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26 Aug, 6 tweets, 2 min read
I feel like I am apologizing constantly at work these days. Every shift it's... 1/6
Sorry to my patients for waiting so long to be seen, to be treated, to be transferred, to get admitted, or to get a bed in a room. Sorry to their families because I agree that it isn’t right. 2/6
Sorry to the nurses at triage who absorb everyone’s frustration. Sorry to our experienced nurses (but I understand why you’re leaving), to our current nurses (as I ask you for more), and to our new nurses (for what they are walking into). 3/6
Sorry to our paramedics for the hours they spend in our halls as the calls build up, to the people that answer the ‘safety line’ for calling so often (though I could call more), and to my colleagues for not having a room for them to assess their patients (there aren’t any). 4/6
Sorry to the charge nurses, managers, directors, and physician leaders for constantly asking for you to do something about this when you've already done everything that you can. I am sure you are tired of apologizing, too. 5/6
While I am at it, sorry Saskatchewan if we can't keep this up. At some point, something will have to give. Sorry we couldn't do more - but please know that we are giving it everything that we have. 6/6 #covid19sk

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More from @Brent_Thoma

Brent Thoma Profile picture
31 Aug
Beds in Saskatoon's overnight EDs (JPCH, RUH, SPH) last night: ~70. Consulted/admitted patients in our EDs: 73. Total # of patients in our EDs: ~155.
"That can't be possible, where are the emergency patients seen?" Good question. 1
First, not all admitted people get a bed. Our consultants also admit patients from the waiting room or a hallway. This gives emergency very few beds that are only used by really sick patients. Second, we maximize our space however we can. For example, at RUH: 2
We put a stretcher behind triage to see the 30-40 waiting room patients. It's in the main hallway behind a curtain so not ideal. People get assessed then sent back to the waiting room. Some meds are provided by already overburdened triage nurses. Many get discharged from here. 3
Read 14 tweets
Brent Thoma Profile picture
30 Aug
Interested in knowing what our provincial Medical Health Officers are recommending to the SK government regarding #COVID19SK? They really lay it out in this letter: trk.cp20.com/click/cffs-2ft…
In summary:

General
1) Improve government messaging. The pandemic isn't over. We don't have enough immunization to 'live with covid', we need to use tools from the past 3 waves.
Immunization
2-4) Mandatory immunization for all health care works (especially those in long-term care facilities), all eligible students and their parents, teachers, and school staff, and all government employees.
Read 12 tweets
Brent Thoma Profile picture
27 Aug
As summarized by @awong37 there was a Saskatchewan physician town hall tonight. During the Q&A I described the state of Saskatoon emergency departments and asked for help. The recording is now posted publicly. saskhealthauthority.ca/intranet/medic…. In brief: 1/12
Royal University Hospital has ~35 adult emergency beds. Recently we had 98 patients in the department including >40 admitted/consulted patients. One admitted patient waited >160 hours (almost a week) for an inpatient bed. 2/12
As a result, we go entire shifts seeing patients in hallways or pulled into the stretcher we snuck behind triage. We make space for patients where the vending machines used to be and try to find enough clipboards for their charts.3/12
Read 12 tweets
Brent Thoma Profile picture
5 Mar
Excited that the @Royal_College Research Forum on using CBD assessment data to improve CBME that I presented at has made its way online (with subtitles!). Full presentation here: royalcollege.ca/rcsite/researc… Tweetorial here:
Historical assessment programs often consisted of 12-13 rotation-based assessments per YEAR of training. CBME has changed that - in Canada our EM residents are getting 100-200 EPA-based assessments of patient interactions per year.
Multiply that by ~70 Canadian EM residents per cohort and when our programs are filled with CBME residents we'll complete ~50,000 EPA assessments/year across Canada.
Read 21 tweets
Brent Thoma Profile picture
10 Feb
Hey @SkGov, am I missing something, or does your new #covid19sk vaccination plans contradict the Canadian NACI recommendations and previous @saskhealth plans by deprioritizing immunizations for healthcare workers?? I'm worried about exposures to #COVID19 in these HCWs :(
I don't seem to be missing anything... @SkGov, why??? Exposures happen in frontline healthcare environments not currently classified as 'high-risk settings' and one COVID+ case can knock a cohort of healthcare workers into isolation. We don't have spare HCWs. Please reconsider.
Initially, I was confused. Now I'm getting angry as I hear from disheartened colleagues seeing #COVID19 patients daily in high-risk contexts. They are lumped in a risk category with others 'their age.' We need to take care of them as they take care of COVID patients for us.
Read 4 tweets
Brent Thoma Profile picture
1 Dec 20
Many believe we are overreacting, #COVIDsk is just the flu, only the elderly/those with comorbidities die, we can protect the vulnerable, if you survive it you are fine, your activities can continue safely, and it will not end up being as bad as we are making it out to be. 1/10
The SK Health Minister suggested this week that we could still follow their 'optimistic' modeling scenario and may be able to relax restrictions over Christmas. None of this is true. The optimistic scenario is clearly not happening. 2/10
The realistic models (which have not been clearly presented to the public) show that we are tracking a scenario that leads to cancelled surgeries and overwhelmed emergency departments, wards, and ICUs. A scenario that leads to a lot of unnecessary death. 3/10
Read 11 tweets

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