a day ago
Emergency departments in N.S. still struggling with closures
On a recent July day at the Digby General Hospital's emergency department, visitors would have been greeted by a sign no one wants to encounter as they reach the front door: the site was closed. It's a sign that's been getting a lot of use lately.
Digby, like many rural health-care facilities around Nova Scotia and across Canada, has staffing problems and those problems cause closures. Right now, the site has just one full-time emergency medicine doctor, with the remaining shifts covered by locums — doctors who travel to the community to fill in.
According to publicly-available information, the emergency department in Digby was closed for 518 hours in June, 514 hours in May and 383 hours in April.
For years, closures have been stubbornly difficult to solve at certain sites, but Nancy Whalley is hoping there could be light at the end of the tunnel for Digby.
Whalley, the area's community navigator, said Digby General will welcome two nurse practitioners in the fall who are relocating from the United States and another doctor could be in place by the end of the year, all to bolster the ranks of the emergency department.
"It'll be huge," Whalley said during a recent interview.
It's the kind of payoff health-care professional recruiters and community navigators around the province hope to achieve as they pursue doctors, nurses and other health-care professionals.
Digby is not the only site in Nova Scotia with an emergency department plagued by closures.
Roseway Hospital in Shelburne, which has relied entirely on locums for at least the last five years, is consistently one of the emergency departments in the province that struggles the most to remain open each year.
The site was closed for 498 hours in June, 631 hours in May and 489 hours in April.
The emergency departments at Eastern Memorial Hospital in Canso and Strait Richmond Hospital near Port Hawkesbury also see persistently high closure hours.
For years, the provincial government was required by legislation to produce an annual report on emergency department closures, outlining where and when they happened, along with details about community meetings to discuss problem areas.
A change in reporting
Health Minister Michelle Thompson said earlier this year that the report is no longer useful because of the gap between when it's published and the time it covers, and other information the government and health authority make publicly available.
The annual accountability report covered a fiscal year, but was not released until the following December.
Thompson's government passed legislation during the winter session at Province House to do away with the requirement to produce and publish the report.
Despite that decision, CBC News has been tracking emergency department closures across the province using public notices released each week by Nova Scotia Health.
Dr. Rod Wilson, the NDP health critic, said that regardless of whether the government is producing an annual report, people in rural communities know when their emergency department is closed and he's worried closures might be viewed as standard practice by people in some areas.
"We shouldn't accept that," he said in an interview.
A physician by training who still does some part-time coverage at emergency departments, Wilson said that what communities need to see is a plan from the government outlining how many hours people should expect sites to be open and how much staff is required to meet those expectations. The government should also report on how it does meeting such benchmarks, he said.
"If there's a plan, we're not aware of it," said Wilson.
Despite the ongoing struggles to keep some sites open, a senior official with Nova Scotia Health said there are no considerations to downgrade any of the sites to a different service model.
Tanya Penney said there are geographic considerations for rural emergency departments because of the distance from them to the nearest regional hospital.
"Rural emergency departments are absolutely vital and staffing shortages sometimes, unfortunately, make it difficult to keep them open," she said in a recent interview.
"But we're super focused on recruiting and retaining and supporting health-care workers needed to provide care in those areas."
As recruitment efforts continue, Penney pointed to other initiatives that have been rolled out to help get people access to care closer to home even when an emergency department is closed. That includes primary care clinics at pharmacies, mobile care clinics and virtual urgent care.
Easing doctors' workloads
The latter, now available at more than 20 sites around the province, operates even when an emergency department is closed. Qualifying patients see a nurse in person and have access to a doctor virtually. Blood work and X-rays can be ordered, prescriptions written and follow-up care is provided.
The sites normally operate seven days a week, 12 hours a day.
Whalley said having services like that in place can be helpful for people considering working in Digby because it shows them that the responsibility to provide care for the community won't rest entirely on their shoulders.
"I think that's huge and I think that that is the way it's going now everywhere," she said.
"[Doctors are] getting used to having those other accesses to care so that it's not falling all on them."
