The back-to-back closures of small community emergency rooms on northern Vancouver Island over the weekend are another example of the overall erosion of the primary care system in rural communities, according to the BC Green Party and the BC Nurses’ Union.
Due to ongoing staffing shortages, Port Hardy Hospital’s emergency room was temporarily closed from 9 a.m. to 7 p.m. Sunday. The closure came on the heels of another temporary closure of the emergency department at nearby Port McNeill Hospital from 3 p.m. Saturday to 7 a.m. Sunday.
Island Health recommended residents go to the open emergency room in either community over the weekend, advising that BC Emergency Health Services has put in place protocols to ensure that ambulances transported patients to an open emergency room. The distance between the two communities is approximately 41 kilometres, and the nearest regional hospital emergency department is in Campbell River, 2.5 hours away.
The rural primary health care system is facing erosion, if not collapse, due to pandemic-related burnout, long-standing staff shortages in hospitals and the inability to attract or keep family doctors in small communities, BC Green Leader Sonia Furstenau and Adam Olsen, MPP for Saanich North and the Islands, said Tuesday afternoon.
While some of these challenges are felt throughout the health care system, they hit rural communities hardest, Olsen said.
The shortage of primary care doctors in smaller communities is increasing the pressure on local emergencies and vice versa, he added.
And overcrowding or closure of local ERs and shortages of doctors can have a ripple effect on regional hospitals and ERs in communities like Campbell River, Comox Valley and Nanaimo, which are also under strain, Furstenau told National Observer of Canada.
“There just seems to be this strain, this increasingly chronic strain, which is now becoming acute on the system,” Furstenau said.
“The toll it’s costing nurses is quite significant,” she added.
But rural Vancouver Island residents are expressing concerns about local emergency room closures, long commutes to other communities and the reliability of ambulances, she said.
“For people, there is a real concern about being able to access health care when you need it.”
Adriane Gear, vice-president of the BC Nurses’ Union, said the increased frequency of temporary North Island emergency room closures and ambulance response times reflect an issue affecting communities across the province, including the mainland communities of Ashcroft and Clearwater within the Health Region.
Residents of small island communities like Port McNeill and Port Hardy might choose to visit hospitals in larger care centers, like Campbell River or Comox Valley, more often, Gear said.
“But these hospitals are already at a breaking point,” she said.
And the drive from North Island to Campbell River is on a freeway with long stretches with no cell service.
“Can you imagine driving your spouse with chest pains for about an hour and a half with spotty cell service?” she says.
“It’s absolutely a crisis situation and it’s impacting the health of those communities.”
Port McNeill Hospital in northern Vancouver Island is pictured.
Nurses are physically and mentally spent and cannot be asked to do more after more than two years of the pandemic, Gear said, adding that the number of COVID-19 patients in hospitals is on the rise right now.
“It’s very painful to work in a facility and know it’s going to have to close because you’re going to take your first vacation in two or three years,” Gear said.
“Or because you’ve contracted COVID and can’t go to work.”
Island Health has relied on traveling nurses, often those without extensive experience or familiarity with a new facility, to fill staffing gaps at the last minute, Gear said.
“Our nurses are hired to work in one area, but are then constantly sent to another unit or another facility that (they) have not been referred to and which may not even be qualified to work,” he said. she declared.
The health authority also relies increasingly on contract nurses from private agencies, whose help is welcome, but they cannot be redeployed and they also may not know the facility where they work. , she added.
Island Health is struggling to meet its minimum threshold of having 70% of staff in hospitals and authority facilities, and the displacement of nurses is only compounding the problem and leading to the continued “bleeding out” of nurses of the system, Gear said.
“I think (Island Health) needs to stop constant redeployment as a staffing strategy.”
No one was available from Island Health to speak with Canada’s National Observer about the North Island ER closures.
However, staffing shortages due to COVID-19 are impacting the health authority, as in other areas of the province, Island Health said in an email.
“This can lead to shortages which are particularly difficult in rural and remote communities and in smaller sites or programs,” the email says, adding that sometimes a staff member calling in sick can affect the minimum levels of staff needed. to patient safety.
There was no situation where the two local ERs north of Campbell River were closed at the same time and no patients were diverted south of Port Hardy or Port McNeill due to weekend closures , said Island Health.
Recruiting staff in the North Island and elsewhere is a key priority for Island Health, the authority said, adding that it was running a local, national and international recruitment campaign to attract employees to the region.
The temporary closures of North Island ERs do not impact ERs at regional hospitals in Campbell River, North Island or Nanaimo, Island Health added.
Island Health has not said whether it expects further local emergency closures in North Island.
Information on staffing levels and emergency department capacity at hospitals in Campbell River and Comox Valley was not available from Island Health prior to the National Observer of Canada’s publication deadline.
Port McNeill Mayor Gaby Wickstrom said in an email that the ER closures are worrying residents in her community.
“We are actively working with Island Health to think about recruitment and retention solutions,” Wickstrom said.
“Island Health has been open with us that this issue will not be resolved overnight, and we will need to navigate through shortages over the summer.”
Olsen said housing shortages compound the difficulty of recruiting family physicians to rural communities. So is the lack of respite, or back-up, doctors available to replace those who are exhausted and therefore considering early retirement, he added.
Along with establishing a locum strategy, the government must provide community health infrastructure, including office space and administrative support, so doctors can more easily build patient care teams, the Greens said. .
The province also needs to modernize the fee-for-service model for physicians, including salaries and adjustable fees for different levels of patient care.
The province announced Tuesday that it is funding 322 post-secondary training seats, two-thirds of which are expected to be operational by fall 2023.
“Building and supporting our health workforce is our highest priority,” said BC Health Minister Adrian Dix.
“Our communities have told us how important the need for more health services is, and we are listening.”
The training seats include one-time funding for a dozen urgently needed medical laboratory assistant seats at Camosun College, Vancouver Community College and Thompson Rivers University’s open learning program.
There will also be a new bridging program to train advanced care paramedics from overseas or other provinces to practice in British Columbia and 20 unique places to fast track respiratory therapists at Thompson Rivers University.
The province is also allocating $4.5 million in bursaries to attract internationally trained health professionals who want to move to British Columbia.