Chesley hospital’s emergency room remains closed overnight, due to a shortage of nurses and increased demands on them due to COVID-19, the hospital corporation’s president and CEO said Friday.
The department has been closed from 8 p.m. to 8 a.m. since September 2019, to ensure patient and staff safety, hospital officials have said.
Of the 11 emergency departments in Grey-Bruce, Chesley’s hospital is the only one without 24/7 emergency room coverage.
It takes a skilled, experienced nurse to work in the emergency department, particularly overnight when they are by themselves and may encounter any health emergency, Michael Barrett, South Bruce Grey Health Services’ president and CEO, said in an interview Friday.
Recruitment for the position has not been successful so far but Barrett cited reasons to remain optimistic. He also detailed a proposal made to the Ontario Ministry of Health to address issues he said many small hospitals are facing.
“I am optimistic that we will get Chesley reopened. We’re doing a tremendous amount of work on improving the education, mentorship for new nurses coming into our organization . . . and ensuring that our new nurses will have the skill and expertise to become one of those nurses that will fill those shifts in the emergency department in the future,” Barrett said.
He declined to estimate when the department would reopen around the clock.
An ER typically would have a doctor and a nurse, and could call on in-patient staff in life-and-death situations, Barrett said. Chesley has 10 beds for patients waiting to get into other facilities and eight acute-care beds.
Eighty-five per cent of ER visits take place between 8 a.m. and 8 p.m., he said. At night, people travel and ambulances are directed to other hospitals. The community has been “very clear” it wants the ER to be open 24/7, which the hospital board is committed to doing, Barrett said.
In February, the Chesley and Clinton hospital administrations submitted a four-pronged proposal to the Ministry of Health to deal with their immediate needs and common concerns at small, rural and northern hospitals, Barrett said. Clinton’s ER has been closed since December 2019 due to a nursing shortage too.
“It’s not only our two emergency departments; there’s many others across the province that may be one or two nurses away from finding themself in a similar spot,” Barrett said, based on conversations in Ontario Hospital Association meetings involving people from small, rural and northern hospitals.
The proposal suggests how the Ministry of Health could support hospitals like theirs to provide 24/7 emergency department service again:
Recruitment and retention: Provide more funding to pay the extra expense of a seasoned nurse while training a new nurse; permit nurses in part-time positions to benefit from the new nursing graduate guarantee program, which pays nurses’ tuition if they work in rural areas. Currently its for full-time positions only.
Enhanced model of care: Allow nurses to consult people at other hospitals virtually, consider funding two emergency room nurses on overnight shifts.
“I think we need to talk about it,” Barrett said. “If we’re going to sustain small emergency departments, if we’re having challenges finding the appropriate skilled staff to fill those roles, we need to look at a different model. And that model could be having additional staff available on those overnight shifts.”
Though there are in-patient nurses in the hospital to call on, and a doctor is on-call overnight, having a second nurse on the shift may help ease concerns of potential candidates for emergency room work, he said.
Address system barriers: When nurses go on non-emergency patient transfers, it leaves the emergency department short, so non-emergency transfers need to be re-examined, Barrett said. Likewise, dispatching a mental health worker to a police incident may avoid someone coming to the hospital unnecessarily, he said.
Specialty service support: There’s an anaesthetist shortage in Walkerton hospital, where they birth 450 babies a year. Funding is needed to fill that gap because currently people are working long hours and on-call to meet the demand, he said.