As Nova Scotia works to address its surgical backlog, creating beds and maintaining operating room (OR) staff is the next step toward reduction.
“The surgical workforce has not been the rate-limiting step, the rate limiting step has been the anesthesia workforce,” said QEII Health Sciences Centre cardiac surgeon Dr. Greg Hirsch.
He says Nova Scotia Health and the Department of Health and Wellness are working hard to attract and recruit anesthesiologists, nurses and to create beds.
“The nursing staffing issue is significant and in the OR they’re very particularly specialized trained nurses, so not just any nurse can go into the OR without specialized training,” said Minister Michelle Thompson.
Doctors Nova Scotia president-elect and anesthesiologist Dr. Colin Audain says he is able to complete his surgeries, but never with a full staff.
“We were missing at least seven nurses today for sure,” said Audain on Wednesday.
He remembers the previous day seeing two nurses go their entire shift without a break.
“They worked their entire shift and they didn’t even get to leave early,” he continued. “They still incurred overtime, because they were short at least four staff.”
The health and wellness minister told media on Thursday that the provincial government is “looking at where our gaps are in the system and also making sure that we have opportunities for patients who require admission post-surgery to have the capacity in hospitals to be admitted.”
Dr. Hirsch, who is also senior medical director for surgery at Nova Scotia Health, says he’s had to put the breaks on the volume of cardiac surgeries being performed in an effort to ensure no harm comes to patients as the health human resources problem is addressed.
“By pushing high volume through a skeleton crew you really risk burnout and making the situation worse,” said Hirsch.
But recent provincial initiatives and announcements have Hirsch feeling optimistic for the future.
“I do feel this is the first time in my 25 years here that there’s been such an unprecedented, concerted effort to get this train pulling together in the right direction. To de-silo all the concerns so that we can, not so deeply, affect bed availability for surgery … And take a more balanced, more intelligent, more data-driven look.”
This includes Nova Scotia Health’s development of an internal algorithm that tackles wait times for surgery and access to consultations — while considering patient and provider preferences.
“The queuing for new surgery has evened up with the performance of surgeries, so the waitlists aren’t growing,” said Hirsch. “We need to now get them down so that people can get hips and knees and less acute things done.”
Minister Thompson has said that stabilization and significant improvement in staffing should be seen in two to four years — a timeframe she says the premier will ask to be reduced.
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