Ontario Nurses' Association says Humber River Hospital ERs Risky for Patients
February 26, 2014
Management fails to fix patient safety issues
TORONTO—The Ontario Nurses’ Association (ONA) is warning patients in Toronto that two of the city’s busiest emergency departments remain dangerous places for those seeking care.
A full year after an expert panel made 40 recommendations to improve patient care and safety at Humber River Hospital’s emergency departments, the hospital continues to fail to take action. Patients and staff remain at risk because of understaffing, inadequate infection control and escalating violence.
“It’s outrageous that patients continue to be subjected to the conditions at the Church Street and Finch Avenue ERs of Humber River Hospital,” says ONA President Linda Haslam-Stroud, RN. “They see a high volume of acutely ill patients who need expert Registered Nurse (RN) care, safety and cleanliness, yet the hospital continues to put patients at risk.”
An Independent Assessment Committee (IAC) – a panel of nursing experts – made recommendations to improve care and safety at the two ERs a year ago. Despite these recommendations, the hospital continues to: inappropriately use government funding for ambulance offload; fail to provide a safe work environment for RNs related to an insufficient number of security guards in an ER where there is regular gang-related violence; house acutely ill ICU patients in the ER without appropriate RN staffing when other hospital units are at capacity; and fail to provide facilities to facilitate proper infection control procedures. In addition, RNs note that unregulated Physician Assistants are misrepresenting themselves, telling some staff and patients that they are doctors, and inappropriately writing orders and directing care.
Other incidents documented by the RNs include the use of the ambulance offload area as a “mini-ER,” forcing patient care to be provided in hallways. Registered Practical Nurses (RPNs) are inappropriately assigned outside of their scope of practice caring for the unstable, unpredictable, complex patients. These patients are receiving care in hallways where they have no privacy, and their conditions are inadequately monitored. There are also regular violent incidents against nurses due to the frustration of patients and families enduring long waits for care. Finally, a number of patients are discharging themselves because of what they view as inadequate care.
“ONA has worked persistently to develop meaningful and effective solutions to correct these problems,” says Haslam-Stroud. “Despite multiple attempts over the last five years to work with Humber management, they have been unwilling to take the necessary steps to improve patient and staff safety. As RNs, we feel it is our obligation as patient advocates to speak out. The evidence and research is clear that every patient added to an RN’s workload increases our patients’ death rate by seven per cent.”
Haslam-Stroud continues to urge immediate action by the hospital to address the multitude of issues. “These practices are not acceptable in any hospital, and Humber River Hospital’s ER sites see too many vulnerable, acutely ill patients for these types of chances to be taken. Humber must implement the IAC recommendations so patients can access quality care – now. Our patients deserve no less.”
Ontario continues to have the second-lowest ratio of RNs-to-population in Canada, behind only British Columbia; 17,500 more RNs would need to be hired in Ontario hospitals to start closing the gap of nursing care patients face here, compared to patients almost everywhere else in the country. Having more front-line nurses would mean shorter wait times, fewer re-admissions and better health outcomes for patients.
ONA is the union representing 60,000 registered nurses and allied health professionals, as well as more than 14,000 nursing student affiliates providing care in hospitals, long-term care facilities, public health, the community, clinics and industry.