Longer surgery waits, overflowing hospital beds in North

Written By Rob Shaw

“The situation is dire.”

Danette Thomsen

Health workers from B.C.’s North are raising the alarm at staggering over capacity in hospitals, lengthy wait times, burnt out staff and declining conditions for patients.

The University Hospital of Northern B.C. in Prince George recently hit 125 per cent over capacity, with the Emergency Room short-staffed and the beds overflowing, said Danette Thomsen, the northeast regional council member for the BC Nurses Union.

“You have hallway beds everywhere,” she said. “There’s a patient tucked underneath a desk in the ER. They are overflowing in the beds in the wards. There’s nowhere to put people, but you can’t turn them away.”

‘Dangerous’ overcrowding

In the hallways at the UHNBC are posters with giant red text that reads “Over Capacity Alert” and asks all physicians to “please review all inpatients for possible early discharge or transfer to another facility” due to overcrowding.

“The situation is dire,” added Thomsen. “It’s actually dangerous.”

“There’s a patient tucked underneath a desk in the ER.”

Danette Thomsen

B.C.’s healthcare system is under pressure across the province as it struggles to recover after the burnout caused by a three-year pandemic. But the situation in the province’s North is particularly bad, given the fewer facilities, long distance between healthcare sites and persistent difficulty recruiting healthcare professionals to rural and remote areas.

Wait times double in the North

Wait times for hip, knee and shoulder surgeries are in many cases more than double the rest of the province.

“I’m sitting in my office every day with five patients who just can’t cope anymore,” said Dr. Paul Van Zyl, an orthopaedic surgeon at University Hospital of Northern BC. “My waiting list is two years.”

Van Zyl said the wait times have reached such a state that some patients languish for months on a wait list, unable to live independent lives and do simple tasks like go to the toilet by themselves. 

“I’m sitting in my office every day with five patients who just can’t cope anymore.”

Paul Van Zyl

He said he’s available to conduct more surgeries, but is stymied by the system.

Under-utilized surgical rooms

At UHNBC, there aren’t enough anesthesiologists to run the seven surgical rooms a day. Instead, there’s only three to four rooms in use, he said.

When Van Zyl conducts surgeries in other communities like Quesnel, Smithers and Vanderhoof, he said there are bare skeleton staff – mostly travel nurses used to keep facilities afloat – and he often can’t even find an assistant to help. 

Although surgery waitlists have reduced provincially, they’ve gone up in the North. Chart shows total cases waiting at a point in time. [Chart B.C. Ministry of Health]

Health Minister Adrian Dix was unavailable for comment, and Northern Health Authority did not provide any information by deadline. 

“At one point you wonder, do you stop seeing people? It’s a moral dilemma.”

Paul Van Zyl

Dix previously unveiled a surgical renewal plan to run more operating rooms 24/7 and clear wait lists that built up during the COVID-19 pandemic. 

But in the North, that has meant pausing more recent patients further down another wait list, said Van Zyl. 

The health authority has also curtailed his ability to bump needy patients up his wait list if their ability to live independently is threatened by their surgical wait.

‘It’s a moral dilemma’

“At one point you wonder, do you stop seeing people?” asked Van Zyl. “Because when you see them, you can’t help them for two years. But that doesn’t make sense. It’s a moral dilemma. If you don’t see them, they see no one at all. But if you see them, you put them on this never-ending waiting list. It’s ethical questions like that.”

Prince George-Mackenzie MLA Mike Morris took to social media recently to call the lengthy waits unacceptable.

Northerners face the longest surgery wait times on nearly all fronts. [Graphic BC Liberals]

“This has resulted in many people in the North being left in debilitating pain, often unable to cope with everyday life,” he wrote. “Many will also suffer from reduced health outcomes after waiting more than a couple of years for their surgeries.”

“Many people in the North being left in debilitating pain.”

Mike Morris

Some “hardy” people are choosing to drive hours away on wintery roads to get surgeries at smaller outlying hospitals, but the situation is unacceptable for a health authority that covers half of the province, wrote Morris.

“The people of the northern half of B.C. deserve the same attention and health outcomes as those living in the south.”

Recruitment at pace with departures

The Northern Health Authority is struggling with a 20 per cent vacancy rate for staff, according to a February board report. In rural areas, it’s even higher for “priority professions,” such as nurses and diagnostic technicians.

“Health service providers are departing the organization at nearly the same rate as they are recruited,” read the report. “Recruitment alone will not solve our health care workforce shortage – we need to retain staff, and expand supply as well.”

Nurses are leaving because of the working conditions, said Thomsen. 

“I’ve never seen this much distress for our member, ever. It’s heartbreaking.”

Danette Thomsen

Nurses are handling as many as three times the patients per person as they should, she said.

Five of eight critical care doctors, known as intensivists, have left the area, and the system is chronically short of, not only nurses, but doctors, physiotherapists and occupational therapists.

Nurses who are supposed to be dedicated to leading code blue response teams now also have patients. And nurses who are supposed to only be dedicated to one patient on a ventilator at a time now sometimes have as many as three or four, said Thomsen.

“I’ve never seen this much distress for our members, ever. It’s heartbreaking,” she said.

‘They can’t cope anymore’

“I heard from a nurse last week who broke down in tears. She was one nurse to 11 patients on a medical ward and because of her own sanity and mental health is going to a different job,” said Thomsen. “They just can’t cope anymore. They are leaving in droves.”

The B.C. government has tried to respond in several ways, with new training spaces for health professionals, an HR recruitment strategy and most recently a $1.5 billion lift to health funding in last month’s provincial budget.

But it’s not having any impact, said Prince George-Valemount MLA Shirley Bond.

“When you are waiting years in pain for hip surgery, what is being said in the legislature doesn’t matter.”

Shirley Bond

“I honestly think that is the most discouraging part, is that the words do not match how the people on the ground feel,” said Bond.

“You can tout all the statistics you want, but when you are waiting in a hallway, when your elderly parent can’t get a place in long-term care, when you are waiting years in pain for hip surgery, what is being said in the legislature doesn’t matter.”

“I talked to a group of nurses yesterday and it was frankly heartbreaking,” added Bond.

“They were at their wits end. I know it is a complex issue, but what’s most frustrating these days is it is completely dismissed.”

The government needs to replace UHNBC with a new hospital that has expanded areas like cardiac capacity, so that it can recruit and retain new staff with a modern facility, said Bond. UHNBC serves as the north’s biggest hospital, and as it struggles so does the entire region.

‘Very dooming’

For physicians like Van Zyl, identifying the problems are one thing, but crafting the solutions are something else entirely. He admits he’s not sure what the province could do entice back departing health workers, other than boost incentives to live and work in the north.

“The sense I got, which is very dooming, is that people are giving up trying,” he said. “They lost the drive.”

“You walk through the emergency department, their turnover now is extremely high, the ICU is extremely high. The nurses are feeling that they don’t see a light.”

“People have lost a little bit of hope.”