Nurses quit, emergency departments close down
TORONTO — On Oct. 25, an exasperated leader of the opposition Peter Tabuns (NDP –Toronto-Danforth) stood up in the Ontario legislature and said that “in September a four-year-old child with a broken arm was left waiting more than four days for minor surgery at McMaster Children’s Hospital.”
Staffing shortages are now commonplace, Tabuns said. “How much worse does the crisis in our health care system have to get before the minister and the premier give nurses and front-line health care workers the support they need?”
In September, a boy waited 23 hours for an emergency bed at Ottawa’s Children’s Hospital of Eastern Ontario. That same month, a nine-year-old girl was hospitalized for two weeks after her appendix ruptured, then sent home but her appendix was not removed. Her parents were told that the appendix has a 60 per cent chance of rupturing again and her scheduled operation is now about five months away. The family contacted a U.S. specialist to see about arranging for an operation south of the border. The specialist was surprised that the appendix was not taken out immediately and asked the mother: “Do you trust the system?”
In rural areas, it’s worse. Staff shortages mean hospital emergency wards just shut down.
On Sunday, Oct. 30, the Norfolk General Hospital emergency department closed for 24 hours due to a staffing shortage. Ambulances were re-routed to neighbouring towns 30 minutes or more away. The hospital was still short-staffed when the emergency department re-opened, down to 31 nurses when 60 are required. Area residents are getting the feeling that this is the new normal.
The Chesley hospital closed its emergency ward for two months. It won’t re-open until sometime in December. Early in the summer emergency departments were temporarily closed at Mount Forest, Clinton and Seaforth.
Hospitals in Seaforth and St. Mary’s reduced emergency room hours in August, with only three on staff for emergencies. The Listowel hospital emergency department closed for one night in late September.
The Toronto Star wanted to find out how bad things are in farm country and counted 86 temporary closures of emergency departments in rural Ontario from July 2 to mid-September
In Eastern Ontario, the Perth hospital temporarily closed its emergency department in early summer. The Kemptville hospital closed its emergency department several times. On the Labour Day weekend, rural hospitals at Carleton Place, Almonte, Kemptville and Alexandria closed for one night due to staffing shortages.
“Three rural hospitals in Eastern Ontario closing on the same weekend is abysmal and an indictment of the failure of the minister of health to understand the breadth of this crisis,” Dr. Alan Drummond, an emergency physician at Perth, said just before the Almonte hospital joined the list of closures.
The Smiths Falls hospital closed its maternity department for two weeks in October.
According to the Society for Rural Physicians of Canada, there is no plan to improve health care in rural areas. In its July newsletter, the rural physicians’ society stated that “Currently, Canadians living in rural communities do not have equitable access to health care services. There is no national, provincial, or territorial rural health care strategy to address the needs of rural populations.”
The situation is not only unprecedented but also extremely dangerous, said Dr. Drummond, who is also co-chair for public affairs with the Canadian Association of Emergency Physicians.
A spokesperson for Ontario’s Ministry of Health said the province was working to bolster workforce capacity, including lump-sum retention bonuses and funds to recruit nurses to target areas across the province.
The province did promise to increase the number of nursing spots at colleges and universities by 2,000 starting last year. But the Registered Nurses Association of Ontario say that’s not enough. “We entered the pandemic with the lowest registered nurse-to-population in Canada – a shortfall of 22,000 RNs, said association president Claudette Holloway. “During the past two and a half years more RNs have left due to excessive workloads, deteriorating working conditions, stress and burnout.”
Nationally, things are improving but not fast enough. More than 12,000 students graduated from registered nursing programs in 2020 and that number has been rising for seven years, reported the Canadian Association of Schools of Nursing. There were only 5,000 graduates in 2000.
Ontario NDP health critic France Gélinas argues that the province needs to immediately repeal Bill 124 that capped wages and prevented signing bonuses and contract extensions. “It is illegal, discriminatory, disrespectful and it demoralized our tired and burned-out health care heroes,” she said. The argument goes that nurses can earn more working for private nursing agencies and many would return to work if the province would repeal Bill 124.
Gélinas also argues that the province needs to set higher PSWs (personal support workers) wages with benefits, sick days and a pension plan to get more and better workers.
There is no shortage of ideas to unclog the system. The argument for a two-tier system is that everyone wins because by removing the willing payer from the public system, you shorten the waiting time for everybody. A further increase of post-secondary spots for medical students and nurses would be another obvious help.
An idea, already used in numerous countries, is charging a nominal fee (say, $25 or $50) to see a physician to end doctor shopping for a second and third opinion and curtail running to a doctor for minor issues.
So, why haven’t some of these ideas been tried? Sometimes good ideas are abandoned because of a lack of will, or interest in solving people’s problems. Or as one man told me after waiting eight hours in an emergency room and leaving on crutches without seeing a doctor: “Don’t be so certain the problem isn’t just the incompetence of those in charge.”