Why ERs are under intense pressure across Canada — and how to help fix them

This is an excerpt from Second Opinion, a weekly analysis of health and medical science news emailed to subscribers Saturday mornings. If you haven't subscribed yet, you can do that by clicking clicking here.

Emergency rooms across Canada are facing a growing crisis — staffing shortages, burnout, worsening wait-times, closures, a lack of adequate funding and a surge of patients seeking urgent care, all threatening to overwhelm a system on the brink of collapse.

This isn't the same type of pressure they faced during the COVID-19 pandemic, but doctors and nurses across the country who spoke to CBC News say the current strain on ERs can feel worse now than it was during the past few years.

Dr. Yogi Sehgal, an ER physician at Dr. Everett Chalmers Regional Hospital in Fredericton, said his emergency department narrowly avoided disaster a few weeks ago when multiple critically ill patients arrived in a packed waiting room at the same time. 

If those patients had come in just three hours later, he would have been forced to call a Code Orange — typically reserved for extreme situations like plane crashes — where every available health-care worker in the community is called in to try to help keep patients alive.

"We would have been scrambling to get as many of the interventions done with each of the patients that were simultaneously crashing with basically no staff," he said.

"Thankfully, I think all of them did well in the end. But again … had it been in the next shift — who knows what would have happened?"

Unfortunately, the situation can be dire for some, with reports from Quebec, Alberta, Manitoba, British Columbia, New Brunswick and Nova Scotia during the past year of patients tragically dying after waiting for hours in crowded hospitals, unable to get the care they need.

A patient went into cardiac arrest last week while an on-call doctor wasn't on site at Soldiers Memorial Hospital in Middleton, N.S. Paramedics and firefighters attempted life-saving measures until the doctor arrived, but the patient did not survive.

Health-care workers are fed up with the situation, and hundreds of emergency physicians in Calgary and British Columbia have signed open letters in recent weeks to sound the alarm about the worsening ER crisis.

Last week, 15 national medical organizations representing doctors and nurses across the country published a joint statement, calling on the provinces to make reforming the health-care system their top priority at a meeting of the premiers in Winnipeg next month.

Dr. Urbain Ip, a leading emergency room physician at Surrey Memorial Hospital, came forward last month to speak openly about the growing crisis in one of B.C.'s busiest ERs and the toll it was taking on staff. 

"I live in the community, and I said this is personal for me — I cannot confidently send my loved ones to my hospital," he told CBC News. "I don't have to explain more when I've worked there for 30 years and I cannot trust that the hospital can take care of my family." 

An ER in Minden, Ont. recently shut down permanently due to staffing shortages, and the next closest emergency services are 25 kilometres away, forcing health officials to announce an urgent care clinic will soon open at the site.