It’s only a matter of time

That’s what the last line of a recent letter to the editor of a local newspaper claimed a few days ago when expressing concern about the shortage of registered nurses in BC hospitals:”It is only a matter of time before there is a major crisis….”

It would be easy to dismiss the lament as just another complaint by a disgruntled nurse or nurse sympathizer. Easy, but unwise. As a recent short-term guest of Victoria General my 36-hour stay from operating theatre to “you can go home now” hardly qualifies me as an expert on major hospital staffing requirements. But it was long enough to give me a brief inside look at the pressures faced by those from whom we expect unstinting TLC when human frailty overtakes us.

It was long enough for me to understand that I was not the only patient in that large institution being monitored throughout a long night to make sure nothing bad was happening to my old body. While I was wandering in and out of the shadows of sleep the night-watch nurses kept vigil, not just on me but on every other person seeking comfort and care and lucky enough to have found a hospital bed.

It is figured that on average three registered nurses assisted by one care aide are responsible for the care of 24 or 26  patients. Among the patients will be a few like me ambling slowly to full recovery after relatively minor surgery, and a few seriously ill who can require urgent emergency care at any time, night or day. If three patients decide to take a turn for the worse at the same time, three on duty nurses would be hard pressed to meet the standards of care patients have come to expect – and nurses are trained to give and do, all too often under considerable stress..

It was that stress that could one day lead to the crisis and system breakdown the letter writer warned about.

Dare I suggest a breakdown crisis looms even larger that the letter writer suggests? We are told a major ‘quake will happen; that it is not an “if” but a when. We are also told, and conduct drills to prove it, that when it happens our emergency services and hospitals will be geared to handle it.

I wonder – and I’m sure hard pressed duty nurses must wonder – how they could possibly handle the instant influx of hundreds, maybe thousands, of injured, many seriously, if THE BIG ONE is as big as expected.

And I wonder, if total effort is turned to handle those stricken by natural disaster, what happens to those among us  struggling with more mundane, “ordinary”, weaknesses of the flesh that already jam our emergency wards?

What happens to wait lists for major surgery? What happens to the keeping of clinical records? What happens to routine laboratory tests now so casually ordered and taken? Will everything now happening day to day be put on hold until we can once again get back to normal?

USA President J.F.Kennedy once famously said “ask not what your country can do for you – ask what you can do for your country.” Maybe it’s time for a paraphrase to suggest our emergency care providers ask not if the people are ready for the big one, but if they are.

They could start by asking hospital workers for their thoughts on where health care will be in the days and months following the Big One.


  1. Recently I have read letters to the Editor of the Times Colonist submitted by Nurses who are not the union leaders but just ones dedicated professional asking the same questions to the new method of care. The one I saw today was lovely, have the senior management do a night shift. One of the points raised why are our annual 120 Nurse graduates having to look elsewhere .
    To your point , we are the hub for major ferries and flights and an alternative airport so all we need is one flight having a mishap and 200 + folks needing attention or a ferry accident or a major illness breaking out on one of these travel methods.
    We do not need to wait for an earth quake to test our readiness. Something else will

  2. Some years ago, the closure of the Malahat when a propane tanker crashed, prevented a number of nurses who lived North of that incident from getting to work for their shift. Calls from VIHA persons asked what the City of Langford was doing about it. Obviously none of the VIHA emergency planners had considered this. They were told to take the Mill Bay ferry and to ask for priority boarding.

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