” sick, but they are lonely, or worse yet, hooked on prescription drugs. Maybe, just maybe, they want to make spending time there so rotten, the “regulars” won’t come back as much.. it’s a poor theory, but hey, it’s a theory none the less.

At any rate, I have to say.. the nurses of the ER are some of the best out there. And I should know, but I hope I never see them again .

at the risk of sounding like a big cliche, they really are over worked, and surely under paid. And spending all my time on the other side of those mysterious green doors, I can tell you honestly that they really are working as hard as they can to get people in and out of the waiting room as quickly as possible.

hope Oliver is feeling well soon. :-)

Cyril's picture
Cyril on March 9, 2004 - 06:37 Permalink

Do you think the politicians are required to wait? Or do they sneak in the side door?

Nils Ling's picture
Nils Ling on March 9, 2004 - 14:01 Permalink

Yes, politicians wait. Everybody waits. If you think the hard-working people who sit behind the desk are going to give a break to the very people they see as at least partial authors of this disaster, you underestimate them terribly.

Much of the reason for large waits are the number of people who, like Peter and his family, are there for relatively routine, “non-emergency” treatement, either because their own family doctors are hideously overworked or because they haven’t yet managed to FIND a family doctor.

(And don’t get me started on that — suffice to say I’m pretty sure the worst of the doctor shortage would disappear if the Medical Association — surely the most effective union organization around today — were just a little less protective of its members’ grotesquely overloaded practices. It’s one thing to utter platitudes about improving health care on the Island. Imagine the outrage if the Medical Association concluded each statement with “as long as it doesn’t cut into our members’ businesses.”)

For my part, if I was headed into Emergency, I’d take a survival kit including: a cooler full of healthy snacks and whatever I want to drink; my laptop; headphones; and several DVDs. In most cases, I could watch the fourth season of the Sopranos before my number came up.

Mandy’s right — I know several of the heroic nurses in Emergency personally, and have only the tiniest inkling of how stressful their daily grind must be. Anybody who has worked in any job where contact with the public is required knows that the public doesn’t always behave as it should in … well, in public. When someone has a sick child in her arms or is frightened for his or her very life or is in severe pain, all bets are off.

Jason's picture
Jason on March 9, 2004 - 14:30 Permalink

I’ve found the consistency of the QEH to be all over the place. While walking through the regular part of the hospital, there’s a nice part in the building where you walk past big open windows shining light in, then you get to your destination…which seems like it’s a time-warp back to the 70s. The front lobby i inviting..but still has an old feel to it. And Peter, as you said, the emergency room which looks rather drabby.

Living in Haliax, I can tell you that the QE2 hospital gets it right.

I personally feel it’s time for an overhaul of our towns only hospital.

Chris Lantz's picture
Chris Lantz on March 9, 2004 - 15:38 Permalink

First of all, “thank you” to those of you who pointed out the good work of the nursing staff of the QEH emergency department. It’s nice to hear from people who understand that we are doing our best with severely limited resources.
Having worked in the department for more than 12 years now I can tell you that the state of our department has never been as critical as it is now. The reasons for the overcrowding and long waits in our department are many. The biggest factor is the profound shortage of nurses. Without nurses to staff them there are dozens of empty hospital beds while patients that we have admitted lay on hallway stretchers or in examining rooms. These patients can wait several days like this before getting a bed on one of the inpatient units. Sometimes they are improved and discharged before this happens! Because of this congestion we often have literally no place to see the patients who are waiting.

Another factor,which Nils touched on, is the lack of family physicians. This also has a dramatic effect on our congestion and wait times. People need a primary care provider who they can access without having to wait 2-3 weeks! I could go on about the underfunding of home care nursing, timely access to investigations and surgery ,etc. but the initial discussion took place around the pitiful surroundings in the department’s waiting room and I couldn’t agree more. From the moment you arrive at the entrance( which one of my collegues describes as being like that of an inner-city bus station) the impression is that of an overcrowded, “tired” and outdated facility. The waiting room is inadequate for the volume of patients, it’s uncomfortable and it’s unhealthy. Keep in mind that we are there to deal with serious illness and injury first and foremost and I believe we do a pretty good job. Having said that, the department does need to be completely redesigned and rebuilt. To that end we have worked very hard in putting together a plan which the government has promised to follow through on. It is our hope to have a modern, well-designed emergency department (complete with a well-decorated, comfortably-furnished waiting room) within the next 3-4 years. Until then thanks… for your understanding!

Dr. Chris Lantz
Chief, Department of Emergency Medicine
QEH, Charlottetown

Ann Thurlow's picture
Ann Thurlow on March 9, 2004 - 16:50 Permalink

I would like to add that our family recently had occaision to use the emergency room for a true emergency and that they couldn’t have been more wonderful. Dr. Chris Lantz was the doctor on duty and, although he was juggling a number of serious and not-so-serious cases, we received prompt and thorough care. I was sitting in a room in the minor treatment section for several hours and got a chance to see how the place works from an unusual vantage point. I was amazed at the caring concern, the professionalism and, above all, the good humour evidenced by the very busy staff.
I believe that they were doing the very best they could and — considering the circumstances — probably better than we could possibly have expected.

The QEH relies on the generosity of the community, including individuals and businesses. Maybe Re-invented and friends would like to make an upgrade to the emergency room a corporate fundraising project ;-)

Alan's picture
Alan on March 9, 2004 - 17:33 Permalink

Good call, Ann. Putting a hand in one’s own pocket is a great way to get whatever you particularly want.

Peter Rukavina's picture
Peter Rukavina on March 9, 2004 - 18:09 Permalink

Chris, thanks for your well-worded reply; we’re just home now from 14 hours in the emergency room with Oliver. Although the waiting room experience was a dreadful as I related, all other aspects of the care were second to none: the doctors and nurses we dealt with were kind, patient, and took care of Oliver. You have our thanks.

Peter Rukavina's picture
Peter Rukavina on March 9, 2004 - 18:09 Permalink

PS: Oliver is okay; he appears to have a viral infection of some mysterious sort that manifests only in a fever.

Mandy's picture
Mandy on March 9, 2004 - 19:06 Permalink

Good to hear Peter. I would not say that you are in the “overly cautious, better safe than sorry” phase of parenting… those fevers can really take hold of those little ones.

Sorry to hear you had such a long wait.. but as you said, the care you receive makes the wait worth it. While our hospital is small and low funded, it’s like any other small town operation. The staff are eager to make you feel well, get to know you you are and make your time there as pleasant as they can. I don’t think half the nurses in the QE2 wards I was in knew my name, let alone make a point to “stop in and chat”.

Jim Thompson's picture
Jim Thompson on March 9, 2004 - 22:39 Permalink

As I wake up with coffee before heading back into another night shift tonight, it is wonderful to feel the sense of support for our ED staff that I read in these posts. Thanks folks.

Prison modern” — love that!! My wife and I are getting a great chuckle.

Glad to hear that Oliver is doing well.

Jim Thompson MD
Past Chief, QEH Emergency Department

Craig Willson's picture
Craig Willson on March 10, 2004 - 00:32 Permalink

Ann’s comment reminds me of the generosity of a co-worker. A few years ago his mother was dying of cancer and the last few months of her life were spent in the Summerside Hospital. He was a devoted son and spent each evening and as many days a possible at the hospital.

Apparently in the section of the hospital where she was, there was a lounge for visitors. It too, was described as a dreadful institutional environment. Plastic chairs, yellow walls, tile floors and harsh lighting.

With the hospital’s encouragement, and in memory of his mother, he personally supervised the re-decoration of the lounge. He installed comfortable chairs and sofas, repainted with an appropriate colour, provided cherry end tables with subdued lighting and has arranged to have it maintained.

I suspect many have been made more comfortable by this generous gift

Ann's picture
Ann on March 10, 2004 - 13:11 Permalink

I love hearing stories like Craig’s. It really is within our power to do so much good — and it’s considerably more satisfying that complaining. Thanks Craig — you made my day.

Alan's picture
Alan on March 10, 2004 - 13:30 Permalink

So somebody start a paypal link for a fund for the Emergency Room refit.

Robert  Paterson's picture
Robert Paterson on March 11, 2004 - 17:04 Permalink

First Peter — Glad to hear that Oliver is OK. Second — I have been on the road for two weeks and I have missed being linked into Island life and your page is a lifeline. What an amazing conversation to have with all these people both inside and outside the ER talking directly to each other — I am a bit stunned by what an opportunity you have given us.

What if we did something really weird? What if we asked to see if there was enough support to volunteer to make our ER a better place in terms of looks and comfort and maybe offer some social help to those that both work there and who have to go there on ” business’.

An aha that I am getting from what is going on both nationally and locally in politics right now is that our reliance on political systems as they stand to provide us with the support we need is misguided. We could instead start to act our selves — not in protest but in making small steps to make the hot spots better — the ER would be a good place to start. I would be prepared to volunteer both time and resources to help. Anyone else?

Alan's picture
Alan on March 11, 2004 - 17:31 Permalink

Like I said, set up a paypal account for this and I am in.

Mandy's picture
Mandy on March 12, 2004 - 06:42 Permalink

Agreed.. as they say, the squeaky wheel gets the grease..

Nils Ling's picture
Nils Ling on March 13, 2004 - 13:35 Permalink

One proviso … anything that gets done, and any money that gets raised, is directed to the Emergency Room as opposed to “General Revenues”. As someone married to a person who works in the hospital, I am less than confident that money which falls into the Administration’s hands will be used wisely.

(At our house, we’re still smarting from finding out my wife had to take a “holiday” during a blizzard. I’d love to check the pay packets in the big offices and find out if they made it in that day — and if not, if their pockets were lighter.)

Craig Willson's picture
Craig Willson on March 13, 2004 - 15:42 Permalink

I have long been intrigued by employees who consider it an employers obligation to carry the cost of ‘snow days’. I have been employed for close to 30 years by arguably, one of the most honourable and enlightened employers on PEI.

When many employers on PEI were still treating their staff like indentured servants I had a pension plan, group life and health insurance, generous holiday provisions, access to the business owner for exceptions if needed and a manual that clearly outlines my rights as an employee and also outlines the obligations and rights of my employer.

I also do not get paid for ‘snow days.’ The policy is clear:

*Employees are the best judge of safety and their decision to come to work (or not) is not questioned.

*If the Provincial Government offices are closed in the community that our office is in, then we are closed — with pay.

*If the Provincial Government is open — so is our office — and employees who can not safely get to work are expected to take a holiday day or make the time up.

*People who can get to work — even when the Provincial Government is closed — are granted a day off at a time of their choosing.

In my opinion, my choice to live outside of my business community and when I can reasonably anticipate there will be day that I can not get safely to work when others can — is not my employers problem or cost. I made the decision as to where I live and (IMHO) it should not be reflected as a cost to my employer.

Rob MacD's picture
Rob MacD on March 13, 2004 - 16:32 Permalink

I have long been intrigued by employees who consider it an employers obligation to carry the cost of ‘snow days’. I have been employed for close to 30 years by arguably, one of the most honourable and enlightened employers on PEI.”

I would hazard, Craig, that if you weren’t employed for 30 years by one of the most honourable and enlightened employers on PEI, your concept of employer v. employee obligation would change.

Derek Martin's picture
Derek Martin on March 13, 2004 - 16:41 Permalink

I also do not get paid for ‘snow days.’ The policy is clear”.
“If the Provincial Government offices are closed in the community that our office is in, then we are closed — with pay.”

I’m having trouble reconciling these two sentences.

Craig Willson's picture
Craig Willson on March 13, 2004 - 19:50 Permalink

Derek — quite right — the comment is irreconcilable. To be clear, I do get paid when the Provincial Government offices are closed and I do not get paid if they are not.

Rob — very good point. Agreed. However I would (and have) seek alternative employment if I was not treated with honour and integrity.

My point was directed to the concept of obligation and perhaps a better choice of word would have been ‘right’. I do not feel my employer is obligated to pay me if, by my choice, I live in an area that I can reasonably expect to miss days as a result of weather conditions. I don’t presume to have any rights of payment if I have not provided a service.

For the record, as well as being an employee for over 40 years, I am also an employer in another business. The employees in our company are paid if they can’t reach work because of weather conditions. They are paid, not because of a particular right that they have, but rather are paid because I can and I feel that on many occasions those very same employees will go the extra mile on my behalf. In my case, it is the right thing to do.

Rob MacD's picture
Rob MacD on March 13, 2004 - 20:08 Permalink

It shouldn’t be a right, but it’s the right thing to do. I agree with that. I think that is why employees would be upset if their employers docked them a day’s pay for a snow day.

Nils Ling's picture
Nils Ling on March 13, 2004 - 23:14 Permalink

I can agree that “it shouldn’t be a right but it’s the right thing to do”. It’s very much the right thing to do when you are understaffed and there is a tacit expectation that employees will “go the extra mile” to take up the slack.

I’d be keen to know if management at the hospital docked themselves any pay for not making it in that day. Any bets?

Just to be clear, my wife and I don’t live in Tignish — I can be at the hospital to pick my wife up six minutes from the time I look at the clock and go “Oh, hell, I forgot again!” So I don’t expect the hospital to carry the cost because we’ve chosen to live “outside our business community”. We’re right there. But the roads were impassable.

Interestingly, there were some hospital employees who were able to make it to the hospital on that day (which, lest we forget, was not “just another snow day” but was, in fact, one of the worst blizzards in recorded history. Not only were Provincial Government offices closed — the damn snowplows were yanked off the road because conditions were too dangerous). Those employees turned around and left before ten o’clock and were not docked a minute’s pay. Those who couldn’t leave stayed around with little or nothing to do, and in fact by evening there was an acute shortage of food in the hospital.

I’ll be curious to see what happens the next time a storm like that one blows up. How many employees will risk their very lives to get into work?

Craig, you’re correct. Consideration for employees under extraordinary circumstances is not something that is required of a business. It’s just … an expectation of any decent employer. And when it isn’t met, the organization appears petty and venal.

And shortsighted, too; you just know things aren’t going to get better in the health care system, and one day, the hospital will come asking its employees to go yet another extra mile. The hospital will only have itself to blame when the employees tell them to stuff it.

Peter Rukavina's picture
Peter Rukavina on March 13, 2004 - 23:44 Permalink

Isn’t this (snow day pay, or not) something that is properly covered in the collective bargaining process? It seems to me that given the variations of work environments and situations, it wouldn’t make sense to add this sort of thing to employment standards legislation, but rather to have it negotiated between employee and employer on a workplace by workplace basis.

Nils Ling's picture
Nils Ling on March 14, 2004 - 05:41 Permalink

I guess. But the Unions at the Hospital make no more sense than the unions at any big institution. My wife, a physiotherapist, is in a union that represents steelworkers, for God’s sake.

I personally have as much faith in unions as I do in management.

Carol's picture
Carol on March 16, 2004 - 23:06 Permalink

I would just like to make a comment on the emergency room procedures at the Queen Elizabeth hospital. I know that the employees work hard, and are often overworked during a shift, but is there not a policy to ensure that the sickest patients get seen first? should a person who is literally dying have to sit and wait for hours to be seen , and then sent home with a prescription without actually being examined thoroughly by a doctor? Something has to be done about the situation in the emergency room today. it seems that if the government has enough money to build a multi million dollar hospital in summerside, why do they not have the money to staff and open the beds in the hospital we already have ??? doesn’t make any sence to me!! and if they can’t find the money to staff the Queen E , how are they going to staff the new hospital?? any ideas???

oh , by the way , the patient i am talking about died after being sent home

Mandy's picture
Mandy on March 17, 2004 - 06:22 Permalink

Carol — I’m sorry to hear that you know someone that passed away in such an unfortunate way. I can understand your anger

But on the other hand (and not knowing this person’s situation), sometimes even the best doctors can never know what will happen to a person. Dying is a mystery and we just never know. But it is heartbreaking to know that we don’t have the room, the equipment and staff to give 100% to everyone who walks through the ER doors. I agree that major changes need to be made.

But as I said, I really feel that 95% of the staff of the QEH are giving everything they have in them. There is a small percentage we could do with out.

Nils Ling's picture
Nils Ling on March 31, 2004 - 16:02 Permalink

Noted in the new budget that money is being directed towards upgrading the emergency room .. how ‘bout that?

Michelle's picture
Michelle on January 12, 2006 - 01:35 Permalink

I have read some of the comments and thought i would like to share some.

I am not a doctor or nurse nor do i work in the medical field but i am an islander, a mother, and someone who has used the QEH emergency more than once. On every occation there has been a wait…which seemed like and eternity…and i’ve left feeling frustrated on more than one occation. Unfortunatly until our government puts health care in the forefront that will not change. I often think that the ones who allot finances toward healthcare must go outside canada for care. Wil it ever change? I can’t answer that but i can hope. Man if we needed a golf course…we’d have the funds for sure!

JACKIE BEATON's picture
JACKIE BEATON on January 30, 2006 - 02:57 Permalink

I am complelled to give my opinion on the QE2 ER
I have been in the situation where I have been in the emergency room for 12 hrs on a Friday night.
Yes I am aware that it is busy time with stupid drunk people coming in with there “poor broken hand”
Yes the nurses are over worked but as I was getting low on energy trying to sit up in the unconfortable chairs.
I had no choice but to use my jacket as a pillow and lay on the floor.
My boyfriend had gotten a nurses attention after I was puking for 6 hrs in the cornerjust to the left of the big green doors
We were told that the blood that I was puking was not serious enough for a bed or her attention.
As for the REAL pillow and warm blankets I had to confort myself with they came from the cleaning staff.
THank you to the lady who gave me that.
I got in the emergency room they gave me IV for a couple of hours and I was told that they would like me to be able to keep 1 cup of water in my system before they can release me.
The wonderful morning nurse sent me home and I was in just as bad shape as we I came in.
So I got some nurtence and they sent me packing.
No explaination nothing to fix my puking.
Basically I felt as if
“you do not have to go home but you have to get the hell out of here”
Luckily I got to go and visit these people with in 3 days since they did next to nothing for me.

They still did nothing so I went back to my small home town hospital.
They were nice enough to give me a stretcher before I came in to the ER.
And they actually let me stay until I felt better.
OH and they founf out what the hell was wrong with me.
SORRY QE ER you suck.
IF I had they choice I would have paid to see a doctor instead I spent the money to go home.
THANKS TO the staff at New Waterford
I know how to treat my stomach so that this will not occur again.