After months of overcrowding, Quebec ERs brace for the worst following holiday season

It's a new year, but Quebec's emergency rooms are still dealing with the same problems.

Overcrowding, staffing shortages and sicker patients have been crippling emergency rooms across the province for months.

Following a period of holiday celebrations the first in three years without strict public health rules health-care workers say the situation will worsen before it improves.

"We would like to be wrong, but unfortunately, we've got to prepare for the worst," said Dr. Judy Morris, head of the Quebec Association of Emergency Physicians.

Notorious forbroken bones, respiratory viruses and heart attacks induced by shovelling, January and February send emergency room capacity levels surging year after year, saidMorris.

But with most hospitals across the province already operating at more than 100 per cent capacity and new variants of COVID-19 adding to that list ofviruses she fears the looming surge could break the short-staffed health-care system.

"We've already been overcrowded, we've already been stretched thinthe whole system lacks room for patients," she said.

On Tuesday morning, Montreal's Lakeshore General Hospital emergency room was operating at 210 per cent capacity not an uncommon occurrence these days, according to ER nurse Nathan Friedland.

"I would call it a disaster," said Friedland of the situation at the West Island hospital.

He said patients are showing up even sicker than usual due to backlogs in primary care throughout the pandemic.

"You have two years where people didn't go to a doctor, two years where their health problems got worse, two years when they weren't treated for cancer," he said.

"It's going to get a hell of a lot worse before it gets better."

More beds, sharing of burden needed

As of Tuesday morning, the average occupancy rate in emergency rooms across Montreal was133 per cent it was126 per cent acrossQuebec.

In Montreal, the most overcrowded hospitals included the Santa Cabrini, Lakeshore General, Jewish General, Montreal General and Royal Victoria.

But Friedland said the figures don't represent the number of people waiting to be triaged.

"If you don't get a stretcher, you go back to the waiting room and you're not on the count," he said.

In October, the Quebec governmentestablished a crisis unitto help manage the overflow of patients in emergency rooms. Following the unit's recommendations, theHealth Ministry put in place some new measures, including opening five clinics run by nurse practitioners and expandingthe 811 Info Santlinefor pediatric services provincewide.

While health-care workers say these measures will help with waiting room traffic, they won't necessarily alleviate overcapacity on stretchers.

"Those are patients that are sick enough to need an emergency room and 811 cannot help those people," said Friedland.

Dr. CristianToarta, the associate emergency department chief at the McGill University Health Centre, said an ideal solution would be more hospital beds. Without them,emergency room nurses are being forced to look after people on stretchers whowould otherwise be up on a floor being taken care of by ward nurses.

"Everybody's busy, it's just the [backlog] always happens through the emergency department so that's why it may take longer for our nurses to come see you, to give you pain medication, why the physician may have more trouble seeing you it's often hard when we're dealing with hallway medicine," he said.

The Health Ministry's crisis unit alsoreleased an overcapacity plan, which included a listof directives to be adopted by hospitals, back in early December.

Similar to Toarta's proposedsolution,one of the directives involved redistributing the pressures onhospitals' ERs and theirwards having those wards accommodate more patients.Another stratgey involved having better and more timelyaccess to radiology and consultations, includingextending hours of availability.

Morris says putting "a little bit of pressure on the wards" will make a big difference for the ERs, but she says the question remains whetherhospitals will actually implement these recommendations.

"We need hospitals and the whole health-care system pretty much to come together and work on a plan to help us out," she said.