Tag: patients

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News

Overcrowded emergency rooms pile on the pressure 

ER crisis puts stress on both patients and medical staff

Long wait times and overcrowded emergency rooms across Montreal are putting a strain onto an already overworked healthcare system, which has left some patients feeling as if they’re not receiving proper care.

According to Santé Montreal daily emergency room capacity reports, emergency rooms on last Thursday were running at an average of 129 per cent capacity, with some emergency rooms reporting rates as high as 179 per cent.

Doctors are feeling the effects of overfilled ERs. “It puts a pressure on us to work faster, because it’s scary to see the amount of people waiting increase,” said Dr. Guylaine Larose, an emergency pediatrician at the Centre Hospitalier Universitaire (CHU) Sainte-Justine. “There’s a significant risk of giving lower-quality care, which is not something that we like doing.”

“You’re always scared that patients who wait too long will worsen before you’re able to see them. It’s a big worry, for both doctors and nurses,” Larose added.

Patients are feeling the pressure as well. “What I really picked up on was a lack of bedside manner, which I think has a lot to do with how busy hospitals are right now,” said Megan Devoe, a Concordia student who was sent to the ER at the Centre Hospitalier de l’Université de Montréal (CHUM) after fainting due to low blood sugar. “They ran all these tests on me without telling me what they were doing or why they were doing it. It was really confusing and pretty disorienting.”

Devoe had her blood taken, on top of other tests, and was never given the results to any of them. Indeed, she was not given any discharge information or any way to contact the hospital for a checkup or the results of her tests. She recounts the hospital staff waking her up at 4 a.m. to ask her if she could walk. She was then asked to leave the hospital despite being unsure if she could.

“Wait times aren’t new, they are cyclical, and usually higher during the holidays and winter,” said Dr. Larose. “Increased traffic will happen when viral infections increase, usually in winter but for the past two years also during unusual moments. What we’re seeing this year is an increase in viral infections which has been especially high over the past two months.”

Devoe was kept in the hallway on a stretcher the entire time of her stay and had to ask multiple times for food or to be accompanied to the washroom. She believes her negative experience is due to the overcrowded ERs and thinks the “healthcare system is falling apart a little bit.”

Devoe’s experience is not unique. According to data from Santé Montréal, 214 patients were on stretchers for over 24 hours and 73 for over 48 hours last Thursday.

“Healthcare professionals, whether they be doctors or nurses, feel a lot of responsibility towards their patients,” said Dr. Larose. “With the rise in overcrowding in emergency rooms and the heightened risk of giving lower quality care, that responsibility is still there and adds to the level of stress. The patients who wait hours to see us have the patience of angels and many show us gratitude and wish us good luck. It’s incredibly touching.”

Graphic by: Le Lin @spicybaby.jpg

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News

Montreal’s first clinic for post-COVID complications opens to the public

Patients still experiencing symptoms after COVID-19 recovery will be thoroughly examined at the new facility

The city’s first post-COVID-19 clinic welcomed Montrealers with debilitating symptoms following their COVID-19 recovery, opening on Feb. 12. Located at the Montreal Clinical Research Institute (IRCM) in Plateau-Mont-Royal, the clinic primarily focuses on studying COVID-related complications, which often last several months.

Dr. Emilia Liana Falcone is the clinic’s director, having specialized in inflammatory complications even before the COVID-19 outbreak. She leads a multidisciplinary team of nurses, dieticians, cardiologists, neuropsychologists, and other consultants for post-COVID symptoms.

The IRCM researcher started to develop the clinic in April 2020, when Canada was experiencing the first wave of the pandemic.

“When I saw that there’s such an exuberant inflammatory response to COVID-19 — and that there will likely be long-term consequences of that — the idea of founding such a clinic came up, so we began the process,” said Dr. Falcone.

The facility is currently designed to accommodate up to 570 patients. Every person goes through an evaluation procedure that involves blood and saliva tests, liver and kidney checks, as well as pulmonary and cardiac function tests.

The COVID-19 evaluation clinic.

The clinic functions as a research and diagnostics facility rather than a hospital where all patients are treated on the premises. By collecting samples from patients, the clinic builds a biobank that fosters downstream research, which allows for more targeted treatments of each post-COVID complication.

“If there needs to be a quick intervention or if the situation is urgent, then we will treat the patient with the resources we have. However, our main goal is to complete a thorough assessment and then refer the patient to a proper specialist for further medical treatment,” Dr. Falcone explained.

Intense fatigue, shortness of breath, chest tightness, and insomnia are some of the common post-COVID symptoms the clinic has witnessed. Some patients also suffer from brain fog — they are unable to concentrate for months and even experience a certain degree of memory loss.

Other Montrealers have reported increased levels of anxiety after contracting COVID-19, as well as losing interest in hobbies and activities they used to really enjoy before the pandemic.

Dr. Falcone told The Concordian that “There’s also a possibility that our evaluation will uncover complications that don’t translate into symptoms right away, such as kidney failure or liver dysfunction. The patient might not feel the symptoms, but that’s something we could detect in the blood test.”

Those who contracted the coronavirus in recent months are more likely to feel these symptoms. However, according to Dr. Falcone, some patients still suffer from side effects almost a year after getting the virus.

The research institute aims to increase its capacity once more resources become available, since restructuring the IRCM’s entrance for the clinic already required significant financial commitment.

On Feb. 18, Quebec’s Health Minister Christian Dubé announced that the IRCM will receive a grant of $1.1 million for the clinic’s further development. The funding will be provided by Quebec’s Ministries of Health and Economics, as well as the Fonds de la recherche en santé du Québec.

“Fundamental health research is essential to meet the challenges we’re currently facing. Thanks to the projects such as that of the IRCM, we’re preparing Quebec’s response for the months and years to come,” stated the Minister of Economy and Innovation, Pierre Fitzgibbon, on Thursday.

Even with the current capacity, the clinic’s operations are a major step forward for Montreal’s fight against the pandemic. Post-COVID clinics are quite rare in the country, with only a handful located in Toronto, Vancouver, and Sherbrooke.

As for the future, Dr. Falcone expects fewer COVID-related complications once the vaccine becomes available for the general public. She added, “The approved vaccines already seem to be effective, so now the question is how well they will protect us from the recent variants of COVID-19.”

While vaccine developers are working on preventing the spread of COVID-19, the clinic has already begun researching the virus’ side effects to ensure a smoother recovery for the coronavirus’ survivors.

 

Photograph by Kit Mergaert

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Opinions

A prescription for the museum

Graphic by Ana Bilokin

Art therapy is a better way to approach mental health issues, not a trip to a museum

According to CNN, doctors in Scotland have been handing out “nature” prescriptions to patients with depression and high blood pressure amid evidence that spending time outdoors and getting in touch with nature helps ease symptoms. I personally do not find this difficult to believe, as someone who experiences anxiety and depression and has been treated for both. What I do find difficult to believe, however, is a prescription to the museum.

Montreal doctors, in partnership with the Museum of Fine Arts, will now give out “museum prescriptions,” citing the benefits of cultural experiences on mental health and wellness, according to Global News. I believe it’s important to first examine the evidence supporting the impact of art and nature on mental health. I am all for certain forms of nature therapy, though I hesitate to embrace museum therapy.

It may be beneficial to prescribe a patient with a trip to the museum to help them get through what they’re experiencing, until a proper diagnosis can be determined. However, I believe that immediately medicating when further examination is needed isn’t the best route, especially if other forms of treatment can help. If the symptoms are mild, or if used alongside other treatments in more severe cases, I think the suggestion of getting closer to nature holds merit.

A psychiatrist suggested I purchase a SAD lamp, which mimics natural light to help symptoms of seasonal and non-seasonal depression while I awaited further evaluation. I found this to be helpful. Maybe fresh air and real natural light can have similar or better effects, especially given the implied exercise. Exercise is known to increase blood flow and release endorphins, improving mental and physical health, sleep, appetite, libido and quality of life for people suffering from mild-to-moderate depression, ADHD and anxiety.

Doctor Diane Poirier representing Médecins Francophones du Canada in the Global News article said the study is a pilot project that involved the museum doing research on the benefits art has on mental health. The act of prescribing a trip to the museum is not art therapy given by a licensed art therapist. It’s also not nature exposure or physical activity, both of which have evidence that supports their effectiveness. Art therapy is supervised by professionals who have training to assist the patient, whereas a trip to the museum is self managed. Although I can’t say it isn’t effective, I think it’s important to not call it therapy, as unlike nature exposure or physical activity, it’s doesn’t have an immediate range of effects nor is it supervised by a professional.

Art therapy with an art therapist can have evidence-supported benefits, according to several studies. In my opinion, however, this doesn’t just entail sending patients to the Musée des Beaux Arts de Montréal (MBAM) to stare at some Renaissance paintings and stop feeling empty inside. Most kinds of therapy, such as cognitive-behavioural therapy (CBT) and art therapy are guided by professionals. Going outdoors is patient-managed, but there are observable physical effects to exercising and being outdoors. If the patient is offered other options but chooses museum therapy, so be it. I would still hope medical professionals suggest treatments that have more effectiveness first. It was not specified how doctors will determine whether a museum prescription is a good option, and when they will prescribe more effective treatments versus participation in this study.

I wonder what would happen if psychologists and therapists were accessible and covered by Medicare, given that waitlists for mental health services at the CLSC are terrible and resources at schools can vary based on demand. People suffering from depression are navigating a very difficult system and can spend a lot of time going back and forth until properly diagnosed. It may do patients a disservice if they do a study rather than be offered effective treatment, unless this is truly what the patients want.

Even if the museum trips work to an extent, art therapy itself has proven benefits. Therapy administered and followed by a professional is structured and effective, yet incredibly difficult to access. The museum therapy idea appears to be a way to mimic some of the results of art therapy without providing a patient access to a professional. The government needs to put more funding into mental health services. When everyone has a range of accessible options, they have better chances of hitting the mark.

Graphic by Ana Bilokin

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