‘Watching the Titanic sink’
Provincial health-care professionals frustrated and helpless
In mid-april, Heather Walshgagnon woke up to a message from her sister: “I think I’m dying.”
Walsh-gagnon is desperately worried about her sister, Charmaine Meaney of Bishop’s Cove. But Meaney’s deteriorating health wasn’t a sudden shock that forced her into action.
For Walsh-gagnon, it was the straw that broke the camel’s back.
Shortly after their mother, Claire Joy Walsh — a nurse for 30 years and one of the founding members of the Registered Nurses Union in the province — died in late 2020, Meaney’s health issues began.
“My mom went to emergency during COVID and was turned away twice,” Walshgagnon said. “And then, they discovered in October that (Mom) had a huge, massive tumour in her abdomen. (She was) diagnosed in October and died in November of 2020.”
On the heels of that loss, Meaney was diagnosed with acute severe rheumatoid arthritis.
“I’m seriously worried that my sister is going to die in her bed if somebody doesn’t take responsibility here,” she said on the telephone from her home in Windsor, Ont.
“I’m not just saying that as a quip. I’m saying that because I really am worried that my sister is going to die.”
Arthritis pain causes Meaney to be bedridden for long periods of time.
This, in turn, made an ongoing issue with diverticulitis (according to the Mayo Clinic, this occurs when small, bulging pouches develop in the digestive tract) developing into a fistula (an abnormal opening or passage between two organs or between an organ and the surface of the body, according to the United States National Cancer Institute) between her bowel and vagina.
“So now, the fistula has grown into the bladder. And I mean, that’s a hole. There’s a hole between her bowel and vagina, and now a hole between her bowel and bladder. You can imagine the infections that she’s constantly having, urinary tract infections, and that’s really painful,” Walsh-gagnon said.
“It’s not nice to talk about, but she’s living with this every single day and nobody seems to be doing anything. … I understand the health-care system is overloaded everywhere right across Canada. COVID has increased demand. But for goodness sake, there are people out there who will work. Hire some more staff.”
That morning in April when her sister sent what she thought might be one of her last messages, she was lying on the bathroom floor. She had managed to crawl there from her bed, but was unable to lift herself onto the toilet.
That’s when Walsh-gagnon sent letters to the provincial government and the Prime Minister’s Office.
The issue is still unresolved.
‘WATCHING THE TITANIC SINK’
The past couple of years have been “tremendously challenging” for those in clinical medicine, but it was an uphill battle before the COVID-19 pandemic, Dr. Susan Macdonald said in a telephone interview.
“The writing was on the wall 20 years ago that we were going to have this crisis of just not enough bodies to do the work,” said Macdonald, who works in palliative care. “I think every clinician who has patients who have been waiting for treatment, or investigations, has struggled along with their patients.
“It makes you go home at the end of the day feeling frustrated and helpless.”
To know an otherwise healthy and fit patient might be unable to work for two years while they wait for orthopedic surgery, for example, kills you, Macdonald said.
“That patient has got a family that relies on them working. The chronic pain from that puts them at risk for self-medicating with alcohol or other drugs. They could potentially get hooked on painkillers. And it is mentally very unhealthy not to be a productive member of society,” she said.
As the president of the Newfoundland and Labrador Medical Association (NLMA), Macdonald has been advocating on behalf of her profession.
But the government has a different perspective than those on the frontlines.
“It’s in our face every day with people not being able to get their treatments or not being able to go for their mammogram or waiting for the surgery,” she said.
“We have to deal with the emotional fallout from that on a daily basis, but the government is a little bit removed from that. And perhaps it’s more numbers to them, rather than individual people.”
Health Minister Dr. John Haggie tends to talk positives, she said, rather than directly indicate where the crises are.
“You can’t fix something that you don’t acknowledge,” she said.
This is why the NLMA has been pressing the government to create a public dashboard to show the number of people awaiting surgery, so the public can see when there are improvements and slowdowns.
“Every person in this province who pays taxes, they pay for health care. They have a vested interest as a taxpayer in knowing how well the system is working,” she said.
Though Macdonald said the number is likely higher now, the most recent data from April 12 says 6,797 people were waiting for surgery.
“That’s 6,797 people and they all have families and loved ones,” she said. “These are people and they’re suffering and they deserve better care.
“It’s like standing on the shore and watching the Titanic sink. And you’re hearing the screams of the people as they go down and you can’t reach them. That’s what it’s like.”
COVID’S OTHER TRAGEDIES
A day before a scheduled medical appointment in March 2021, Linda Hennebury’s daughter, Bobbi-lynn Hennebury, died at the age of 46.
Four years previously, it was discovered Bobbi-lynn had a torn esophagus, a lump on her bowel and a lump on a rib.
A plan was put in place for regular check-ups and, if anything got worse, an emergency operation would be performed. But five appointments were deferred because of the COVID-19 pandemic.
Though the lumps weren’t cancerous, they proved to be fatal.
“As she got worse, the pain got worse,” Hennebury said. “The swelling would start three or four o’clock in the evening and was like (someone who was) pregnant.”
Last time they had checked, the lumps were the size of marbles. But when Hennebury asked the proctologist after her daughter’s death, they were the size of grapefruits.
“Her bowel burst with peritonitis,” Hennebury said. “She had a massive heart attack immediately.”
According to Johns Hopkins, peritonitis is an inflammation of the tissue that lines the belly or abdomen. Bacteria can enter the lining of the belly from a hole in the gastrointestinal tract.
Though the medical issues differ, Hennebury said she has heard from more than a dozen other people across the province with similar stories.
“It’s definitely the government’s fault and it’s definitely COVID’S fault,” she said. “And this is what happened, if they didn’t have COVID, they died because they didn’t get attention.
“I know nurses are all overworked and everything. But there’s a shortage of nurses anyway. They say there’s no beds. But there’s beds, there’s no staff. They need to cut back on something else and pay the nurses.”
A light thud accompanies the word “pay,” as her hand hits the table.
‘THINGS HAVE FALLEN OFF THE RAILS’
Addressing the backlog of surgeries means putting more pressure on people already on the brink, says Yvette Coffey, president of the Registered Nurses Union (RNU).
“We have nurses now who are going to work, they’re taking a change of clothes, meals for the next day if they’re in for a night shift, because they have no idea if they’re getting home in the morning after doing a 12-hour night,” she said.
“And a lot of times, it’s leading to 16-, 20-, 24-hour shifts, or they’re in there working short (of staff).”
It’s not just a shortage of registered nurses, she said, but licensed practical nurses (LPN), personal care assistants (PCA), psychologists, social workers, respiratory therapists and physicians.
“The list goes on and on,” she said. “It’s everywhere.”
The past two years have done no one any favours, the public and health-care workers alike, she said.
“We’re all consumers of the health-care system,” Coffey said. “We’ve all had procedures and appointments cancelled, postponed. And for sure, people have fallen through the cracks waiting for diagnostic tests and surgeries that would have been routine but are now considered urgent or emergent.
“Our hearts go out to the public. … There are beds. We just don’t have the personnel available to care for them.”
In her 32 years as a nurse, there have always been challenges, but things have fallen off the rails, she said.
‘TOP OF MIND FOR THE LAST TWO YEARS’
Regarding an online dashboard displaying the number of backlogged surgeries, Health Minister Dr. John Haggie said, discussions between the government and the NLMA have led to a commitment to “clean up the data.”
“At the moment, what we have is some numbers. What we need to do, for a whole variety of reasons, is to identify those numbers as names, as procedures, as time waiting and priority,” Haggie said.
“That process will actually then allow us to make sure that the information that we’re working on is agreed and common to all.”
There’s no doubt the current situation has been very distressing for families, Haggie said, but he would argue with the perception that people are not being cared about.
“We knew that by having to close down certain elements of regular planned care that there was a problem with that,” he said.
“It wasn’t something that was done lightly. But it wasn’t all about reallocation of resources, it was about protecting the hospital beds and making sure they were available for people who could not wait because they were acutely ill with COVID.”
It’s been top of the mind for two years, he said.
“It’s probably not comfort to anybody in this province, but I think it’s fair to point out that at a federal, provincial, territorial meeting recently, when provinces compare notes, whilst we’re all in this storm together with wait lists, our boat is nowhere near as leaky as the others,” he said.
“This is nothing new across the country. It’s affected everywhere. But we have managed to keep a basic level of emergency surgery, emergency procedures being done, and also some cancer care at the surgical level. And the chemotherapy had never stopped until the cyber-attack. And similarly with radiation treatment.”
Families who have been adversely affected by delays regard this as a crisis, Haggie said.
“(But) at some point, we have to make (the province) an attractive place to come and work. We are in a good position to do that. But if all people hear is the negative, who on Earth leaving medical school or a residency program or graduating as an RN or an LPN is going to think about staying?” Haggie said.
“And, quite frankly, we are better off than other provinces. The other man’s grass is always greener because there’s a bit more fertilizer on it.”
On May 2, the Department of Health and Community Services announced the provincial government and the College of Family Physicians are working together on the retention and recruitment of all healthcare professionals, led by Dr. Megan Hayes as the assistant deputy minister of health professional recruitment and retention.
In a meeting with the NLMA, which included several surgeons, they agreed to “convene a group or task force … that would put surgeons and departmental staff and regional health authority personnel in the same room” to work toward solutions, Haggie said.
As well, the federal government recently announced an additional $27.7 million to the province, which the task force can utilize once it has a plan in place.