Last month nine out of 10 patients ambulanced to the QEII Health Sciences Centre Emergency Department waited more than six hours to be admitted. Six hours and 42 minutes, in fact.
该令人不安的信息包含在上个月为Nova Scotia Health（NSH）准备并提交给卫生部长的救护车卸货时间报告。它证实了许多人已经知道：前线的情况变得更糟。
Former Health Minister Zach Churchill became alarmed last April when it was clear overcrowded emergency departments were creating a bottleneck. More and more ambulances were unable to respond to new calls because they were tied up outside the emergency department waiting to discharge patients. The grieving families of凯莉麦克风andApril Georgehave spoken out publicly about their frustration watching loved ones die waiting for an ambulance to show up.
该省设定的目标或基准是30分钟才能抵消抵达急诊部门的90％的患者。30分钟后，护理人员/救护车司机应该自由地回应另一个电话。
That goal increasingly looks like a cruel fantasy. The situation at the Halifax Infirmary has even deteriorated since June, when patients being transported by ambulance waited four hours in the parking lot or in the hospital corridor. We’ll look at the factors contributing to those numbers in just a moment.
The data in the August report show all four health zones across the province saw an increase in the wait time for ambulances at emergency departments.
At Colchester East Hants Health Centre in Truro, nine out of 10 ambulances waited more than three hours at Emergency. In June that would have been a two-hour wait. At Cape Breton Regional Hospital, the wait time was one hour and 20 minutes, or nearly three times the half-hour benchmark. The South Shore Regional Hospital in Bridgewater reported nine out of 10 patients waiting two hours to be admitted to its emergency department.
Wait times to deliver patients into care were even longer across the Halifax Regional Municipality.
During the first three weeks of August, ambulances waited four hours to offload patients at the Cobequid Community Health Centre in Sackville. Cobequid ER nurse manager Jamie Stewart described working conditions “as a war zone” in a recent interview with The Current on CBC Radio. Stewart described one night early in September when the 30 beds were full, 44 patients were in the waiting room, and eight ambulances were lined up outside. The Sackville community health centre isn’t supposed to be open after midnight, but the same tired staff continued to work through to the next day to handle the backlog of patients.
同时在达特茅斯综合医院，医护人员平均超过三个小时（185分钟）等待排放患者。8月10日，达特茅斯86岁的罗斯·奥布里恩摔倒了，摔断了他的臀部，然后等了三个痛苦的时间来救护车到达。
“Code Critical”
“Code Critical” is the hashtag used by paramedics to indicate an area is without an ambulance — a phrase repeated several times a day during August. Both Nova Scotia Health and the unions involved suggest the most probable explanation for increased wait times outside emergency departments is a combination of summer vacations and “an unprecedented shortage of nurses.” That leaves large areas of the province without coverage in the event of a heart attack or car accident.
“医护人员缺乏缺点，”新斯科舍省护理人员联盟总裁Michael Nickerson（Iuoe本地727.）。他估计有多达200的残疾或压力休假。“但一个更大的问题是护士的短缺相结合的缺乏对家庭医生和占据医院的床铺的人，因为他们正在等待长期护理（护理家园）。”
Nickerson认为上个月哈利法克斯医务室的卸载时间急剧增加是因为在医院的所有“豆荚”或单位的工作人员都没有足够的护士。7月中旬，新斯科舍省健康副总统科林史蒂文森证实了CBC消息，即一些服务可能必须被削减，因为医院是如此短暂的注册护士。史蒂文森表示，夏季开始以20％的护理职位在全省境内未填充。Nova Scotia Health估计为许多200 RNS和LPNS在医院留下了工作，帮助公共健康接种和接触跟踪。
仅在人力资源管理局中，急诊部队人员有19个职位空缺，预计不会填补9月。审查员要求NSH解释救护车卸载时间，特别是地铁的增加。以下是NSH高级通信经理Brendan Elliott的回复。
Ambulance offload times are influenced by many factors, including emergency department volumes, the number of admitted patients within the health system, the number of hospital inpatients who would be better served in another setting, and overall staffing levels. Over the past several months, Nova Scotia Health – much like other health systems across North America – has experienced very high demand for service, with increased visit volumes and increased admissions to our emergency departments.
Elliott continues:
This increase has been experienced at a time when we have also been facing significant workforce challenges. In addition, overcrowding in emergency departments is a symptom of difficulties transferring patients elsewhere in the system, whether it’s into long term care or another setting in the community…Nova Scotia Health is committed to working every day to improve access and flow across the system, including timely offload of ambulances.
Will nurses return or not?
As vaccination clinics ramp down, Nova Scotia Health is hoping nurses will return to work in hospitals. But union leaders have suggested people are quitting or retiring because they are tired and there aren’t enough of them to provide the care required for critically ill patients during a pandemic. In Quebec, the government of Francois Legault is offering nurses $12,000 to 18,000 bonuses if they will come back to work full-time.
After a series of meetings around the province, Premier Tim Houston acknowledged on Friday the ongoing and worsening delays for paramedics who are waiting to offload patients at hospital emergency departments. “Many of the health-care providers we spoke with mentioned our ambulance system as a key area for improvement,” Houston “Suggestions to free up front-line staff from non-emergency tasks like routine transfers is something we can do in the short-term. This will alleviate pressure and ensure our paramedics can focus on the emergency care people need quickly when they call 911.”
The van plan
Let’s hope so. Since April, the province has bought three Ford Transit vans for a pilot project to see if more patients who are not critically ill can be transported in a vehicle other than an ambulance between hospitals for tests and medical appointments. Finding a different vehicle for moving non-urgent cases was a key recommendation contained in theFitch Report delivered to the Liberal government in 2019.The report found paramedics spent 47% of their time driving non-urgent cases between hospitals instead of responding to actual life or death emergencies.
The Progressive Conservative government is considering buying more vehicles to relieve some of the pressure on paramedics. However, the current criteria for the pilot project may be flawed since it limits how many patients can use the service.
面包车的司机在CPR和急救中受过培训，但患者必须能够走路或使用轮椅，因为驾驶员一旦患者被丢弃。许多长期护理设施的居民太虚弱地走路，因此Vans在试点项目的早期从养老院看到有限的摄取。紧急卫生服务还将医务人员添加到其通信中心到分类来电，并提供替代方案 - 例如呼叫811的医疗建议或心理健康危机线 - 在救护车可能不是适当的回应的情况下。
作为一名竞选“修复医疗保健”的首要尊重，蒂姆休斯顿在长期等待挑战之前不必等待。
I hope the province cuts the amount of money it gives HRM for certain operating and capital expenditures. HRM is sitting on a large amount of cash. For almost 20 years the province has given HRM $3.6 million a year to fund 40 police officers and the amount is a rounding error in the accounts of HRM . Take the money and spend it on what I call ‘the essentials’ – housing and/or healthcare.