Island Health says no emergency rooms on North Vancouver Island will close permanently as an ongoing staffing crisis continues to force temporary closures in small communities.
The nightly shutdown of Alert Bay ER is being extended another two weeks due to a lack of nurses, Island Health announced last week.
Nightly closings for the Cormorant Island Community Health Center ER were originally scheduled through August 16, but the ER will now continue to be closed daily between 7 pm and 8 am through August 31.
Alert Bay residents fear the closures will become permanent.
The impact on the island community’s emergency room continues Repeated temporary closures and patient diversions at the Port Hardy and Port McNeill emergency rooms in July and August.
There’s a 40 percent vacancy rate for nursing staff at the Port Hardy and McNeill sites, and COVID-19 sick calls are compounding the problem, said James Hanson, Island Health’s vice president of clinical operations for Central and North Island.
“We’re not entirely happy with the situation in the North Island, and access to care in that region is a huge priority for us,” Hanson said, adding that the health authority is working tirelessly to try to reduce the gaps in service. but at this time it is not considering combining staff at emergency sites to ensure more consistent service.
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“We’re doing absolutely everything we can to prevent that,” he said.
In addition to ongoing nurse recruitment efforts, in the short term, Island Health sends out system-wide requests for staff from the South Island’s most populous centers to volunteer to fill gaps that may suddenly arise due to a illness, he said.
Staffing shortages in rural and remote communities existed before the pandemic, with the health authority relying on privately contracted nurses or agency nurses to fill the gap, Hanson said.
Increasing reliance on temporary contract nurses is contributing to the hollowing out of public health care and will likely only exacerbate the nursing staffing crisis, says health policy researcher @a_longhurst.
However, now that the medical personnel crisis is a problem throughout the province, in rural and urban communities, even agency nurses are in short supply, he added.
“Health care systems as a whole, not just Island Health, but in BC, Alberta, Ontario and even around the world, rely more than ever on agency and private duty nursing,” Hanson said.
Island Health is making progress in setting up an “in-house agency” of roving nurses within the health authority to fill in gaps in smaller communities, he said.
Island Health is asking South Island staff if they would temporarily relocate to underserved regions like Alert Bay, Hanson said.
“We would provide transportation, housing, whatever they need to make that transition.”
Island Health has increased funding for the North Island and is looking to staff the region more so it can better cope with staff absences, Hanson said.
“I have given the approval to hire several more nursing lines so that we are not as vulnerable to short-term sick calls as we currently are,” he said.
“The challenge is trying to find people to come and live in the region permanently.”
To achieve more consistent staffing, Island Health wants to negotiate different terms with nursing agencies that would see contract staff taking on six- to eight-month commitments in the North Island.
The health authority is also working with communities to secure housing for staff given the lack of available housing, Hanson said.
Andrew Longhurst, a health policy researcher at Simon Fraser University, said health authorities’ heavy reliance on agency nurses is a quick-fix form of creeping privatization that is likely to only aggravate and perpetuate nursing crises and primary health care at a higher cost to the taxpayer. .
“It’s a really vicious cycle that empties public-sector nursing,” Longhurst said.
It’s no wonder that nurses, exhausted by the pandemic, family obligations, staffing shortages coupled with heavy workloads and mandatory overtime, are leaving the public system for the private sector, she said.
Contract or agency nursing pays better, even if it doesn’t provide job security or benefits that come with unionized work in the public health system, he said.
And as welcome as the extra help from agency staff is, it means more work for public nurses, who have to train and supervise higher-paid private peers to familiarize them with a facility or unit.
Relying on temporary or agency nurses is not sustainable, ultimately fails to address long-standing staffing concerns and can compromise the quality and continuity of patient care, Longhurst said.
Instead of fighting to recruit nurses from abroad, it makes more sense to find out why nurses are leaving the public sector in the first place, Longhurst said.
“What is driving the workload in our health system? I think that’s a much more nuanced conversation,” she said.
The province needs to take steps to relieve pressure on the health system doing more to contain the rise of COVID-19 numbers, following the recommendations of experts to stop the toxic drug crisis that overloads the emergency response system and strengthening primary care, particularly for older people who do not have access to family doctors and care for chronic conditions or supports in the home and the community.
“Too many older adults continue to rely on acute care to meet their ongoing health care needs, or end up in a time of crisis because they haven’t had that ongoing care,” Longhurst said.
“Then they end up in a hospital bed and that means other resources fall short because the system is trying to provide care to too many people.”
A provincial focus on team care would help meet communities’ primary health care needs, attract more doctors into public practice and ease the burden on emergency rooms, Longhurst said.
Team care is essentially a public community health center staffed by doctors and supported by a variety of medical professionals, such as mental health counselors, nurse practitioners, pharmacists and social workers, he said.
“The idea here is that you’re sharing the workload in a way that allows those professionals to work to the best of their skill set,” he said, adding that fewer people would end up in the ER with chronic issues that can’t be adequately addressed. on those sites.
Hanson pointed out that recruitment for the North Island is not just focused on nurses, but on all medical professionals.
“Regardless of what role they play … I want them in the community,” he said.
“But I don’t want to be in a place where we’re constantly bringing new nurses, new people into the region. We’re trying to get to a point where we have more consistency in the environment.”
Rochelle Baker / Local Journalism Initiative / Canadian National Observer