For city dwellers used to the chaos and crowds of an urban emergency room, the typical scene in a small rural hospital is decidedly quieter.
Though there are busy periods, waiting areas are often empty or close to empty much of the day. At times, there appears be more staff on hand than patients.
In terms of size and design of the buildings, an average rural hospital has about 20 beds, while the smallest facilities have as little as four or five. In comparison, the Royal Alexandra Hospital in Edmonton has 502 beds.
Much of the noticeable activity tends to occur in the long-term care units, which are often incorporated into the original hospital building or are housed in an adjoining structure. In some places, such as the hospital in the east-central town of Hardisty, most of the space that was originally designed for patient rooms has now been taken over by long-term care residents. There can also be at least one room reserved for palliative care.
Such rooms are often furnished by a townâ€™s volunteer hospital foundation or auxiliary, which also raises money for new equipment and keeps the hospital looking spiffy with new paint and other decorative touches.
Among other changes to the buildings over the years, many rural hospitals no longer deliver babies, and only about half still have working operating rooms.
Outside, virtually all hospitals are equipped with an ambulance bay and a helipad. The province has started to upgrade helipads around Alberta to meet new federal transport rules and to accommodate the larger AW139 helicopters that now form part of the STARS fleet, though this will take several years.
Almost all rural sites also have an X-ray machine and a small lab that collects fluid samples and does some analysis. But very few have a CT scanner or MRI machine.
As well, family doctorsâ€™ offices in several towns are now located at the hospital site. Smaller towns might have just two doctors, who are jointly responsible for tending to the 24-hour emergency room when needed. These doctors usually are general practitioners, so they can stabilize patients and provide basic care, but have to send people with serious conditions to bigger centres.
This would include patients experiencing heart attacks and strokes, and those with severe injuries or infections. In some cases, patients can be taken to a city or regional centre by ground ambulance. In the most serious, life-threatening cases, they are often airlifted to major trauma centres in Calgary or Edmonton.
As an example, Parrish Tung, the mayor of Elk Point in northeastern Alberta, recently had a 250-kilometre trip through three hospitals to deal with a case of appendicitis.
After his local doctor initially admitted him to the 12-bed Elk Point Healthcare Centre, Tung was taken by ambulance one morning to Cold Lake, which has the only CT scanner in the region. A few hours later, it was off to St. Therese Hospital in St. Paul for surgery, after which Tung was returned to Elk Point to recover.
â€œIt was appendicitis, so it could have been a very bad outcome,â€� Tung said from his hospital bed in October.
â€œBelieve it or not, that CT scanner runs on business hours, Monday to Friday, nine to five, no exceptions unless you have a stroke. Guess how lucky I am that I got in on a Friday.â€�