Hospital situation is ‘urgent,’ officials agree, but solutions are scarce

Yukon's health minister is calling on the chair of the Yukon Hospital Corporation to set up a meeting between the government and health-care representatives to discuss how to reduce the strain on the Whitehorse General Hospital.

Yukon’s health minister is calling on the chair of the Yukon Hospital Corporation to set up a meeting between the government and health-care representatives to discuss how to reduce the strain on the Whitehorse General Hospital, after an impassioned letter from Dr. David Storey circulated last week.

But in the week since Storey’s letter was published, few concrete solutions have emerged.

In his letter, Storey complained of a chronic shortage of beds in the hospital and a lack of staff to treat surgical patients. The major issue he described is that more and more beds are being occupied by long-term care patients who shouldn’t be living in a hospital, but who have nowhere else to go.

“Our need is now and our need is critical,” he wrote.

On Sunday, Nixon published an open letter to Craig Tuton, chair of the Yukon Hospital Corporation, calling for a meeting.

“Acting together, I am sure that we can develop and implement short-term solutions to help alleviate the pressure on our medical professionals,” the letter reads.

Nixon’s letter says his department has been working on solutions, but doesn’t provide any details. He did write that the 150-bed Whistle Bend continuing-care facility, currently under construction, is “the single most important piece of this puzzle.”

The health minister declined to speak with the News about the issue.

But as the officials plan their meetings, health-care workers at the hospital are running off their feet, spending more and more of their time with people who should be living elsewhere.

Susan Walton, who’s been a registered nurse at the Whitehorse General Hospital for 23 years, said she’s now spending 70 to 80 per cent of her time with long-term care patients. She works in the east unit of the hospital, which was traditionally a surgical ward. But of the 15 to 17 beds on the floor, over half of them are now occupied by long-term care patients.

Walton explained that long-term care patients tend to require more time and attention than surgical patients, who often recover quickly. That means the three registered nurses on the ward now have much more work on their hands.

“We’re not taking any breaks and a lot of times we’re missing lunches, missing dinners,” she said. “You’re running for 12 hours. You’re busy for 12 hours.”

And that has an effect on the quality of care they can provide, she said. The nurses still do the essentials – feeding and bathing their patients and helping them to move around, for instance.

But it’s the extra things that are sometimes lost. The nurses don’t always have time to sit with patients or give them back rubs or extra skin care, she explained.

“I find it frustrating, that’s for sure. Because that’s one of the reasons that I love nursing,” she said. “That’s hard when we know the ideal and yet it’s very difficult to live up to it.”

Walton said she decided to speak out because she feels a responsibility to advocate on behalf of her patients.

James Low, a spokesperson for the Yukon Hospital Corporation, agreed that the situation is urgent. He said the average bed occupancy at the hospital was 86 per cent in the last fiscal year, and the hospital was at full capacity about 20 per cent of the time.

Since last October, he said, about 43 per cent of the hospital’s beds have been occupied by people who should be elsewhere.

But he also said that only 11 out of 3,000 surgeries were deferred last year due to a lack of capacity at the hospital, and most of those were rescheduled within a week.

Low said the hospital corporation is also working to find solutions to the problem. He said $1.1 million was spent on additional nursing staff in the last fiscal year, and the hospital is developing a volunteer program to help with basic tasks. He said hospital staff are also being coached on how to care for elderly patients.

But Low was reluctant to say whether the hospital still needs more staff. Instead, he focused heavily on the strain caused by the long-term care patients.

“We acknowledge that there’s issues related to bed pressures on the hospital, and this has led to added staffing pressures,” he said. “If those patients were actually in the appropriate level of care, we wouldn’t have a bed issue.”

But Walton clearly pointed to staffing as a problem. She said the number of registered nurses on her floor hasn’t increased since the beds started filling up with long-term care patients.

“Even one more RN would make a difference,” she said.

Steve Geick, president of the Yukon Employees Union, also disputes the idea that the number of staff isn’t a major issue. “The staffing levels have been in question for quite some time,” he said. “Anytime that comes up, the stock answer is ‘We can’t afford to hire new staff.’”

Geick said that after the latest collective agreement was negotiated two years ago, a joint committee was formed to look at the workload of hospital staff and to find areas where work could be reduced. But he said some departments – especially the secure medical unit and the laboratory – have simply responded by saying they need more people.

Geick also said the hospital corporation always has jobs posted, and he worries about the government’s ability to staff the Whistle Bend facility when it does open.

“If they have trouble now, where are they going to find the people to staff this facility?” he asked.

Currently, the hospital corporation’s website lists 15 job postings, including six for registered nurses.

Low said it takes one to three months on average to fill a position, and the annual turnover rate is less than 10 per cent.

Other ideas to alleviate the strain have been met with mixed reactions. In his letter, Storey suggested reconfiguring the Thomson Centre next to the hospital to hold more beds, or increasing taxes to provide more funding.

NDP health critic Jan Stick agreed that the government should look at opening more beds in the Thomson Centre, though she was reluctant to suggest that a tax hike is required.

“I don’t think more money is the answer,” she said. “I do believe that spending it better … is what we need to be looking for.”

She also said better home care would help to keep people out of the hospital.

But Low cautioned that renovating the Thomson Centre isn’t exactly a short-term solution, either.

“If you’re talking about bringing the Thomson Centre up to code for long-term care, that could take upwards of a year to do, so it may not be feasible,” he said.

Meanwhile, the Whistle Bend continuing-care facility may well be the long-term solution to the current bed shortage.

But the centre is only slated to open in 2018, and Alison Freeman, president of the Yukon Medical Association, said the issue is urgent now. Freeman is a family doctor with a private practice in Whitehorse, but she also works at the hospital.

“I think the message really to get out is we need a solution and we need it fast,” she said. “And I think we’re not really sure when Whistle Bend is going to be opened. These big projects are often pushed back.

“We needed this two years ago.”

Contact Maura Forrest at

maura.forrest@yukon-news.com

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