Winnipeg's Grace Hospital has become so accustomed to having an overflow of patients in its emergency corridors that the gurneys are now permanently numbered with plaques along the wall.
Yesterday, 13 patients were being treated in the emergency-ward hallways -- the rest of the facility was full to capacity.
And on the weekend, as many as 38 patients languished on stretchers in the emergency ward of the 282-bed hospital.
"I've been here since Sunday night," said one 50-year-old patient who identified himself as Bill. He was reading a newspaper in hallway bed No. 2, beside a plastic bin labelled "Soiled linen," while an orderly swept used tissues and gauze from the floor. A sign above the hallway entrance said "Private" -- but it wasn't. Bill was suffering from breathing and heart problems. He said he had been in the hospital before, but this was his first experience in the crowded hall of the emergency ward.
"You don't get much sleep," he said. "I really feel for the older folks -- most of them aren't getting much more than catnaps. You get really tired. You hear the sirens coming and going. They do dim the lights a bit at night."
A fire inspector toured the ward yesterday following media reports of hospital crowding. He told staff to clear away empty stretchers from the admitting area.
Most of the emergency-ward patients are elderly with chronic health problems that tend to flare up during the holidays and with the cold weather, said Dr. Ann McKenzie, an emergency-ward physician.
She said patients take longer to recover in the hallway than if they were admitted to a permanent bed, and it's a challenge for doctors and nurses to ensure proper care.
The basic problem is that there aren't enough nurses to allow Grace and other Winnipeg hospitals the flexibility to open new permanent beds.
"Nurses are already overworked," Dr. McKenzie said, adding that fewer young people are entering the nursing profession because the pay isn't great and the working conditions aren't particularly enamouring either.
Eight nurses in the Grace emergency ward were caring for at least a dozen acutely ill patients in the observation area, along with the overflow patients in the hall. Nine more patients were in the stretcher bay, seven in one treatment room and three more in a holding room: a total of 49 patients in an area designed for no more than 20. The area is staffed with three physicians, two during the day and one at night.
In the past several days, two suburban Winnipeg hospitals, Grace and Victoria General, have been forced to house patients in the hallways.
"It's nothing new," said Grace Hospital spokeswoman Anne Bennett. "It's become par for the course, unfortunately."
In November, Manitoba Health Minister David Chomiak ordered Manitoba hospitals to open 100 new beds. Ending "hallway medicine" was a major promise of the new NDP government. Just 30 beds, including six at Grace, had been opened by mid-December because there weren't enough nurses.
Larger facilities such as Winnipeg's Health Sciences Centre and St. Boniface General were spared the latest crush of overflow patients.
Ms. Bennett said part of the problem may be demographic. The city's west end is populated by a predominantly older group of citizens. And they have more chronic health problems. Moreover, the hospital discharges fewer patients during the holiday season, so there is no room for new admissions. Personal-care homes also admit fewer residents during the Christmas-New Year's period. It's also flu season.
Bill in hallway bed No. 2 took a puff of his inhaler and removed the plastic oxygen tubing from his nose. He rifled around in his jeans, kept under the stretcher, looking for some change so he could wander down the hallway for a cup of tea.
"There is a problem with privacy," he said. "But I feel for the staff. They're just rushed off their feet."
Carol MacFarlane was visiting her mother, Eva Hay, 89, who has been in the emergency hallway since Sunday. "She feels safe here," Ms. MacFarlane said. "She was at home but couldn't really take care of herself." Mrs. Hay was being assessed by social workers to see if she can be admitted to a nursing home. At 2 p.m., the social worker arrived.
"Do you know where you are?" he asked Mrs. Hay. "That's right, you're in the hospital."