Nurse bullied, inquiry told.

Culture of intimidation sparked complaint, doctor tells inquiry

Dr. Paul Parks told a public inquiry into preferential health access on Wednesday that a senior administrator at the University of Alberta Hospital once called the emergency room in an attempt to obtain preferential treatment for a dignitary.

A physician at the hospital at the time, Parks said the senior administrator tried to bully a nurse in the emergency department into bumping the VIP ahead of sicker patients in an overcrowded waiting room on Nov. 27, 2007.

“The triage nurse told her there were lots of very sick patients in the waiting room and expressed that there was no way to move him up,” Parks told the inquiry before Justice John Vertes at the Shaw Conference Centre. “The tone of the executive she was speaking to became unfriendly.”

Parks, who complained about the attempt at queue jumping in an email to the hospital’s chief of emergency service, said he was not on duty when the incident occurred, but that it was indicative of a culture of intimidation that existed at the time.

The charge nurse received another angry call from the senior administrator a while later. “The gist was, ‘What in the heck are you guys doing down there?’ ” testified Parks, who is now chief emergency physician at the medical centre in Medicine Hat. “She wanted to know why he was still in the waiting area.”

Explaining the context of his email, Parks said he was exasperated because of overcrowded conditions in the emergency room. On the evening the incident occurred, 39 of 42 beds in the emergency department were occupied by non-emergency patients diverted there because there was nowhere else to put them. Doctors had complained to officials at Capital Health about how dangerous the situation had become, but to no avail, Parks said.

So, when the senior administrator called and tried to exert influence, “That was the piece that broke the camel’s back,” he said.

A lawyer for Alberta Health Services argued earlier that Parks should not be allowed to testify because the incident he described was hearsay and that witnesses could not be crossexamined to determine if the complaint was valid. Vertes disagreed, saying Dr. Brian Holroyd, the hospital’s chief of emergency medicine, was expected to corroborate the story.

Appearing later, Holroyd said emergency physicians complained to him several other times that the same senior administrator had tried to pressure them to allow dignitaries to jump the queue. The identity of the administrator was not revealed during proceedings, and her name was blacked out in court documents.

Holroyd thought the situation had become so untenable that he wrote a formal complaint letter to senior officials at the hospital on Dec. 5, 2007, asking that a review of the executive’s actions be undertaken. In 14 years of working at the hospital and for Capital Health, he had never encountered such a litany of concerns expressed by physicians and staff about an executive, Holroyd said.

“Our perception is that she demonstrated complete disregard for the care of other, more seriously ill patients in the emergency department and had no apparent concern for the compromise that might occur to the care of others in carrying out her directives,” Holroyd wrote in the complaint.

Holroyd said he was called to a meeting on April 9, 2008, attended by the senior administrator and the hospital’s vicepresident and chief operating officer (Debbie Gordon) and medical director (Dr. Dylan Taylor).

Holroyd said officials were upset that he had written a letter of complaint rather than discussed the matter privately with the administrator.

“Normally, I would try to talk to the individual, but in this case I felt it was important to raise the issue to my superiors and officials who run the hospital,” Holroyd said. “I spent a lot of time soul-searching, trying to determine what the best tack was, and felt I needed to advocate for the department in a formal manner.”

Neither Parks nor Holroyd was aware if the official was disciplined for her actions.

The inquiry will resume at 9:30 a.m. Thursday.

Both Parks and Holroyd said the situation has improved under the direction of Alberta Health Services, but that targets for treating emergency patients still are not being met.