Staff scramble to relieve pressure on Alberta Children's Hospital as families are left waiting

Robyn Coulter's ten-month-old son, Arthur, went into respiratory distress in October after testing positive for COVID-19.  (Supplied by Robyn Coulter - image credit)
Robyn Coulter's ten-month-old son, Arthur, went into respiratory distress in October after testing positive for COVID-19. (Supplied by Robyn Coulter - image credit)

Robyn Coulter knows what it's like to wait in the emergency room at Alberta Children's Hospital, for hours, with a very sick baby.

"It was just very scary and unsettling," said Coulter, whose son, Arthur, was born nine weeks premature and suffers from a serious heart condition and epilepsy.

Arthur, who is 10 months old, went into respiratory distress in October after a rapid test came back positive for COVID-19.

Coulter called his specialists and rushed him to Alberta Children's Hospital where he was triaged immediately, taken to a stretcher in the ER, and treated with oxygen and a feeding tube.

But according to Coulter, nurses were too busy to keep a really close eye on him and it was a total of 17 hours before he was admitted and moved to a bed upstairs.

"It's really hard to sit there and watch your baby in distress when you know they're struggling and you can't seem to be getting help," she said.

The Coulters are one example of a growing number of families caught up in pediatric system overwhelmed with a dramatic increase in children with respiratory illnesses including influenza, RSV and COVID-19.

Supplied by Robyn Coulter
Supplied by Robyn Coulter

Triage waits up to 6 hours

According to Alberta Children's Hospital pediatrician Dr. Suzette Cooke, the wait just to see a triage nurse can be as long as four to six hours.

And, she said, families are routinely stuck in triage lines that snake out the emergency room doors.

"That's a little bit concerning because sometimes you're going to see a child in line who's very sick and needs to be seen immediately," said Cooke, noting some illnesses such as appendicitis can't wait.

Once a child is triaged, families can wait a further 17-18 hours to be seen by a physician, she said.

"That is the longest time I've ever seen in my career of 21 years," she said.

Supplied by Suzette Cooke
Supplied by Suzette Cooke

"Our inpatient units are overwhelmed. We have far more patients than we actually have beds for so we're trying to make spaces where we can for those patients," said Cooke who is treating a large number of children with respiratory illness who are under the age of five.

According to Alberta Health Services (AHS), inpatient units at the Alberta Children's Hospital have hit at least 100 per cent capacity.

The pediatric intensive care unit is nearly full too.

And, the health authority said, the emergency department is seeing more than 300 visits a day recently, compared to between 180 and 220 prior to the recent surge.

Adding capacity, moving patients

"We know wait times are very frustrating … when you're worried about a very sick child, waiting in the emergency department is very stressful," said Margaret Fullerton, senior operating officer at Alberta Children's Hospital.

"We're working really hard to look at how we can open up more capacity."

That includes adding staff and expanding the emergency room and potentially the ICU down the line.

According to Fullerton, the hospital opened an overflow ER on Sunday night, when volumes were extremely high, and it will be used as needed moving forward.

She said they've found space within the facility to treat some emergency room patients more quickly.

The hospital is also planning to open short-stay units for children who need to have their airway monitored for a day or two, but don't need longer term care.

And older teens can be transferred to adult hospitals.

"This would be a case by case basis if our ICU becomes overwhelmed at a particular hour of the day," she said.

That happened over the weekend when one teenager was transferred from the ICU at Alberta Children's Hospital to an intensive care unit at an adult hospital.

But Fullerton said their main focus now is opening capacity within the hospital itself and there is no formal plan in place to transfer teens to adult hospitals on a routine basis.


Nurses worried

The head of the United Nurses of Alberta (UNA)  is raising the alarm about the state of the Alberta Children's Hospital.

"It's traumatizing for the patients, the kids, the families," said Heather Smith, UNA president.

"It's the volume … of sick children that are coming to the emergency department — that's just overwhelming. Physically there is not enough space. It's very scary for staff."

She's calling on Albertans to take steps, including masking, to try and stem transmission and protect children. Smith, though, is disappointed Alberta Premier Danielle Smith has closed the door on the possibility of a mask mandate.

"We were late in terms of … dealing with the tragedy of seniors. Are we going to potentially make the same mistake here and not take every step — use all the tools we have available to us to help prevent unnecessary illness and god forbid loss of life for children in this province?"

Meanwhile, according to Cooke, all health care providers at Alberta Children's Hospital, from doctors and nurses to social workers and pharmacists, are under a high level of stress and are working flat out to treat children as quickly as they can.

"Everyone is doing their best to get to each and every patient to provide the same quality of care that any parent or caregiver would expect. But that is getting to be more difficult day by day."