If you’ve visited an emergency room in Providence recently, you may have noticed it seemed busier than usual.
Melissa Arruda works as a nurse at Rhode Island Hospital. She’s worked there for 13 years. And lately, she said, the emergency room is operating at capacity.
“The waiting room where patients walk in (is) standing room only,’’ Arruda said. “There are 15 stretchers lined up where the ambulances come in, in an area that really should only hold five.”
Sometimes, she said, Rhode Island Hospital’s ER runs out of stretchers. So she has to go looking for more just to get patients out of the ambulances.
When hospitals don’t have the space or staff to take more patients, they tell ambulance drivers to go to another emergency room. Hospital administrators call these diversions. And at Rhode Island Hospital, the number of hours on diversion rose 80 percent from January through July compared with the same seven-month period in 2017, according to state health department data.
Arruda said nurses in the emergency room feel the surge in patients hours before the hospital starts diverting ambulances. She described the situation as “utter chaos.”
Nurses and other union workers at Rhode Island Hospital and another Lifespan hospital, Hasbro Children’s Hospital, are expected to begin a three-day strike Monday, after rejecting a contract offer from Lifespan. The dispute includes staffing levels and wages.
At The Miriam Hospital, in Providence, diversion hours have increased more than 200 percent during the first seven months of this year, compared with the same period in 2017, according to state health department data.
Last June, a Providence resident named Ellen brought her college-aged daughter into Miriam’s emergency room. (We’re not using her full name to protect her privacy.)
“There was no place to sit in the emergency room, so they had set up chairs in the corridor, right outside the emergency room, for people,’’ she said. “And those chairs were almost completely full as well.”
Ellen said she and her daughter waited 2 ½ hours sitting in the hallway, only briefly seeing an intake nurse.
“Finally I asked the nurse at the triage desk what kind of wait time where we looking at,’’ she said. “Doing the math, the nurse and I calculated it was going to be four or maybe more hours.”
She decided to leave and bring her daughter to see her primary care doctor the next day.
Lifespan operates The Miriam and Rhode Island Hospital. The company said in a statement that both hospitals have had to care for more patients since the closing of Memorial Hospital in Pawtucket last year.
The presidents of The Miriam and Rhode Island Hospitals, as well as several state lawmakers, testified about the impact of Memorial’s closing on emergency department patient volume at the two hospitals during public hearings held by the state Department of Health.
The Miriam, in particular, has felt the strain, according to Lifespan. Lifespan said it has increased staffing levels and added a 10-bed unit in The Miriam’s emergency department.
But Melissa Arruda, the Rhode Island Hospital emergency room nurse, said when the ER gets so overwhelmed that they have to divert ambulances, she can’t care for patients the way she was trained.
“With the number of patients and the inability to get them seen, we have sicker patients waiting longer than we would like.” Arruda said. “As the nurse that is never your intention.”
Lifespan officials declined to be interviewed for this story, but said in a written statement, “all of our patients receive excellent care and we strive to treat all patients in a timely manner.”
