Violent crime wave overwhelms QEH A&E

A spike in violent crime, including a record number of gun-related deaths, is overwhelming the Accident & Emergency (A&E) Department at the Queen Elizabeth Hospital (QEH), with senior officials warning that the toll on staff and resources is becoming unsustainable.

The violence is disrupting operations and traumatising frontline healthcare workers, said CEO Neil Clark, describing the effects of the unseen toll of criminal violence on public health infrastructure as far-reaching and deeply felt within the hospital.

“Absolutely. It has a major impact on the QEH,” he said. “The staff clearly will treat anybody who comes in, but having to treat somebody who’s coming with gunshots is not only slowing down everybody else who’s coming without the gunshots, it slows down the whole department and the department moves into lockdown.”

As of Wednesday, Barbados had recorded 17 gun-related deaths.

Clark stressed that while A&E staff remain committed, fear and psychological distress have become routine parts of their job.

“There’s also a fear amongst the staff that that might continue into the department. So they’re treating people and being nervous at the same time,” he said. “Our security team is excellent… but sometimes those injuries are horrific and that has its toll… especially as a child [is] involved in a shooting.”

The emotional burden, the hospital boss added, is compounded by the sheer unpredictability and scale of trauma cases staff must face.

“They’ve got the normal, mild conditions of people turning up with mild illnesses or they’ve twisted their wrist, and then the next minute they’ve got a multiple shooting coming in… and then after that they’re supposed to go back to work normally,” he pointed out.

He called on the public to show greater empathy and understanding, noting that frustration over long wait times should not be directed at individual nurses or doctors.

“They’re doing their best,” he said. “We have to take our hats off to those people who work in A&E and do this day in, day out.”

Director of Nursing Services Henderson Pinder added that the psychological cost of repeated exposure to violent trauma is mounting across departments.

“These are psychologically hurtful incidents… and they do have an effect on not only nurses, [but] all the staff,” Pinder explained. “We have what we call a huddle after these incidents… but in most instances, it’s more than that. So we need to have outside counsellors and bereavement persons come in to help staff work through this.”

Beyond the emotional fallout, Pinder said that violence consumes precious human and material resources: “We have to use a lot of individuals, specialists, doctors… and we as a small country can ill afford to be using so much resources. It would be better if we could cut out the violence and live as a peaceful nation.”

He also flagged ongoing concerns about security, with fears of retaliation even when patients are hospitalised.

“When they get on the ward there’s always the fear of retaliation… so it places additional strain on our security personnel and puts our nurses… always having to quell these disputes,” Pinder noted.

Clark said the QEH has mental health support in place but recognises the need to scale it up.

“We already have counselling support available for all staff… and we’re hoping to expand that as part of the QEH strategy,” he said. “We’re even looking at mental health first aid training.”

The CEO highlighted a gap in national preparedness around recognising and addressing stress and anxiety, saying: “A lot of people suffer silently… and we have to look after our own staff and each other.”

Speaking more broadly about the A&E, Clarke said the hospital is making progress on a systemic redesign of its A&E Department to ease bottlenecks and improve overall patient care.

“We’re about a quarter of the way through a redesign of our A&E flow,” he said. “It’s not just about the A&E Department… it becomes the bottleneck for the whole healthcare system.”

Clark explained that improving patient flow requires action at every level – from the triage process to diagnostics, ward admissions, and discharges.

“Everybody who arrives at the A&E should be triaged within 15 minutes by a nurse… if not, there’s an escalation process,” he said. 

The hospital CEO admitted that delays persist but insisted patients are not neglected once they enter the system.

“They may be in A&E for two days but they’re still under the care of the specialist doctor,” he said. “It’s no different than if they were on the ward…, but I accept it’s not the right place for that treatment to be taking place, and we hope to change that in the near future.” 

sheriabrathwaite@barbadostoday.bb