Kitchener mom appalled by emergency room wait

This piece was also featured in: Waterloo Region Record
Published: Feb. 14, 2013 | [ WEB ]

KITCHENER —

Sitting in a local emergency room, Catherine Brindley anxiously watched her three-year-old son struggle to breathe for over eight hours before seeing a doctor.

After arriving at Grand River Hospital in an ambulance on the evening of Jan. 28, her son was not treated until 5:30 the next morning. Brindley is furious.

“He was left for eight and a half hours and he was checked three times (by nurses),” Brindley explained. “I brought him to them to check him. They didn’t come to see how we were doing and his condition worsened as the night went on.”

Brindley first took Shane to Laurentian Walk-in Clinic on Ottawa Street South at 7:30 p.m. because his breathing was “laboured” and he was running a fever.

Shane struggled to speak, needing to take short breaths between words.

Dr. Sherry Soliman, who examined Shane at the clinic, wrote in a statement to The Record that the boy “had an elevated heart rate” and “had an elevated respiratory rate” in her initial examination.

“He was immediately given oxygen and a ventolin mask as a stabilization measure, while an ambulance was called,” Soliman said.

Soliman decided to call an ambulance because she believed quick transportation to the hospital was in Shane’s best interest.

“Put simply, he looked sick and was clearly unstable by mere observation. Children tend to be especially vulnerable when they show these signs and when they deteriorate, they do so very quickly, and it can be fatal,” she said.

Soliman provided a referral to paramedics and the hospital, outlining the presumed diagnosis of pneumonia with respiratory distress.

Brindley said the speedy treatment went downhill once they reached the hospital. She said paramedics spoke openly that they believed her son’s case was not severe enough to require an ambulance.

“The paramedic continually complained to other paramedics … that they didn’t think our case was of severity for them to have been called,” Brindley recalled. “They didn’t think that was a good use of their resources.”

Once registered at the emergency room, Shane was given Tylenol to treat his fever and left in the waiting room without any other medication or oxygen for the next eight hours.

Brindley said she asked nurses several times over the course of the night to check on Shane, who was increasingly struggling to breathe.

“I got the feeling like I was putting them out, like I was an inconvenience to them,” Brindley said.

Officials from Grand River Hospital were unable to discuss Brindley’s case due to privacy regulations. However, they did explain practices in the emergency room.

“The emergency department wait times is a strategic priority of the hospital, it is something we know we do need to work on,” said Karen Bell, program director of the hospital. Improvements include adding staff and expanding physical space in the hospital.

According to data available from the province, the average wait time at Grand River’s emergency room — from arrival to discharge home or another ward of the hospital — is 6.5 hours for complex conditions and 2.7 hours for minor conditions as of last December.

For nine out of ten patients, the wait is actually about 10.9 hours for complex conditions and 5.3 hours for minor conditions.

Brindley said in total they were at the hospital for approximately 11 hours, having finally left at 8 a.m.

Wait times tend to increase through the day as the volume of patients grow in the afternoon and evening, Bell said.

Adding another physician to the emergency room during the day is under consideration to reduce the number of patients that remain in the department into the evening when only one physician is staffed, said Jill Schitka, clinical manager of the emergency department.

Wait times also vary between patients depending on the severity of their case.

Patients coming into emergency rooms across the province are prioritized by triage nurses on a five-level scale with level one the most serious requiring resuscitation and level five considered “non-urgent.”

In addition to symptoms and physiological conditions, age is also considered when prioritizing patients.

Taking an ambulance can reduce the urgency in some cases if the patient improves on the way to hospital because of paramedic intervention, said Schitka. But, if a patient gets worse while in the waiting room, a nurse will always contact a physician, she said.

“When you come, you’re not just stamped with a number that says this is where you are, so just wait. During that wait, you’re continuously reassessed so you can wait safely,” she said.

While information on what level Shane was categorized at could not be disclosed, Schitka did say better communication between nurses and patients on how prioritization works could help improve patients’ experiences.

“Maybe the nurses could do better, and we apologize for that. Maybe they didn’t communicate well enough to the family what their child was waiting for and how they were waiting safely,” Schitka said.

When Shane was finally taken to a bed to be assessed by a doctor and pediatrician in the early hours of the morning, Brindley said they warned her that her son may be admitted if he didn’t respond to medication.

But Shane improved quickly after receiving three types of medication and Brindley was able to bring him home. Brindley will take Shane for a follow-up check with the pediatrician to determine if he has asthma.

Although Brindley is relieved her son was fine after the ordeal, she contacted the hospital to complain about the paramedics’ “unprofessional” manner and the long wait to see a doctor.

“I feel that Grand River Hospital has failed him,” she said.

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Linda Givetash

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Linda Givetash is a Canadian-South African freelance journalist based in Vancouver, B.C. Her work has appeared in print, digital and broadcast media outlets around the globe.