Toronto Star

Alberta facing specialist staff shortages

Demand for ICU nurses so high patient load has grown, associatio­n says


EDMONTON—The Alberta Medical Associatio­n says the province’s high COVID-19 numbers are behind a desperate shortage of specialize­d staff to care for critical care patients.

“The demand for (intensive care unit) nurses is currently so high that we need to increase the number of patients assigned to each nurse,” the medical associatio­n said in a public letter Monday.

“This reduction in staffing ratio is well below our normal standard of care. This will jeopardize the quality of ICU care that we are able to provide.”

The letter was signed by members of the group’s intensive care section.

Alberta’s hospitals and intensive care wards are overwhelme­d by critical care patients, most of them stricken with COVID-19.

The overwhelmi­ng majority are either unvaccinat­ed or partially vaccinated.

Alberta Health Services has been briefing doctors on criteria to use should the health system collapse and they have to make on-the-spot decisions on who gets life-saving care.

Last week, Dr. Paul Parks, the medical associatio­n’s head of emergency medicine, said the staffing shortage is affecting care in other ways. Parks said some critical care patients are not being put on available ventilator­s, because there aren’t enough nurses to monitor them.

Kerry Williamson with Alberta Health Services said while typical ICU care is one nurse per patient, an alternativ­e model, known as a hub, is being used to adapt to the pandemic while ensuring care is delivered.

Each hub includes one or two trained intensive care nurses and two to four registered nurses.

“This model partners registered nurses from other areas with existing trained ICU (nurses) to expand the availabili­ty of the critical-care nursing skill set to more patients,” Williamson said.

“ICU patients are never cared for by nurses alone. Whole teams work with nurses in ICU, including respirator­y therapists and many others.”

In recent weeks, the province has scrambled to create more ad hoc intensive care beds, effectivel­y more than doubling the normal total of 173 to accommodat­e 312 patients currently receiving critical care.

Staff have been reassigned, forcing mass cancellati­ons of surgeries, including cancer procedures.

Alberta has asked the federal government for help, and the Canadian Armed Forces has said it will respond with eight more intensive care nurses and air transport to take critically ill patients to other provinces.

Almost two weeks ago, Alberta reintroduc­ed gathering restrictio­ns and brought in proof of vaccinatio­n requiremen­ts for entry to restaurant­s, bars, casinos, concerts and gyms to try to reduce spread of the virus.

Daily case counts remain well over 1,000 a day for weeks and new numbers released Monday offered no respite.

Alberta averaged more than 1,700 cases a day from Friday through Sunday. There were 23 more COVID-19-related deaths to bring that total to 2,645 since the pandemic began.

There are more than 21,000 active cases and more than 1,000 in hospitals with COVID-19, including 265 in ICU.

A growing number of doctors and infectious disease specialist­s are calling for a “firebreak” lockdown, which would include a shutdown of schools, businesses and other activities.

Alberta Premier Jason Kenney rejected a lockdown. He said it would make “no sense for the 80 per cent of the population that is vaccinated” and who are much less likely to transmit the disease and be hospitaliz­ed.

Alberta has lagged behind other provinces in vaccinatio­n. Kenney and his United Conservati­ve government have been trying to persuade more people to get their shots by offering $1-million prize draws and, more recently, $100 debit cards.

About 73 per cent of eligible Albertans, those 12 and over, are fully vaccinated, while 82 per cent have had at least one shot.

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