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N.B. emergency room in rural community to close overnight: health authority

WATCH: Horizon Health Network says it will be closing the Sussex Health Centre emergency department overnight due to ongoing physician shortages. The decision is a last resort, but as one doctor in the community says, something had to give on the pressure placed on the facilities emergency department staff. Nathalie Sturgeon has more – Sep 6, 2022

Horizon Health Network in New Brunswick has announced that the Sussex Health Centre, which has been under the pressure of the staffing shortages, will temporarily be closing overnight.

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Margaret Melanson, the interim CEO of Horizon Health Network, said there is no date for when the temporary overnight shut down might come to an end, saying she was fearful to put a timeline on it.

“This temporary change of service will ensure the necessary emergency department, physicians, nurses and staff are in place to provide safe quality and timely emergency care,” she said in a press conference Tuesday.

Effective Sept. 12, the emergency room will close at 8:30 p.m. nightly and reopen at 7:30 a.m. the following day, according to the health authority.

She said it is committed to restoring the 24-hour service, but it is dependent on recruitment and retention of physicians to the area.

For Sussex family physician Dr. Brian O’Neill, the decision was a last resort but is also disappointing.

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“I guess I would start by saying as physicians in Sussex, we’re really disappointed this had to happen and it’s really just the sickest of the sick that come to the emerg in the middle of the night but something had to give,” he said speaking to reporters on Tuesday.

O’Neill said a large portion of physicians end up coming in from Saint John, which is also struggling with staffing its own emergency room.

On Aug. 26, Horizon Health Network asked people to avoid the emergency room in Saint John and Moncton due to a critical shortage in staff.

He said local doctors are also trying to fit in patients who typically present at the emergency room but aren’t necessarily in an emergency situation to alleviate some of the pressure, but in the end, it isn’t enough.

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“I don’t want to sugar coat this, like, this is a devastating thing for our community,” he said. “Still if somebody comes in with an acute MI (myocardial infarction)  into my office, there is not much I can do here.”

According to statistics in the annual report from Horizon, about seven patients per day visit the emergency room during the hours of 9 p.m. and 7 a.m. It says about 45 per cent of those were Level 1 (resuscitation), Level 2 (emergent) or Level 3 (urgent).

In 2020, the Higgs government alongside the CEOs of the health authorities proposed closing several rural emergency rooms overnight, including Sussex. It also looked at turning acute care beds into long-term care beds, which this change does not do.

In fact, Horizon says there are no changes to the acute care beds, and it is also exploring more ways to increase the use of the SHC’s operating room and its ambulatory care services.

The community rallied on Feb. 20, 2020 and were able to save services, but it has been plagued with overnight closures and interruptions ever since.

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Sussex Mayor Marc Thorne said there is only one permanent ER physician in the community, the rest come from Saint John.

He said he was advised of the decision to close overnight, but has been reassured by leadership within the health authority the change won’t be permanent.

Thorne was a fierce opponent of the reforms in 2020.

“In my view, and I maintain that view today, that was a disaster,” Thorne said in a interview on Tuesday. “They seem just as wrong to me today as they did then. It feels the same … but the cause is different. It’s not an overall plan to close the Sussex hospital.”

He said he is sure the health authority is dedicated to making sure the hospital returns full service to the community, but knows even that will garner some skepticism.

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“That said, it doesn’t lessen the impact on the families that are impacted,” Thorne said. “It doesn’t lessen the impact on our nurses who could be losing shifts and so it doesn’t diminish that stress.”

Horizon said for non-urgent medical needs, Sussex-area residents are encouraged to continue to use other options, such as Tele-Care 811; pharmacies; virtual care such as eVisitNB.ca; and after-hours clinics.

New Brunswick residents can also call 811 to assess whether their medical needs are urgent and could require emergency care.

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