Similar dramas were played out in emergency rooms in Quebec. As predictable as the weather forecast, log-- jams in emergency departments were chronicled in the press, with daily graphs detailing how many patients were waiting in each ER. Just before Christmas, 80 patients were competing for 34 stretchers at Montreal's Maisonneuve-Rosemont Hospital. A 725-bed facility serving half a million people, its emergency room is one of busiest in Montreal. Of the 46 patients waiting in the corridors, 12 had been there for more than 24 hours. "A lack of manpower is the biggest problem," says Dr. Pierre Masson, the director of professional services, who had reduced the number of nurses for staff holidays. "The system is particularly clogged today because of a shortage in nursing, but that's not the real issue. The emergency room is the doorway and security net for the entire health network. If there's a problem anywhere in the system, it shows up in the ER."
"There are not many beds in the city because of hospital closures and there are not many at the Montreal General because of budget cutbacks," explained Dr. Robert Primavesi, the head of emergency medicine, who estimated that the hospital lost 24 beds last year. He noted that even if beds are available, "we often don't function at maximum capacity because of nursing shortages."
Primavesi said other factors are in play, such as beds closed for infection control. "If a VRE [vancomycin-resistant enterococcus] patient comes up in a 4-bed room, all 4 patients have to be isolated and can't be transferred." Then there are patients who arrive with an acute illness but can't be sent back to their living situation. The CLSC's (Quebec's community health clinics), which usually arrange home care, were closed for the holidays or maintaining only skeleton staff levels, as were private clinics. People with acute respiratory problems and flu found hospital emergency rooms the only place to go.
Similar dramas were played out in emergency rooms in Quebec. As predictable as the weather forecast, log-- jams in emergency departments were chronicled in the press, with daily graphs detailing how many patients were waiting in each ER. Just before Christmas, 80 patients were competing for 34 stretchers at Montreal's Maisonneuve-Rosemont Hospital. A 725-bed facility serving half a million people, its emergency room is one of busiest in Montreal. Of the 46 patients waiting in the corridors, 12 had been there for more than 24 hours. "A lack of manpower is the biggest problem," says Dr. Pierre Masson, the director of professional services, who had reduced the number of nurses for staff holidays. "The system is particularly clogged today because of a shortage in nursing, but that's not the real issue. The emergency room is the doorway and security net for the entire health network. If there's a problem anywhere in the system, it shows up in the ER."
"There are not many beds in the city because of hospital closures and there are not many at the Montreal General because of budget cutbacks," explained Dr. Robert Primavesi, the head of emergency medicine, who estimated that the hospital lost 24 beds last year. He noted that even if beds are available, "we often don't function at maximum capacity because of nursing shortages."
Primavesi said other factors are in play, such as beds closed for infection control. "If a VRE [vancomycin-resistant enterococcus] patient comes up in a 4-bed room, all 4 patients have to be isolated and can't be transferred." Then there are patients who arrive with an acute illness but can't be sent back to their living situation. The CLSC's (Quebec's community health clinics), which usually arrange home care, were closed for the holidays or maintaining only skeleton staff levels, as were private clinics. People with acute respiratory problems and flu found hospital emergency rooms the only place to go.
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