I wish to share with you the heartache that we, the physicians and nurses, are feeling at Whitehorse General Hospital.
Last Thursday, June 2, I was told that there were no beds in the hospital – something we have been used to for a very long time now – and that all the holding areas for short-stay were filled with admitted patients apart from one bed and that we had to cancel my mastectomy for cancer the next day and my gallbladder operation for chronic pain because there was nowhere to put them and nowhere to hold them waiting for surgery.
I was also told that there were no recovery room nurses and that we would have to wait between cases to recover each patient before proceeding to the next and that even for pre-operative endoscopes we had no room to hold more than one at a time so there would be long delays between cases. You can imagine what kind of a day Friday was.
I started practice in the Yukon in 1974, at which time we had over 100 hospital beds. We had a psychiatric ward as well as medical and surgical wards and a pediatrics ward. We had two full-time orderlies. At any given time we had the two general surgeons working, as we do now.
I believe there were in the neighbourhood of 15 administrative staff and the doctors and nurses were very much involved with planning and decision-making. I don’t recall many, if any, policy analysts, planners or program directors. The nurses and doctors, I believe, at that time ran an exemplary show.
We fast-forward 42 years and we have half the number of beds for far more than double the population. We have no orderlies. We often have no recovery room staff because we lack permanent staff. We have a difficult time finding people to work in our ICU and in our emergency room. Our clinical nurse leaders and managers are literally pulling their hair out to find people to work, to find beds for patients and to arrange transfers to alternative locations. I have literally seen our wonderful clinical nurse leaders crying out of exasperation. No matter how hard they try we seem stymied.
A year and a half ago I had said there was a crisis and it had to be dealt with – not next year but tomorrow. A year and a half has passed and the promises and platitudes sound exactly the same. Next week we have no recovery room nurses. We have extraordinarily poor funding for OR instrument replacement and purchase. We are destined to be cancelling more and more surgeries. Even our visiting specialists are having cases cancelled. The last orthopedic surgeon, I believe, had at least one total-knee replacement surgery cancelled for lack of beds. We have been begging for a colonoscopy suite to get colonoscopies out of our operating room now that we have over, I believe, 800 a year. There seems to be no solid plan but simply promises to do something about it.
The new addition at the hospital is not going to give us a significant number of hospital beds for acute care and post-surgical care. Thus we have only 17 beds to deal with the medical and surgical needs of about 35,000 people. At present, chronic and palliative care patients are using up most of our beds. I’m not saying they shouldn’t have beds, but I fail to understand, for example, why the Thomson Centre can’t be reconfigured to place palliative and chronic patients. We would give up our office space tomorrow. I’m told that the renovations cost too much money, but surely those rooms, if adequate for hospital planners, program directors and policy analysts, should be fit for a dying patient without significant additional risk.
The bottom line of all this, of course, is “no money.” I think most of us would be willing to pay more tax should that be necessary to have a safe and solid facility. So far, all the promises seem lame. I understand that the soil has been turned at Whistle Bend but little more.
Our need is now and our need is critical. Any of you who can lobby the powers that be – and I can’t actually figure out who they are – please help us to procure enough funds and room to deal with our problem over the next few months, not just the next few years.
This letter is out of frustration just from one surgeon and does not represent the Yukon Medical Association, hospital committees or board, but I believe that it does beg for the wants and needs of all our nurses, all our doctors and all the worker bees in this hospital who are involved with patient care, as well as all Yukoners.
Are there risks to patients? Of course there are. Is there suffering? Of course there is. I don’t believe our leaders have any idea how much.
Dr. David Storey is a longtime surgeon at Whitehorse General Hospital.