Nurse pens letter to Holt about grandmother’s treatment

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A heartbreaking open letter to Premier Susan Holt from a registered nurse about the poor conditions her grandmother endured at Fredericton’s hospital was difficult to read, and a sign that the health system remains “broken,” Health Minister John Dornan said on Wednesday.

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Katarina Lekborg, a 31-year-old registered nurse with eight years on the job, posted on social media about what’s happening to her 88-year-old grandmother Theresa, who is a patient at the Dr. Everett Chalmers Regional Hospital (DECH). 

Brunswick News asked to speak to Lekborg but didn’t receive a response. 

“I am writing to you from the Doctor Everett Chalmers Hospital in the middle of the night, sitting beside my 88-year-old grandmother as she lies confused, frightened, and utterly vulnerable,” read Lekborg’s letter, addressed directly to Holt. “She does not know where she is. She does not understand what is happening to her. I wish this letter were an exaggeration born of exhaustion, but every word that follows is true.”

Lekborg goes on to describe where her grandmother was being treated: in the DECH’s Medical Transition Unit, better known as the MTU, a former ambulance bay that’s been partially converted into spaces for 13 patients. 

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“Premier Holt, I need to be honest: this is not a unit. It is legitimately the garage with curtains,” Lekborg wrote.

“There is no bathroom. No running water. No sink to wash hands. She eats inches from the commode she must use to relieve herself. There is no privacy, a tattered curtain with holes. No doors. The lights are relentless, on all day and all night. There are no windows, no way to tell the time of day. Paper thin ‘walls’; the noise never stops.”

Lekborg described her grandmother as a person who “has lived with dignity and quiet strength, until last Friday, when she “became acutely ill.”

“She slipped into delirium so severe she did not recognize her own daughter,” Lekborg wrote. “What followed was not care, it was a maze. Delays. Barriers. Desperation. Family members scrambling, begging, advocating, trying to access timely medical attention that simply was not there.”

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Later, she added: “This is not health care. This is not dignity. This is not acceptable. I understand our health-care system is broken and strained. I have worked as an RN for the past eight years and I know the system all too well. I understand difficult decisions must be made. But the MTU is not a solution, it is concealment. It is hallway medicine hidden behind temporary ‘walls.’ It does not fix overcrowding, it institutionalizes it.

“Immediate action is required. This ‘unit’ should not exist as an option for admitted patients, especially not our elderly, our confused, our most vulnerable.” 

Whether Theresa is still in the MTU is unclear. Brunswick News asked to speak to Holt, but Dornan was provided instead.  

“I think that it’s a very significant symptom of a broken system,” Dornan said when asked to react to Lekborg’s letter.

“When we have senior people in our ERs without adequate bedding, privacy, noise protection, washroom facilities, that is not what I want to be proud of, and so I work daily to try to fix that, to alleviate the pressures on our emergency department, so that we can give more timely, respectful care to people that are in our ERs and in our hospitals.”

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Dornan said the MTU was designed to handle patient overflow, but the root of the problem is that too many New Brunswickers don’t have fast access to primary health care. That’s a problem the Liberals are trying to fix by opening at least 30 collaborative health clinics in the next three years. So far, they’ve announced 11. 

“It’s not that we need bigger emergency departments,” Dornan said. “We need better places for (patients) to go before they get to the emergency department, and after they need to be admitted, we need more spaces on the floor for them to go.

“And so what the Everett Chalmers hospital did as an emergency measure – rather than having people lined up outside the emergency department, because there was absolutely no physical space – they converted an ambulance unit, a garage, so to speak, to an area where you could put a stretcher out of the elements, be able to administer testing, X-rays, blood tests, apply medications, and have nursing staff and physician staff.

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“But it’s like taking the whole team out of the emergency department, and putting them in a sheltered space, (which is) far from optimal, but it was the best that they could do at this point in time.”

After reading Lekborg’s letter, Dornan said “we need to work harder to make that space not necessary, so that people that are in our emergency department are in proper beds with proper facilities, proper noise protection and proper privacy.”

But he said the problem won’t be fixed quickly, and suggested another year will be needed to alleviate the pressure.

“In the near future,” Dornan said, the Department of Social Development and the minister responsible for seniors will unveil short and long-term fixes for the problem with alternate level of care (ALC) patients who are stuck in hospital waiting for placement in long-term care.

But he couldn’t say exactly when that would happen, suggesting it could be days, weeks, or months.

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Holt, when questioned about the open letter Thursday at the release of the province’s  new strategy and action plan for Alzheimer’s disease and dementia, echoed what the health minister said. 

Asked for comment, Horizon Health Network president and CEO Margaret Melanson sent a statement.

She began by saying the MTU was created in late 2024 “to provide overflow patient care spaces whenever the hospital is operating above capacity, which unfortunately happens frequently.”  

“The unit houses 13 beds within curtained spaces and does not have running water. Patients are taken to washroom facilities within the emergency department. The existence of this unit reflects the severe strain our health care system is experiencing, with nearly 40 per cent of our acute care beds occupied by patients who have been medically discharged and are awaiting placement in long-term care or other settings,” Melanson’s statement read.

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“Hospitals are designed to provide acute care, and when so many of our beds are occupied by patients waiting for alternate placements, we face difficult choices about where to care for newly admitted patients.

“We also have patients on stretchers in hallways, storage areas, and dining spaces. These conditions are not acceptable as a long-term reality, and they place significant pressure on our staff who work hard to provide quality care in circumstances that make it extraordinarily difficult. We are continuing to work with our health system partners to address the flow of patients to appropriate care settings, but these are complex challenges that require co-ordinated action and resources across the entire system.

“Our patients deserve better, and we will continue to be transparent about these pressures and advocate for the systemic changes necessary to address them.”

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Melanson didn’t answer a question about how long Horizon intends to keep the MTU running.

Green Party leader David Coon, the MLA for Fredericton-Lincoln, said he was invited by Lekborg’s family to visit her grandmother at the hospital, which he did on Tuesday. By that time, Coon said, Theresa had been in the MTU for three days.

Asked what he thought of the MTU, Coon was blunt.

He spoke about the lack of windows and plumbing, and said it looked like “little rooms big enough for a sort of stretcher cot and chair.”

“It’s like her family members said: if it was just a matter of overnight while waiting to get into a ward … or the day and overnight or something like that, it’d be one thing. But when it runs into days – and for some people, quite a few days, apparently – then that’s a big problem.”

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