Most days at Manitoba's largest hospital are 'morally grating,' says ER nurse at HSC

CBC

11-02-2025

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At a triage counter in Winnipeg's Health Sciences Centre, a nurse watched as the emergency room at Manitoba's largest health-care facility — understaffed and packed to the brim — unravelled in "12 solid hours of chaos," she says.
Some patients were drinking in the waiting room and others were consuming drugs in the washroom, while at the triage desk, three of the five nurses held down the fort without moving or taking any breaks, the nurse told Marcy Markusa, host of CBC Manitoba's Information Radio.
CBC News is not identifying her over concerns she might lose her job for speaking out.
That Wednesday shift in November was one of their worst days in the ER recently, said the nurse, who has been at HSC for decades.
But it's not far from the reality faced by front-line workers almost daily: a shortage of staff and not enough beds adding up to bedlam that worsens when it's cold outside and people come in to get warm, she said.
"I just feel like we're pushed, we're stressed. There's too many people and not enough of us," she said. "We need to be heard.… We're the province's hospital and it's really sad what's going on in our department."
The length of stay in the ER and the wait to see a doctor need to be better, she said.
"We need to do better. It's morally grating to be at work most days."
The nurse is among the first medical staff patients meet at the ER.
The emergency department is meant to provide temporary care, with patients seen by a doctor based on the level of urgency, then moved to other wards if a longer stay is needed.
But with a backlog of patients filling hospital beds, those admitted to HSC are sometimes discharged from the ER before a spot for them opens, the nurse said.
"[The ER] is now a holding zone, a personal care home," she said.
At some of the busiest times, there can be 60 people waiting inside the emergency department, the nurse said, and another 12 to 15 patients staying in the ambulance hallway.
"There's nowhere to put them. They stay with us."
Recently, a patient recovering from a stroke waited for a bed for about 310 hours, or more than 12 days, the nurse said.
"[It] is absolutely shameful," Manitoba Nurses Union president Darlene Jackson said. "It is not unusual for nurses and emergency departments around this province to say we had a patient wait for 110 hours … 200 hours."
"That is a long time to be laying in the hallway on a stretcher with no oxygen, no suction and no quick access to a bathroom. It is terrible."
Some wings at HSC could be used to admit patients but are unoccupied because there is not enough personnel to staff them, the nurse said.
Hospitals across Manitoba are facing similar challenges, Jackson said.
The nurse said the situation has worsened since 2018, when the provincial government was in the process of closing half the city's emergency departments in a controversial effort to cut wait times in Winnipeg's health-care system.
Since the ERs at Victoria, Concordia and Seven Oaks hospitals became urgent care centres, the number of patients going to HSC has been "much amplified," she said.
Unlike emergency departments that are still open at St. Boniface and Grace hospitals, HSC can't turn patients away due to overcapacity, the nurse said.
The hospital is also the city's designated trauma centre.
The nurse said there's a saying among staff members: "All roads lead to HSC." But more recently, it feels as if "all flight paths, all streams and rivers" also end up in that ER, she said.
'It's a broken system'
"It's really hard to describe the world that I live in … the chaos. It's just the craziness of everything that's going on."
Shared Health said in an emailed statement Monday evening a number of steps have been taken that will help address capacity issues at the emergency department, including the addition of 140 acute care beds across the province — of which it said more than 50 are at the HSC — and the hiring of new front-line workers.
"Patient discharges have expanded from five to seven days per week," Shared Health said. "Primary care options on evenings and weekends have expanded, which includes the opening of extended hour clinics."
In early January, Chad Christopher Giffin, 49, died as he waited eight hours for care in the HSC emergency department. A provincial critical incident investigation into his death is in process.
The hospital has said he was triaged as a non-urgent patient, but his condition worsened and he was declared dead after he was taken to a resuscitation room.
"We talk about it like we're lucky that it doesn't happen every day," the nurse said.
"It's a broken system, and it's been broken for the majority of my nursing career."
The nurse was not on shift when Giffin died but said close calls are frequent, in particular with drug overdose-related cases.
"It's difficult to watch. It's difficult to be part of," she said.
Jackson said there have been more near misses than the public will ever know, given patient consumption of drugs or alcohol inside ERs is difficult to track when they are full and understaffed.
At the top of every hour, a list of patients waiting at HSC's ER prints out, and a community service worker is in charge of going through the room and checking on patients, the nurse said.
"[They are] the eyes and ears of the waiting room. If they're concerned about somebody, they come to us," the nurse said. "We work really closely with them, trying to figure out what's going on with all the people that are waiting."
But the chaotic environment, including incidents like fights, could lead to one person on the list being missed, the nurse said.
The ER has also become a place where people who are homeless seek shelter. They sometimes make up half or even three-quarters of patients waiting, the nurse said.
Once they get triaged, they have to be medically cleared before being referred to a shelter, even though nurses know they are likely only in the waiting room because it is cold outside.
"I know them. I know their names. I know their birthdays," the nurse said. "That's how many times I've seen them."
Shared Health said the province provided funding to fill five five full-time equivalent social worker positions at HSC in late 2023, which are able to help patients access resources, including shelters.
On the issue of security, the health authority said it's working to hire an additional 21 institutional safety officers, and also mentioned new artificial intelligence-powered weapon detection scanners which will be installed permanently this week.
"Security engaging with patients and visitors as they arrive and offering them the use of amnesty lockers if they need to … has led to increased use of our amnesty lockers and a reduced frequency of weapons being seized on our campus," it said.
"Shared Health has also taken on a number of initiatives to foster a healthy workplace environment and support the well-being of staff," including the launch of an online well-being hub, it said.
Manitoba's NDP government said it has hired 1,255 new health-care workers, including 418 nurses, since April.
"After years of losing nurses in Manitoba, we've … started to turn the corner," Premier Wab Kinew said on Friday.
But most shifts in the HSC emergency room still don't meet the baseline of 25 nurses, the nurse said, falling short by three or four nurses.
She invited the premier and Health Minister Uzoma Asagwara to come spend a day in the emergency room.
"You don't even have to talk to anybody," she said. "Have a seat in the waiting room."
Health-care workers need help from decision-makers, she said.