As ICU enrollment in Ontario continues to rise, Complex care physicians and nurses warn that the province’s plan to add only hundreds of new complex care beds will not improve the situation they are currently facing in the third wave of this epidemic. Employees say increasing ICU enrollment is pushing the system to the brink – a system they claim was stretched thin before the success of COVID-19.
When asked about the increase in ICU enrollment in Ontario due to COVID-19 cases, Health Minister Christine Elliott said Monday that provincial action is being taken to build greater capacity in hospitals by re-employing staff, postponing selected surgeries and transferring patients.
“We expect to create 350 new locations by this weekend,” Elliott said. He said the plan was to eventually release 700 to 1,000 beds.
“We are building capacity and we make sure we get one for every onlooker who needs an intensive care bed.”
But the medical staff working in the ICU units say that every new bed needs a lot of resources – including specially trained staff – and they are not available quickly.
ICU is what drives the bed
Dr. Michael Tetsky, an ICU physician at Sinai Health Systems in Toronto, said, “At the very least, you need to have body space.”
“You have to have physical equipment … so IV pumps, ventilators, dialysis machines, monitors, all of those things have to be available to patients in real time.”
In addition to space and equipment, Tedsky said each bed requires a network of support staff, including a respiratory therapist, physiotherapist, pharmacist and social worker. It says that in addition to specially trained nurses, he is important.
“It’s not like there are plenty of doctors to serve existing beds, let alone the upcoming‘ expanded thousand beds ’,” he said.
“I have a feeling in talking to colleagues in my own hospital and other hospitals that it feels like there are not enough bodies to take care of patients.
There are not enough trained nurses
The shortage of complex care nurses was an issue that Birkit Umaykba said existed before the epidemic, but now it has grown larger.
Watch | ICU nurse wonders why more beds are not enough:
Umaikba, a nurse from Toronto who specializes in critical care and emergency medicine, says there should be a dedicated nurse for each of the most critical patients.
“You sometimes walk short with three, four, five, six, seven, eight, nine – 10 nurses,” Umaykpa said.
“Dealing with two patients who are actually sick on ventilators is a safety issue … and in those kinds of cases, mistakes can happen.”
Denise Morris, nurse manager in the medical surgery intensive care unit at Toronto General Hospital, said the number of beds in her unit has increased from 30 last year to 44.
“You want to open those beds, but trying to provide enough staff and safe staff is challenging, to say the least,” he said.
“The number of beds is growing faster than the manpower pool we have. We need to reconsider how we provide care. Can this be done in a group-based model with the help of additional colleagues from other fields? “
While the province has said it will re-employ staff, including nurses, from other hospitals in areas where it is more difficult to assist ICUs in hotspots, some who work in health services have pointed out that they do not always have specific training.
“In dealing with some areas that are more difficult than others, you may have nurses who do not have the expertise that those departments have,” said Matt Patterson, a nurse in Toronto who spent nine of her 17 lives. Year life in critical care.
Less staff, and the rest are tired
Hospitals are dealing with a shortage of specialized ICU staff, and they are being burned out by COVID-19 after more than 12 months of service.
According to Dr. Shelley Dev, an intensive care physician at the Sunnybrook Health Sciences Center in Toronto, ICU staff are being stretched thin.
“We can deploy all the beds in the world, but if you don’t have someone who is healthy, efficient, who can help you and who can take care of you while you are in that bed, the bed is no matter, she said.
“They are physically broken by how hard they work.”
Dev said health workers want to do what they can during these turbulent times, but sometimes they are not qualified for it.
“The concern of all of our workers is that our ability to provide that kind of top-notch care – and we take pride in providing it in our health-care system – is declining,” he said.
The act of balancing
CBC News asked the Ministry of Health why the province was adding more beds without the necessary evidence with them, but it did not answer the question in a written reply.
The ministry also did not respond to questions about what it is doing to appoint more important care nurses and doctors or whether it expects help from other provinces.
“Last week, the province issued two emergency orders to support the re-employment of health care professionals and other workers to hospitals,” the report said.
“In addition, we provide hospitals with the flexibility to transfer patients to alternative hospital bases in situations where a hospital’s resources are at significant and immediate risk.”
When asked what steps the Ontario Physicians and Surgeons College (CBSO) and the College of Nurses of Ontario Nurses (CNO) are taking to meet the demands in Ontario’s ICUs – including the registration of physicians outside the province – they both expedite letters to support the regulatory health care system. The bodies also said they had been doing so for a year.
For those working in Ontario’s ICUs, there is the worry of the coming weeks and the balancing act of managing beds with limited resources. Still, Morris says the commitment of ICU staff at Toronto General Hospital is uncertain.
“It’s very stressful, obvious, and scary,” he said.
“But the staff is committed – they are committed to their patients and they are shown every day.”