It’s not a situation unique to St. Thomas Elgin General Hospital (STEGH) as facilities across the province are grappling with staffing challenges, inpatient overcapacity and stressed emergency departments.
All of which is creating capacity challenges which ultimately impact those requiring emergency care.
In an interview with Karen Davies, STEGH president and CEO, on Thursday (June 30), she confided that the hospital is dealing with a more than 30 percent increase in ER visits.
“In March of this year, we were seeing about 900 patients a week and now we’re seeing over 1,200 patients.
“And so the impact in our emergency department and also our inpatient side where we added 22 new beds in the early days of the pandemic.
“All 22 of those beds are full.”
Davies assured capacity issues elsewhere at STEGH have not negatively impacted the surgical backlog, allowing surgeons to catch up on procedures cancelled or delayed due to the pandemic.
“So, we’re back up to 100 per cent of our surgical capacity and, yes we do have some catch-up from the pandemic, and we are doing that well.
“But, most of our occupancy right now is with really sick and complex patients who are occupying our medical, surgical and complex care beds.”
Davies made it clear factors leading up to the present strain on an already fragile healthcare system pre-date the pandemic.
“Healthcare had issues prior to the pandemic. Whether it was a lack of beds, challenges starting with nurses and all healthcare workers and scarce resources.
“We were in trouble, I would say, ahead of the pandemic and it really has just escalated and the demand for extra capacity is just a significant risk right now to the sustainability of the (healthcare) system.”
Most notably, advised Davies, a residual impact of the pandemic is burnout experienced by healthcare staff. It is impacting hospitals across the province, putting further strain on the already stressed healthcare system.
“Burnout is an occupational hazard in healthcare and we’ve known that for a long time. But, with the pandemic, burnout has increased to levels that really impose a threat to maintaining a high-functioning healthcare workforce.
“I suspect the elevated burnout and the other issues of stress will persist long after the pandemic.”
“It’s everywhere from patients just being mean, aggressive and abusive to staff. Anything from biting, spitting and kicking right up to punching and weapons and so we’re really paying close attention.”
She added burnout and stress while caring for patients during the pandemic are the main reasons workers are exiting the healthcare field.
“The healthcare system has always relied on, I’ll call it altruism or people who really want to work in healthcare and goodwill of healthcare providers.
“And, I think years of working in increasingly difficult circumstances have made it difficult for many to continue. Lots of workload, increasing violence, increasing harassment and with other career opportunities available, burnout is an issue.”
This burnout is prevalent in particular areas of the hospital, advised Davies.
“We’re paying a lot of attention to knowing who is at risk and addressing it.
“It’s primarily in our intensive care unit staff, the emergency department, women, recent graduates and also our trainees.
“So, how do we focus on our new grads and those coming through the school system to make sure they know this is a good choice for a career.”
Hospitals across Ontario are also dealing with an uptick in violent and harassing behaviour directed at staff.
To the point where hand-held metal detectors are now used in some areas of STEGH, said Davies.
“And so we’ve been seeing an ongoing increase in violence in the hospital and, again, it’s not just STEGH, it’s across the healthcare system.
“We’ve seen most of the violence in the emergency department, in mental health and sometimes in our medical units.
“It’s everywhere from patients just being mean, aggressive and abusive to staff. Anything from biting, spitting and kicking right up to punching and weapons and so we’re really paying close attention.
“Heading into the summer, after a really difficult two years, it is becoming more difficult to staff all of the shifts. So, our healthcare providers are increasingly not willing or able to take extra shifts to continue to burden themselves and their families.”
“One of the things the pandemic has afforded us is more control over the perimeter of the building and having screening at every door.
“And we’re keeping that in place right now, not just for safety measures, but also because we know COVID is still very prevalent out there.
“We’re learning more about these new B-4 and B-5 variants, so we’re very focussed on violence, lots of staff training, increase in security presence and partnering even more than we had in the past with our community partners such as Elgin OPP and St. Thomas Police.”
Davies predicts high inpatient volumes will continue throughout the summer and well beyond, forcing hospitals to adjust their services.
“Heading into the summer, after a really difficult two years, it is becoming more difficult to staff all of the shifts. So, our healthcare providers are increasingly not willing or able to take extra shifts to continue to burden themselves and their families.
“They’ve made a lot of personal sacrifices that the pandemic has demanded of them to make sure the system keeps functioning.
“My message to the community, as always, is take care of yourself. Be as healthy as you can be and if you feel unwell, make sure you are talking to your family physician or visit a walk-in clinic. Not delaying the care until the illness progresses to the point where you require hospitalization.”
“We’re not unique, all other emergency departments have very high volumes and I think it is going to be a challenge into the summer months and for the unforeseeable future.
“Hospitals are having to adjust their services based on the staff that are not available. Whether that’s closing ORs (operating rooms), emergency departments closing and obstetrics is also a service that has been at risk.
“My message to the community, as always, is take care of yourself. Be as healthy as you can be and if you feel unwell, make sure you are talking to your family physician or visit a walk-in clinic.
“Not delaying the care until the illness progresses to the point where you require hospitalization.”
As to when a visit to the emergency department is necessary, remember there are no hard and fast rules.
Davies noted if your needs are non-urgent, consider other health system supports such as primary care providers, urgent care centres or Health Connect Ontario.
However, in emergencies call 911 so responders can start immediate care and transport individuals to the best location for continued care.
Above all, concluded Davies, “We are not discouraging anyone from seeking care.”
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THE ANNEX: DEDICATED TO HOPE AND FREEDOM
The announcement of an addictions resource centre to be launched in St. Thomas came at the seventh-anniversary celebration of The Grace Cafe at the very end of last year.
Founder and CEO Ginny Trepanier explained the idea for such a centre was sparked over dinner with her husband, Don, who has worked in the addictions treatment field for more than two decades.
Well, almost six months to the day, The Annex officially opened right next door to The Grace Annex.
And literally in the first hour after it opened its doors on June 20, an individual walked in seeking advice on addictions.
It’s a comfortable setting dedicated to hope and freedom, open Monday through Friday from 8:30 a.m. until noon.
Don Trepanier explained it will operate as a pilot project in the first year.
“We’ve got funding for a year, probably 99 per cent we’re going to be going through the next step which is having everybody be here to a full-time job and we’ll start employing volunteers and so it’s going to become a very integrated project.
“An outreach for the community and to the community from the cafe.”
Don has worked for many years at Teen Challenge Canada, where he is a chief program officer.
“I’m a trained counsellor seeing the rising level of people caught in addiction in St. Thomas has gripped our hearts.”
“We want to be a lot more active, more interventionist. We want to be a compassionate ear to people. We want to urge and nudge them slowly to take whatever steps they’re willing to take to get out of addiction.”
Don stressed the centre, along with the other services available, will facilitate recovery treatment opportunities.
“Right now, there isn’t a whole lot of choice in St. Thomas. If you manage to think to yourself I need help and I want to get out of addiction and I want to go to rehab, well where do you go?
“You can maybe do that through your OW (Ontario Works) or ODSP (Ontario Disability Support Program) caseworker or through CMHA (Canadian Mental Health Association) addiction services now.”
It is estimated 21 per cent of the population will struggle with addiction at some point in their lives and Don indicated the addictions resource centre will work with clients in areas of withdrawal management and peer support.
“We want to be a lot more active, more interventionist. We want to be a compassionate ear to people. We want to urge and nudge them slowly to take whatever steps they’re willing to take to get out of addiction.”
The Annex initially has a staff of three, however, the hiring of a second community support worker is anticipated shortly.
Don makes it clear the centre received no government funding and relies solely on donations to operate.
“As a charity, we are dependent on donations and right now we are funded fully for a year.”
You can access the addictions resource centre at 519-896-0080, email don@thegracecafe.ca or drop in at 321 Talbot Street between 8:30 a.m. and noon, Monday through Friday.
TROUBLE AT THE INN
Earlier this week we received a copy of a letter sent to Mayor Joe Preston and Earl Taylor with the Downtown Development Board among others.
It was from Brad Beausoleil, who owns several properties in St. Thomas, including 6 Princess Avenue which is adjacent to The Inn, the city’s recently opened emergency shelter.
A neighbouring building to the north faces Talbot Street and has a number of commercial and residential tenants.
Beausoleil continues, “Due to the increased vandalism, damage, trespassing and general disgusting activity over the past six months, we feel it’s time for action.
“Our repair costs have now exceeded $5,000 as a direct result of The Inn and its residents.”
He shared some photos illustrating the damage sustained in the past few weeks.
Beausoleil continues, “A resident is seen on video being told to move from the location by staff. After five minutes, staff left and the man kicks a window and left.
“Police were called and reviewed the video. The Inn identified the man but said he was having a mental episode, he was not charged.”
Another photo depicts a typical evening in front of 6 Princess Avenue.
Beausoleil explains, “We have lots of video and pictures of this. We have lost the main floor tenant because we cannot keep the door unlocked.
“Both additional tenants are looking for other spaces. We will have an empty building due to the clients at The Inn.”
Other photos illustrate damage at 574 Talbot Street, the former home of Edward Jones financial services.
“Edward Jones paid to break their lease and moved because of The Inn. They were 16 years in that location and the building was known as the Edward Jones building.
“The new tenant is now threatening to leave because in three months he has had a window broken, ongoing graffiti and now the front gate has been broken. He resorted to plywood across the door.
“Two police reports from this tenant have been filed with no arrests.”
Beausoleil has photos of residents from The Inn loitering on his Princess Avenue property.
“A tax break or easily accessible grant from the city for security upgrades; cameras, lights, private security, bars, gates and fences. Something needs to happen now.”
He notes, that the tenant in this building “is a single mom with kids and does not feel safe going to her car. The police have been called half a dozen times but this is a daily occurrence.”
Beausoleil continues, “I understand there are some who need help to kick their addiction or get off the streets.
“However pamphlets like this one found in our front garden are not for those who want help, it’s for those who think they enjoy their lifestyle.”
The pamphlet in question deals with safer crystal meth.
Beausoleil concludes, “The city owns the building that The Inn is in. Therefore the activities of its clients are the city’s responsibility.
“Similar to a bar owner who allows a drunk patron to drive home; if they kill someone the owner of the establishment is also liable. If I, as a landlord, lease space to someone who allows illegal activity I would be responsible.
“Clients cook meth inside the wood enclosure, there is solicitation offers constantly, damage, graffiti etc.
“I notice the city steps are kept very clear of this type of activity, so saying ‘it’s public property and what can I do’ does not cut it.
“The Inn needs to move to a less convenient location. Those who want help will find a way there. Those who don’t want help will find another place to conduct their illegal activities . . . not at the main four corners of the city, which once was the nicest building in town.
“Twenty-four-hour security for the entire block is a must, security that engages verbally with the offenders and calls the police. I have watched the security guard stand and look from the sidewalk but do nothing.
“Compensation for businesses that have lost is a must. Like I mentioned, we have spent approximately $5,000 in repairs, lost two long-term tenants and are at risk of losing a lot more.
“A tax break or easily accessible grant from the city for security upgrades; cameras, lights, private security, bars, gates and fences.
“Something needs to happen now. Thank you for your time and respectfully request your print attention to these matters.”
We will follow up with Beausoleil and understand the matter will come before council at this month’s meeting.
HERE’S YOUR UPDATED LINEUP
Add Steve Wookey to the growing list of current city councillors who are seeking re-election in the fall municipal vote.
Wookey lost out to Joe Preston in the 2018 mayoral campaign but returned to council in March of 2020 when he was appointed to fill the vacant seat upon the death of Linda Stevenson.
To date, only councillors Joan Rymal and Mark Burgess have yet to declare their intention.
A ponderable matter is whether Heather Jackson will mount a bid to return to the council chamber after her unsuccessful run last month to represent Elgin-Middlesex-London under the Liberal banner at Queen’s Park.
She too lost to Preston in 2018 but finished more than 200 votes ahead of third-place finisher Wookey.
Ian's City Scope 