Inside ERs at a breaking point, staff provide care while juggling shortages and closures

It's 6:30 a.m. and a section of the Emergency Department at Kingston General Hospital is closing for the day. The lights are out so patients can sleep, but one by one, they're woken up and told they are being moved. 

"Most likely, quite a few will end up in the hallway by the time we're finished ... It's not very nice," said Monica Griffin, a charge nurse at the Ontario hospital that's a trauma centre for about 500,000 people in the area.

The reason? There is not enough staff to keep Section C — reserved for the least-sick patients — open for the day shift. They're short two nurses, so patients need to be moved elsewhere in the department.

"It's like this all the time — or worse," said Griffin.

Ongoing and widespread staffing shortages in health care mean even a large urban hospital like Kingston is affected. Many doctors and nurses across Canada have been calling for help for months, as the COVID-19 pandemic overwhelmed resources that they say were already stretched — leading to an unparalleled wave of staff shortages that they say is reaching a breaking point.

According to Ontario Health, 18 hospitals in the province have had emergency department service interruptions since the end of June, most often for an overnight shift, due to a shortage of nurses.

About 46,000 more hospital staff need to be hired in Ontario just to deal with staff turnover, hospital job vacancies, as well as the impact of the pandemic and the increased needs of a growing and aging population, according to the Ontario Council of Hospital Unions/CUPE.

In the meantime, the average emergency department wait time in the province is now at 20.7 hours for patients admitted to hospital. 

When The National visited, Missy Calbury, 27, had already spent about 20 hours in a hallway in Section C and was waiting for surgery on her broken ankle. She said she didn't realize how busy the hospital would be, until she came in and saw it for herself.

"I can't really sleep, people going by, always in people's way.... I'd prefer to be in a room, that's for sure," she told CBC News. "They definitely need more people." 

Kingston Health Sciences Centre is southeastern Ontario's largest acute-care academic hospital, consisting of two hospitals (including Kingston General), a cancer centre and two research institutes. 

Dr. David Messenger, the head of KHSC's emergency medicine department, notes that despite the hospital's size, it is by no means immune to staffing challenges facing hospitals across the province and Canada. 

"One nurse makes a difference to our ability to operate sometimes," Messenger said.

Rural hospitals, where staffing margins are often thinner, can be hit even harder by these shortages.