Alberta doctors raise alarm on specialist staff shortages in intensive care wards
By Dean Bennett
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 in an email.
“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.
The medical association added its voice to the lockdown call Monday.
“This is an immediate problem that needs to be acted on. We are on the edge of a very dangerous cliff, one that will see physicians and other health-care workers making decisions on who does and does not receive care if case numbers continue on this path,” president Dr. Paul Boucher said in a news release.
Alberta Premier Jason Kenney, in a weekend radio interview, 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, other gifts 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.
Opposition NDP Leader Rachel Notley said it’s time to partner with community groups and health-care professionals to go door to door and help those who are not vaccinated due to health or work concerns or a language barrier.
Those groups could be “having conversations and offering Alberta vaccines right there on people’s doorsteps,” Notley said in Calgary.