A warning from Eastern Health about "unprecedented pressures" and long wait times in two St. John's emergency rooms is indicative of the problems plaguing Newfoundland and Labrador health care, say the presidents of the associations representing paramedics and registered nurses.
Rodney Gaudet, president of the Paramedic Association of Newfoundland and Labrador, says the warning, issued on Saturday, points to a "critical situation."
"Our system, we've been saying, is on the verge of breaking, " he said. "I think we're beyond that broken point now."
Temporary closures have become the norm for emergency rooms in rural communities across the Eastern Health and Central Health regions. The emergency room in Whitbourne has been closed since June, with patients in that area instead being directed to hospitals in Carbonear, Placentia and St. John's.
On Saturday, Eastern Health asked patients not experiencing medical emergencies to consider "alternate options" before going to the emergency rooms at the Health Sciences Centre or St. Clare's Mercy Hospital. According to the health authority, the request was made due to "unprecedented pressures" and long waits for care.
In a statement provided to CBC News on Monday, Eastern Health said the request was made to alleviate long wait times and help staff focus on individuals with serious medical conditions.
According to Eastern Health, emergency room visits at the Health Sciences Centre and St. Clare's were lower than average last weekend, with 204 visits on Saturday and 177 visits on Sunday. The previous weekend saw 223 visits on Saturday and 239 visits on Sunday.
"There is no way to definitely explain the variability in the volume of patient presentations as there are many contributing factors," said the statement.
N.L. 'hemorrhaging' registered nurses: union
Yvette Coffey, president of the Registered Nurses Union of Newfoundland and Labrador, said working conditions at the Health Sciences Centre and St. Clare's in St. John's have become unsustainable.
She said the emergency rooms don't have the capacity — or staff — to deal with the number of patients coming in.
"On any given day between the Health Sciences and St. Clare's alone, we have upwards of 20 patients admitted with no beds to put them in," she said.
According to Coffey, the emergency room at the Health Sciences Centre was down at least half of its nursing staff for at least one shift last weekend.
She said staff shortages in acute and long-term care units compound the staff shortages in emergency rooms, forcing nurses to find space for patients wherever they can — including in the waiting room, in hallways and even storage closets.
"It is in double-over capacity on a weekly basis, if not daily basis," she said. "They have all of these admitted patients and nowhere to put them."
Coffey said as of last spring, Newfoundland and Labrador was short 600 registered nurses, but she expects that number has gone up. She said the province is "hemorrhaging" nurses daily.
"This whole system is at a critical point and we need major incentives to retain and recruit new people into the system," she said.
Long waits at the walk-in
Last weekend, Eastern Health advised patients to consider contacting their primary care provider, calling 811 or going to a walk-in clinic.
However, the Mundy Pond walk-in clinic had reduced hours over the weekend due to staff shortages. On Monday afternoon, the clinic had a line of about 15 patients, including seniors and infants, waiting outside in the rain.
John Allsop was waiting outside the clinic with his partner, Jasmine Parsons, and two kids. He criticized the long line outside the clinic and the warning from Eastern Health, which he saw on Facebook.
"In a perfect world that's great, where you can tell people to not come to the ER, but we're not trained professionals. We don't do triage. I don't know if my daughter needs to go to the ER or to a walk-in. How are we supposed to make that decision?"
"It's really, really mind-boggling if you ask me," said Parsons. "Neglectful of the people of Newfoundland."
Wanda Caines, who had been waiting for about 20 minutes, said she went to the emergency room on Sunday, but was unable to get the medication she needed, so she presented to the Mundy Pond clinic.
"Oh my god, I never slept a wink last night. Not a wink," Parsons said.
Alanda Keeping doesn't have a family doctor, but has been sick for about six weeks with symptoms similar to COVID-19. Caines called 811, and was told to go to the walk-in clinic rather than the ER.
Caines questioned what will happen when the weather gets colder and people aren't able to wait outside.
"This is the unfortunate by-product of our health-care system failing," Caines said.