The Royal Jubilee Hospital in Victoria is a glowing example of everything that is wrong with our hospital and emergency room system in BC. RJH is never without admitted patients in the department. In hospital services are unable to provide beds to admitted patients and the ED is the “contingency plan” for the over capacity protocol. There is nearly always inpatients admitted in hallways. The elderly, and especially the demented elderly, are boarded in the department for 3-5 days at a time. In the ED where there are no windows, no sense of time, noisy, chaotic is where this fragile population deteriorates until they have to be sedated and restrained for the acute delirium they have developed because this is where they wait. RJH recently opened a new “patient care center” with larger private rooms, state of the art everything, and large flat screens in every room. There are currently two floors that the health authority refuses to open as they are for “future needs”. When the center was opened the health authority informed the ED that we would lose 6 RNs as we would no longer be boarding patients in the ED and our staffing needs would be less. The RNs argued that we had the same amount of net beds if they took overflow areas into consideration. Within two weeks of the tower opening the Ed was once again boarding 20+ patients with less staff. It was months before our staffing levels were restored and we now have even more boarded patients than ever before. Patients are assessed in hallways and wait 3-12 hours for assessments by physicians. If admitted, some spend their entire length of stay in the ED and never see the inside of the new patient care center. The majority of patients never get a stretcher but are seen in the streaming department. VIHA has the capability to decant the ED boarders into real beds but the province will not fund the “future use” beds therefore the boarders stay in the ED and VIHA continues to use this as their “overcapacity” plan on a daily basis.