WhERe is the Care?

I spent two weekends in a row at the WR: The waiting room. Otherwise known as the ER or “emergency room.”

Not to sound entitled, but there are certain things one expects from universal healthcare.

Universality, being one.

Health, another.

And, finally, care.

You see, my father has a heart condition. Over the past eight weeks his heart has been beating down the days until his quadruple bypass surgery. Meanwhile, there has been a complication from a related procedure, and he developed a dangerous aneurysm in his arm.

Left untreated, he could have lost his arm - or even his life. In this instance, thank goodness, he only lost his mind.

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Last Sunday he rushed to the nearest hospital - Branson - a division of the North York General Hospital. But alas, Branson only has an urgent care centre, for which his problem was too urgent.

So from the urgency to the emergency at North York General we went.

Once at the ER, my dad explained his “beyond urgent” problem to the triage nurse, and with the greatest of urgency emerged in the waiting room.

To be clear, in a process that prioritizes people into positions based upon their need for medical attention, my father’s aneurysm could have burst for joy at the mere notion of being put on hold for hours.

The length of two ER episodes later, he was called in to see a doctor, and then waited in that room for the length of two Grey’s Anatomy episodes. (It probably would have been more helpful for my dad to watch those fake doctors dole out scripted advice.)

Finally, the doctor arrived only to tell the potentially fatal aneurysm patient that he needed an ultrasound right away to determine the recourse, and thus … she would have to send him home. There was no one to perform the simple 10-minute test.

I know what you’re thinking: My father should have used his in-home ultrasound machine before going to the hospital. (And probably should have taken a course in radiology.)

Oddly, he doesn’t have an ultrasound at home. (At least now I know what to get him for his next birthday.)

To be fair, the doctor did say that my dad should come back the next day, and if he felt his arm go numb - which could happen at any time - he should immediately return to the hospital.

Rather than be relegated to the waiting room a second day, my father opted to go back to the original hospital where the aneurysm-inflicting procedure was performed – Southlake Regional, in Newmarket, about 40 minutes north of Toronto.

His appointment at Southlake would be on Tuesday, two days later – the soonest we could fight to get him in.

The ultrasound found the problem, and after a minor, but painful procedure the problem was fixed.

Then, a few days later, on Saturday, his vein started gushing blood intermittently from the aneurysm wound. My father was told, should this happen, to go directly to an emergency.

This time, we decided to “rush” and take the 40-minute drive to the small town of Newmarket and its ER, instead of locating a WR in the hospital-filled metropolis of Toronto.

No pun intended – but it was in vain.

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Hours passed. A doctor finally saw my dad. And he needed an ultrasound.

Actually, he literally needed an ultrasound - of his own, because again, there was nobody to perform the routine test.

The hospital’s ultrasound machine was shut down for the day, minutes before the doctor saw my father.

To review: The ER nurses knew the entire time that my father would need an immediate ultrasound. And they knew this while he sat for hours (by the by, long periods of sitting – a no-no for aneurysm patients), only to be seen by the doctor right after the machine for patients was put off-limits to patients.

And again, he was asked to return the next day for an ultrasound appointment, while hoping not to spontaneously die in the interim.

Sunday, after that appointment, my father was sent back to the ER to await his results, but lucky him, he was “fast-tracked.”

So about four hours into the fast-tracking he was seen by a doctor. He will be okay … so long as he never has to go to an emergency again.

And even though my dad waited endlessly for a procedure that should be available on demand, he actually had it good.

According to the province of Ontario, the average ER wait time at North York General is 21.5 hours. At Southlake it is 14.1 hours. Overall, in Ontario, it is 13.5 hours.

People can die in that time.

And they have.

Health Minister David Caplan set a target that patients who need serious care spend no more than eight hours in the province's emergency rooms, and patients who need minor care no more than four.

If he aimed any lower it wouldn’t be called a target; it would be called a grave.

Last year, the Ontario government invested more than $82 million in its Emergency Room Wait Time Strategy to reduce the amount of time people spend in hospital emergency rooms.

This is said to help hospitals improve ER performance in a number of ways: increasing capacity; improving processes; and, speeding the flow of patients into inpatient beds.

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But as an unintended consequence of this well thought out strategy to shorten ER wait times, patients are simply littered into hospital hallways or cast into hospital wards.

Worse, when patients are shunted into hospital wards this pushes back inpatients' care and needs.

Grace, a Toronto nurse, says, “My unit is a post op unit for patients undergoing cancer surgery. Those surgeries get cancelled daily, because we have to take in the emerg patients leaving no beds for the surgery patients.

“Last year, an addition to the emerg doubled its size. However no new inpatient beds were created.”

So, in the end, in the land of free universal healthcare, this makes one wonder:

WhERe is the care?

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