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YORK HOSPITAL CRISIS YCHs space race has four years to go By TERRY CARTER Era editor NEWMARKET What happens when a community must depend on one of the busiest and most seriously overcrowded hospitals in the province and probably in all Canada for its medical care If you dont know look around you because you and your neighbors are in that situation- York County Hospital probably has more patients in and out its doors in a year than any other hospital of comparable size in Ontario and it seldom has an empty bed However the hospital over- ITT cant be out by It am when their crowding its waiting lists and its beds needeJ jammed facilities havent caused It a continuous cycle and any deterioration the standard the active surgical of patient care yet say hospital of- me floors Not a 24hour They have meant patients are in and out of the hospital a lot faster than they used to be Recuperation simply must be handled by the patient and his family at home Hospital beds in Newmarket are too urgently need ed for the very sick to keep them oc cupied by people well on the road to They have also meant more doctors and nurses per patient better nursing care than ever more expen sive and complex equipment available new techniques to speed recovery and of medication EMERGENCIES NEVER TURNED AWAY There is one thing that does not happen emergency cases are never turned away at the door because there is no room No matter how crowded the hospital always urgent patients to co as necessary quickly iod goes by with an empty bed she and then find a bedroom in the morning FAST TURNOVER HELPS PATIENT Surprisingly the faster turn over seems to be working to the pa tients advantage say senior staff members at the hospital Mrs Hope McKinnon Assistant Director of Nursing said experience is proving that the faster a patient be comes ambulatory the fewer compli cations he is likely to suffer She add ed that the hospital is also finding out that people on the road to recovery bed get batter faster at homo where they fewer d are in familiar surroundings and can get the kind of care only a family i bed people not classed by urgent cases a per- hernia operation for ay find he has to wait ven eight months to get The space shortage of course causes a multitude of other problems some just irritating for both slaff and patients The wailing room in the emer gency ward is nearly always crowded there is usually a long lineup of peo ple waiting outside the Xray depart ment patients find themselves being shifted from one room or one bed to another more frequently than in other hospitals where the staff doesnt have to be continually rearranging to make an empty bed and the hospital staff is under a continual pressure not found in most other hospitals York County Hospital serves the area from Sutton to Aurora and from Bradford to and the sta tistics show that it provides this area with 25 hospital beds per thousand persons The provincial average is beds per thousand Although the 254bed hospital has had a 153pIus bed addition on the drawing boards since 1 imposed delays have meant it wont be started until 1972 or be ready until at the earliest hospital board chairman C E Boyd said recently The bed shortage at Is Il lustrated by a Dominion Bureau of statistics surrey of Ontario hospi tals of over beds which showed that In both the first and second quar ters of this year York County pa tients had shorter average stays fa MUST GET OUT Our medical and surgery floors are always full A lot of people cant understand why they cant stay an other day or two said Mrs Jean Maunsell Director of Nursing We must limit their time Where a doctor feels a patient is physically fit we must get him out She said the hospital trys to get patients checked out by am be cause new patients come in between am and pm If we dont have the beds then we have to cancel a patient coming in she said Mrs Maunsell said Toronto has- pitals charge an extra 4day for pa tients who stay after am but we havent had to do that yet although she said some patients might find themselves sitting in the lobby if they can give Mrs Maunsell said patient turn over on the surgical and medical floors is down to an average sevenday stay per patient She said a lot hospitals average 12 to 14 days It means we dont have the convalescent patients on the floor all our patients are sick so were really busy she said The nursing staff seems to thrive on the pressure Staff turnover has dropped from to in the last four or five years It makes their jobs interesting said Mrs Maunsell but they do have to cope with a lot of tension In fact esprit de corps on the whole hospital staff is high and the only trepidation felt by many staff members about the new wing is that it might make the hospital so large it will lose its personal touch BIGGEST STAFF The DBS survey showed the oth er side of the coin too York Coun ty Hospital has one of the biggest and the province to adopt the pant suit the busiest in the province statistics indicate The nearly always full and because patients stay at YCH most other hospitals they require mure attention while seems a busy nurse is happy nurse Morale is high and dropped from to 25 during the past five years centre and Fran Headman check a Gloria Duncan hurries by there However it staff turnover has dropped from 60 Above head nurse roster in search of an empty bed as best medical staffs in the province The hospital has over doc tors on slnff much more than other hospitals of comparable size said as sistant hospital administrator David Hart The survey indicated that the Newmarket hospital gives patients a lot more hours of nursing care than most of the other hospitals it gave more nursing care than any of the other hospitals in the first quar ter of 1970 and was rated fifth in the second quarter the last two periods figures are available for We are wellstaffed in nursing both in quality and numbers said Mrs Maunsell the departments di She said the hospital has a ratio of professional nursing staff to professional Thats the ratio most hospitals arc striving for she said Sonic large hospitals go as low 20 It makes for higher standards lies ahead a volume cent in the first and theres fur at least four of the hospital show ie as high as per nine months of this period last year hope of more space The crisis has prompted the hos pital board to consider renting tem porary facilities in another part of No matter how crowded the may he an emergency on York County Hospitals staff claims the majority of said arent true emergencies Above Newmarket ambulance bring in a patient while nurse Jan Stiles and orderly Bill Annan lever be turned away However one doctor ward patients are abusing the service He rivers Hill Brown left and inch Chester and by Robert White Photos How can you help NEWMARKET How can you help ease the strain at York County Hospital One way says Dr J Hecking of Bradford is dont abuse the hospital emergency ward Dr Hecking who was on call in the ward at the time said of the cases coming into the ward are not real emergencies Unjustified use is the greatest problem we have It a lot of our time and a lot of our money he said He gave what he termed a classic example of this abuse About 1 am on a recent Saturday a very casually dressed girl with long hair and love beads came in She had cut her foot on glass at a beach five days earlier but the cut was not a bad one doctor in had put adhesive on it and sent her on her way The dressing had come lose and she had arrived at the ward to demand that you put another We simply cant emphasis too strongly that people call their doctors before calling us if they possibly can said Mrs Howard Morton who heads the department We must also get across to people that need to learn some basic first aid she said Mrs Morton said a lot of blood doesnt always mean two fingers have been cut off or something like that She said often a little pressure to stop the bleeding and a little water to wash off the blood is all that unit for instance the whole staff are professional people A lot of hospitals have registered nursing assistants in We feel we need professional staff here to keep our standards up Other patient services lab work Xrays administration of medi cations also showed a more inten sive application at than at most of the other hospitals included in the WHAT LIES AHEAD The most alarming thing about the hospitals crowded condition is not whats happening now but what town and moving some of its depart ments said board chairman C E Boyd During that ninemonth period of adult and child admissions for instance jumped 138 over the same period last year reaching a to tal of On top of that 991 new babies entered the world at YCH 318 more than during the January to September period last year Outpatient visits hit an alltime ninemonth high of 253 above last year There were 10622 operations performed at the hospital during that period an hike 17705 emer gency treatments 27847 Xray examinations 109 1831393 lab tests 275 treatments and occupa tional theraphy treatments 87 If the community continues to increase the pressure on its hospital facilities at this rate during the next four years how will the hospital cope Hospital officials dont even try to answer that one They just look at their bursting facilities and hope For instance they point out there is only one small room with one bed in it available for blood tests electrocardiograms and echo grams a method of testing for brain the same four small rooms in the Xray department that were serv ing an average of 6570 patients a day in the summer of looked after an average a day last summer Result longer delays for patients an inability to add needed staff because theres no place to put new people and everincreasing pressure on the existing slaff Stephen Jackson who heads the hospitals Xray department explains that two of the departments four ex amination rooms must be used for gastric patients and one of the re maining two rooms fitted with two tab les for kidney Xrays We are left with the fourth room for all general radiography In cluding emergency cases Since the fourth room also has photoliming equipment for chest work and a spe cial device used for tomography or depth Xray all these types of ex aminations have to be done in this one the nursery which is equipped the sixth floor psychiatric unit always has its beds full has a lot of outpatients coming in for day care and a long waiting list on some days operations must be cancelled because there in the hospital extra staff the maternity beds left in which to place postoper ative patients When this happened one day re cently a worried assistant adminis trator David Hart said if we had a bad accident or something tonight eight or nine injured come in I just dont know what we would do with He said he would probably have to move other patients out into the halls to make space for the Injured Beds in the halls are something weve avoided up to now he said some days it is necessary to give general in the emer gency ward We certainly try not to said Mrs We try to only use emergency ward for small operations that require local anaethetics because it only has three holding beds If those were full and an acci dent came in it would be ing she said or maternity at one time This must be brought the emergency ward must double up on room utilization tfle fracture room is also used for nose and throat examinations recovery rooms arc sometimes used to put sutures in This emergency ward has just grown like topsy said Mrs Howard Morton who Is head of the ward It was originally planned as just an em ergency ward Now because of the room shortage we do minor proce dures operations for instance This means people who must come into the hospital have a minor operation perhaps a small cyst re moved stay in a recovery room a couple of hours then go home are handled as emergency cases WHAT CAUSED IT How did we wind up with the hospital bed crisis in Ontario Things started to look serious in the mid 60s and in the hospital board began thinking of a new wing Planning a lengthy process for a hos pital started early in but in January when things were well along the Ontario government ordered a freeze on all hospital plans as an emergency move The freeze was partially lifted about a year later The province said go ahead with feasibility studies which tied us up in knots for about 10 months said hospital administra tor At They still kept us in limbo he Mr Roeder said the hospital didnt really get the goahead to pro ceed with a particular building pro gram until this September By then the old plans were not only outofdate but completely out of the picture In terms of cost STARTED OVER Planning had to be started all over again Meanwhile costs on the 913 million project were rising at the rate of a month The new plans will give YCH a total of beds but they have square feet less in floor space in them than the old ones did The new addition however will still favor services said Mr Roeder In fact expansion of services will take up a greater proportion of the addition than the bed expansion A expansion because weve been getting by with limited fa cilities for so Jong we Just cant con tinue any more Were having trouble servicing the beds we have with the activity and care were providing he said The real test is whether York County Hospital can weather the storm during the next four years while it is waiting for its new addition to open And the real question is why has the province allowed the crisis to develop these proportions