Patients needing emergency care are waiting for hours in some Ontario emergency rooms. Why?

Long hours in the waiting room are a longstanding issue throughout Canada

Outside view of Ajax Pickering Hospital in Durham Region. (Marva Trim /Toronto Observer) 

If you’ve ever spent hours in an emergency room, you’ve probably questioned what’s happening behind those double doors as you sit restless in the waiting room.

Although wait times in the emergency room are a longstanding issue in Ontario, the effect of the pandemic on fatigued hospital workers has exacerbated the problem.

Data from Health Quality Ontario (HQO), the provincial lead on the quality of care for Ontarians, shows that in December 2022, patients waited on average 1.8 hours for first assessment by the ER doctor, and low-urgency patients waited 2.9 hours. Back in December 2021, the average wait time was lower at an average of 1.7 hours for a first assessment.

“I can’t explain to you how bad it is. It’s a war zone out there, and people are barely making it through the day,” Angela Preocanin, first vice-president of Ontario’s Nursing Association (ONA), said in an interview.

Here’s what’s causing these waits.

What’s the process on arrival to the ER?

Once you enter into the emergency department there are a few steps to consider upon entry.

The provincial government’s website explains what to expect.

On arrival, the patient enters into triage where a nurse does an assessment to determine the level of urgency of treatment and what may be needed on a case by case basis. They will ask multiple questions and do pre-screening before you are sent to the waiting area.

Then, it becomes a waiting game to be called in to see a doctor. Emergency rooms use a severity scale so that more urgent patients get priority to see doctors, which may lead to longer waits for others.

The doctor will then call the patient into an assigned room and begin an assessment. Depending on the next steps, the patient will be sent home with a treatment plan, or admitted into the hospital. 

Are staffing levels part of the problem?

Without efficient staffing of nurses, doctors and health-care providers, the wait times in the ER may increase because there’s a higher patient-to-worker ratio.

The ONA, the provincial trade union that represents 60,000 registered nurses and allied health professionals, says a lack of nurses is part of the problem.

“Certainly the nursing shortage in Ontario is absolutely horrific,” Preocanin said. “It is the worst in Canada and it is part of the reason why we have such long waits …  coupling that with the shortage of other health care providers doesn’t help.”

She said that many of the nurses she hears from are “morally distressed” and don’t feel respected by the government who should “step up” in this climate of health-care distress.

“Our biggest problem is retaining the nurses we have,” she said.

What role does the COVID-19 pandemic play?

The pandemic added an additional strain onto the wait times in emergency rooms by bringing more patients in need of care.

“We have a tremendous nursing shortage that’s been exacerbated by COVID-19, absolutely,” said Michael Carter, a professor in the department of mechanical and industrial engineering at the University of Toronto.

“COVID has increased other respiratory diseases,” he said. “So people are showing up in the emergency department with all kinds of people, we’re getting larger volumes. We’re losing staff.”

And according to Preocanin, the pandemic pushed many nurses to the breaking point.

“It’s terribly tragic when people say to me, ‘I can’t do this anymore, I love nursing [but] I can’t do this anymore,'” she said. “That is really scary.”

About this article

Posted: Mar 27 2023 11:35 am
Filed under: News