This the third in a series of stories on temporary emergency room closures in Nova Scotia. To check out the rest of our CODE ZERO series, click here.
Lucy Anne MacNeil is afraid.
A resident of Shelburne, N.S., she lives only two blocks away from the Roseway Hospital, and the top of the off-white building can be seen from the end of her street.
Despite being so close, MacNeil says she feels left behind by Nova Scotia’s health-care system.
In 2018, MacNeil was diagnosed with metastatic breast cancer. Treatment is going well, but there are side effects.
She’s required to monitor her temperature in order to prevent a “cancer fever,” she says.
If it goes above 101 C for more than an hour, she’s supposed to head to a hospital. But with an increasing number of emergency room closures in rural Nova Scotia, that has become a challenge.
“I feel abandoned… due to my condition,” MacNeil told Global News.
The Roseway Hospital was closed 199 times between 2014 and the first three months of 2018, according to data collected from reports prepared by the Nova Scotia government.
On the December afternoon when Global News spoke with MacNeil, the hospital was closed once again.
Just inside the doors of the hospital, a pink piece of paper is pinned to a corkboard.
“NOTICE OF CLOSURE” is printed in bold type.
“The Roseway Hospital Emergency Department will be closed.”
When that happens, MacNeil and everyone else in the region is faced with the tough choice of waiting for an ambulance or driving nearly an hour to reach the regional hospitals in Liverpool or Yarmouth.
“You may not be able to get an ambulance if you required an ambulance,” MacNeil said, although it has luckily not come to that.
The Roseway Hospital hasn’t been closed when she has needed treatment, and MacNeil stresses she has received nothing but the best care from the staff.
But her dilemma highlights the reality of attempting to staff a large region with many facilities.
“We have only so many emergency department physicians that are trained to do that work that have to staff all the hospitals across the province,” said Jodi Ybarra, site manager for Roseway Hospital.
Hospitals in Liverpool and Yarmouth have staffing priority, and when there isn’t enough to go around, ER doctors work at those locations while places like the Roseway are temporarily shuttered.
For municipal officials like Penny Smith, warden of Shelburne, the closure of hospitals doesn’t make her job any easier.
“Every time I receive an email from the Nova Scotia Health Authority advising of any closure, my heart just sinks,” Smith told Global News.
In a community as small as Shelburne, it’s not hard to inform residents about the status of the Roseway Hospital.
According to MacNeil, as soon as a closure is announced, the information tends to spread like “wildfire” on online Facebook groups or even by word of mouth.
But that doesn’t reduce the challenge of getting to health services that are open.
The element missing in the equation of ER closures is a shortage of doctors.
Residents like MacNeil are sympathetic to the difficulties of recruiting and say something more needs to be done.
“I know you can’t pull a doctor out of thin air, but there has to be some way to think outside the box to handle some things,” she said.
Now, even the municipality — which has no legislated role in delivering health care — is helping out in an attempt to recruit medical professionals.
They’ve produced videos to showcase their community to the world, hoping to entice physicians to the area.
Smith believes health care is a path towards growing her community.
“A lot of times when people are considering moving to an area, one of the first questions they will ask is, ‘Will I have access to health care?’ And if that isn’t available, they will look at other places,” she said.
Katherine Fierlbeck, a Dalhousie University political science professor, said it’s not a surprise that people get upset when closures occur or, as highlighted in Cape Breton, when the government steps in to close down facilities permanently.
“You can’t blame people for the fear of losing a service that might be the crucial factor in preserving the life of their parents or their children,” said Fierlbeck.
“Certainly, it is completely rational for people to be concerned about their ability to access care when they need it.”
In Nova Scotia, Ybarra said specialist salaries are increasing, pharmacists are getting more responsibilities and more nurse practitioners’ services are being used to shoulder some of the burdens of doctor shortages.
The push to improve health care is far from over. Ybarra points to the efforts of regional officials in recruiting doctors as proof.
She said provincial officials in the region are as keen as anyone on improving the situation.
“We are all community members as well, so none of us like to see that,” she said.