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‘Extreme shortages’ expected at N.S. emergency departments over the holidays: union

Communities in Nova Scotia are raising concern over more emergency room closures. Nearly half a dozen ERs are expected to be closed within the next two weeks. As Zack Power reports, the province says that alack of health-care professionals has created a strain. – Dec 12, 2023

The largest union in Nova Scotia says “extreme shortages” are expected in emergency departments during the holidays as many health-care workers are off work and there aren’t enough staff to cover absences.

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Sandra Mullen, president of the Nova Scotia Government and General Employees Union, said the issue is especially pronounced at the Halifax Infirmary, one of the busiest hospitals in the province.

“Today, what should be 17 (nurses) on the floor is down to nine during the day shift,” she said Thursday, adding that it’s an especially busy time due to respiratory illness season being in full swing. “While the staff say they’re managing, they foresee extreme shortages in the coming days.”

The NSGEU represents many of the province’s nurses, as well as health-care workers who do things like testing and diagnostics, administrative professionals and support services.

Acute care units at the QEII Health Sciences Centre, which includes the Halifax Infirmary, were at 98.2 per cent occupancy as of Thursday afternoon, according to the Nova Scotia Action for Health public reporting website.

The Dartmouth General, also in the central health zone, was at 117.9 per cent occupancy. The Annapolis Community Health Centre and the Fishermen’s Memorial Hospital, both in the western health zone, had the highest levels of occupancy at 166.7 per cent.

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Mullen said many people are busy might put off getting care before and during the holiday season, as well as during power outages and adverse weather, leading them to visit emergency departments later when their conditions worsen.

“If you keep putting that off, folks are going to get sicker, and they’re going to end up there,” she said.

She said the province’s reliance on travel nurses — nurses who are hired through private agencies for short-term placements, and are paid significantly more than regular nurses — means that there aren’t enough regular nurses to cover vacations.

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And where travel nurses have more flexibility in their schedules, many of them are away over the holidays.

“With those folks out of the mix, they just do not have the full-time staff that they need to staff these sites as they need,” she said. “We need full-time employees here in this province that live here and are willing to be part of that schedule.”

Mullen said the province’s recent announcement that they will restrict the amount of time travel nurses can work was “long overdue,” but more work is needed.

“Until all the provinces agree to do the same, there will still be these agencies providing this travel nurse service,” she said. “But we need to become less reliant on that.”

She is hopeful that measures like the province’s retention bonus will help raise staffing levels for full-time nurses.

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A joint news release from Emergency Health Services, Nova Scotia Health, and the IWK encouraged Nova Scotians to “make the right call” while accessing care over the holiday season.

It said people should only call 911 for medical or life-threatening emergencies, and minor or non-urgent issues can be addressed by talking to your health-care provider, calling 811, using virtual care, or by going to a walk-in clinic, community pharmacy primary care clinic, urgent treatment centre, or mobile primary care clinic.

“Do not hesitate to visit an emergency department if you are experiencing a medical emergency,” it said.

More than 1,000 nursing vacancies

In a statement, Nova Scotia Health spokesperson Brendan Elliott said Nova Scotia Health currently has 1,067 nursing vacancies.

This is down from 1,504 in May, and “is representative of the gains in recruitment and retention associated with internationally educated nurses, student engagement, and other focused efforts.”

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Currently, the province has a full-time equivalent complement of 5,218 registered nurses with Nova Scotia Health. In any given month, there are more than 350 travel nurses working between long-term care and Nova Scotia Health.

While Elliott said the holidays are “typically a busy time for emergency rooms,” he said people who are experiencing a medical emergency should still seek care by visiting an emergency room or calling 911.

He also noted that people with non-emergency needs can seek care through the Your Health NS mobile app, virtual care, mobile clinics or pharmacy clinics.

The province’s annual accountability report on emergency departments, released Thursday, said the Department of Health and Wellness “continued to innovate and leverage technology to improve emergency care for Nova Scotians” in the 2022-23 fiscal year.

“This included a shift in the model of care from emergency departments (EDs) to urgent treatment centres (UTCs) in some communities, to provide consistent and sustainable care that Nova Scotians can rely on.”

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During the reporting year, more than 570,000 patients visited an emergency department. Of the 530,143 patients who visited a Nova Scotia Health emergency department, just over 10 per cent ended up leaving without being seen. At the IWK emergency department, 8.6 per cent of the 42,653 people who visited left without being seen.

As well, there were 79,813 emergency department closure hours.

The report said multiple initiatives that were implemented or continued over the reporting year include:

  • Physician assistants and nurse practitioners beiung added to many existing ED teams;
  • Care providers and patient advocates supporting patients in waiting rooms;
  • Expansion of virtual care options;
  • Initiatives to improve ambulance wait times;
  • Investments in redevelopment projects, expansion projects, and improved care models.

“We are committed to providing the care all Nova Scotians need and deserve,” it said. “This includes delivering quality care, optimizing the healthcare experience, and ensuring Nova Scotians have the right care, in the right setting, at the right time.”

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