Kamloops doctors have created a new advocacy committee to find an end to the constant crisis plaguing Royal Inland Hospital.
The committee will take physicians’ concerns to the public and advocate for more resources — not just for Royal Inland Hospital, but for the region, said Dr. Steven Rollheiser, president of the medical staff.
At the medical staff regular quarterly meeting Thursday night, the hospital’s capacity — or lack thereof — was the main topic of discussion.
“This hospital has been running overfull and overcapacity for so long we’re experiencing normalization of deviance. That is to say, if it got down to normal we wouldn’t know what to do with ourselves,” Rollheiser said Friday.
“We need more acute care beds and more long term chronic care beds. We need some focussed awareness on the part of the government that the physicians in this community are concerned about the care for their patients. It’s not just doctors here, it’s surrounding communities.”
Doctors have looked at Vernon where the community went above Interior Health and lobbied Victoria to fund new beds and staffing in its just-built surgical tower years ahead of schedule.
The need there isn’t as desperate as it is in Kamloops, as the Okanagan has three hospitals in close proximity, Rollheiser said.
When he came here more than 25 years ago, RIH had 440 beds, and the support beds in Merritt and Ashcroft. Now RIH has 224 beds serving a much larger population; Merritt’s services are diminished and Ashcroft doesn’t admit patients overnight.
While the hospital is getting a new clinical building and parkade, the surgical tower is at least seven years off — if it was started immediately, he said.
“There’s no one magic bullet solution to this.”
While all hospitals face spikes in patients in the normal course of a year, RIH is running between 110 and 135 per cent capacity all the time, he said.
“Every day we get calls for help, is there anybody you can discharge? We don’t even get excited about it unless we’re over 120 per cent,” he said.
“Everybody’s been working really hard to try and get the patients through these tough circumstances and it’s only a testament to everybody that we haven’t had a major disaster yet.”
Four code orange situations involving mass casualties have occurred at RIH in the past year, and it was only because they happened when things weren’t at a peak —or by “stupid luck” — that resources weren’t entirely overloaded, Rollheiser continued.
“We dodged that bullet four times in the last year,” he said.
“That’s the most critically in-your-face fear that we all have. But the day-to-day grumbling fear — we almost don’t notice it any more — is people will be harmed by not being able to be seen in a timely fashion.”
Surgeries are being cancelled and rebooked for later dates because there’s no room in the hospital; patients are admitted and put in hallways, in the post-op recovery room, orthopedic cast room.
Rollheiser credited administration for getting people into residential care beds, and creating programs to move them into Ponderosa Lodge.
There are also patients who don’t need a hospital bed but who can’t be safely sent home, he said.
RIH administrator Marg Brown said there is a program for those people that’s just started. In fact, three new programs are getting off the ground which could have some impact on RIH: Pathways to Home (where patients go to Ponderosa to get stronger), Home First (which provides support in their homes) and Breathe Well (for patients with chronic obstructive pulmonary disease).
She said the hospital has had a relentless pace for the past two and a half months.
“It has been absolutely challenging. All staff are working flat out, the physicians, the frontline staff, the managers, in order to continue to provide the services we need to for this community and the rest of TCS (Thompson Cariboo Shuswap).”
The latest bout of hospital congestion began in January, when several residential-care facilities had outbreaks and patients couldn’t be sent to them.
RIH hasn’t recovered from that backup, she said. Surgical patients continue to have their cases looked at and, depending on the day, postponed.
Brown said Interior Health has tried to provide support, but RIH hasn’t been able to catch its breath.
“Staff are tired. At every level, every kind of staff, doctors to housekeeping. . . . People are tired. They’re doing an incredible job,” she said.
“I would never accept this as being the norm. From my perspective, we’re continually trying different initiatives and different approaches because this should not be the norm.”
Rollheiser said doctors have half-heartedly joked about putting a tent in the parking lot to handle patients, or perhaps opening a Tim Hortons franchise on the hospital grounds.
Seriously, though, physicians are concerned about what happens when the strained conditions take their toll.
“Some of the physicians feel they’re being hung out to dry because when or if a patient is harmed, we’re the ones in the crosshairs.”
He said everyone is doing an admirable job, given the situation.
“I’m really proud of this hospital and all the people who work here. This hospital has always punched above its weight class,” he said.
“People do a darned good job here. We are so squeezed that I think there are some people who are very good at this job who say they just can’t keep doing this.”