Last week news that the Guysborough Memorial Hospital emergency department would close to nighttime service as of Thursday, July 9 due to a doctor shortage spread like wildfire through affected communities. With the Canso emergency department closed overnight as well, which it has been since May of 2019, there would be no overnight emergency coverage in the Municipality of the District of Guysborough (MODG).
Local stakeholders reacted swiftly to the news. On Wednesday, July 8, MODG council held an in-camera meeting with Nova Scotia Health Association (NSHA) representatives. A short-term plan to maintain 24-hour emergency services in the municipality was announced less than an hour after the meeting concluded.
The release issued by NSHA stated that, “Following discussions with the nursing staff and physicians who provide coverage at these emergency departments, there has been agreement that there will be a return to 24/7 operations over the next few weeks daily at Eastern Memorial Hospital (Canso) and on intermittent days at Guysborough Memorial Hospital.”
In the release, Madonna MacDonald, vice-president, operations, Eastern Zone said, “We know the people in these communities want their emergency departments open full-time every day. At this time, we are trying to provide the best level of service we can with the staff and physician resources we have available. Going forward, we remain committed to developing a long-term plan for health service delivery in these communities.”
When asked what had changed in the course of a week in terms of staff availability at Guysborough Memorial and Eastern Memorial hospitals, Facility Manager Leona Purcell told The Journal that in the case of Eastern Memorial, “We were able to hire nurses, and our current nursing staff, we were able to work with them and they worked very hard and adjusted their vacation and scheduled so we could have an ED competent nurse on every shift. I applaud the nurses at Eastern Memorial for making that work.”
In Guysborough, the situation relies on the care provided by the two permanent doctors that have been delivering service at the hospital and long-term care facility without relief for many months. No locums, temporary doctors, have yet been found to work at GMH.
Purcell said the increased hours at Guysborough Memorial’s Emergency dept., “was related to physician coverage; there was an opportunity to have physician coverage enhanced…there were ongoing discussions with the physicians here in Guysborough. I was given the dates that physicians would be then available to provide some emerge coverage for us. That is why you can see we will have some intermittent nights when we won’t have coverage.”
Purcell added that recruitment efforts continued for both long-term and locum physicians. “It is all about being responsive to community and having the safe care that they require when they need it.”
Co-chair of the Canso and Area Stakeholder Working Group Susan O’Handley said, “I am really happy to see our ER open again. Especially with Guysborough being intermittently closed. We don’t want this end of the county not to have any ER service at night. That would not be good. And hopefully we’ll recruit some more physicians to the area and we’ll get back to a more stable situation.”
O’Handley told The Journal that she had been aware that there was a staffing proposal under consideration at Eastern Memorial before the July 8 meeting, but she thought, “part of the caution was ‘we open for a week or two and then we close. We open and then we close.’ That would be hard on the community…with Guysborough closing that made it more urgent.”
Chair of the Guysborough Memorial Hospital Foundation Bill Innis told The Journal last week that the announcement made on Wednesday was a stop gap measure and while he was pleased to see more hours at the ED, this was not a solution to the health care crisis in Guysborough.
“It goes without saying that I am glad to see it opened partially,” said Innis. “But partially is not the answer, we need it open full-time. The only way to do that is full-time physicians which we are in desperate need of.
“We need at least three (physicians) and I think that the Nova Scotia Health Authority needs to make Guysborough a special case in terms of recruitment efforts and put the focus on us; not the province, not the zone but the focus on Guysborough to find physicians, so that we can manage an ER and the other pressures that we do feel here for medical care,” said Innis.
MODG warden Vernon Pitts said in an emailed statement to The Journal about the health care crisis in the municipality, “Here was a bit of good news as to doctor coverage, but no success with NSHA’s recruitment efforts as to permanent full-time physicians.
“I can’t really go into specific details as to what transpired during the meeting but overall the meeting was positive with a healthy exchange of ideas,” Pitts said of the July 8 meeting between NSHA and MODG council.
Pitts also stated that council, which has financially supported recruitment efforts at both EMH and GMH, had put forward a number of ideas to help solve staffing issues at both facilities. “First and foremost,” he said, “NSHA should seriously consider stepping outside the box! NSHA has been recruiting for our hospitals the last number of years with very little success when it comes to doctor recruitment/retention. As with any exercise, if the proper end results are not obtained with the current efforts being put forth, that should show everyone that the process is flawed, and it has to change. If the exercise is not changed, we will continue to look at exactly the same results/outcome in regard to recruitment efforts. There were a number of ideas put forward by council and hopefully the Province will give them serious consideration going forward.”
As of this time, Eastern Memorial Hospital will be fully operational until July 27, 2020. Guysborough Memorial Hospital will have nighttime emergency department service on July 16, July 20, July 22 and from July 24, through 26. The emergency departments in both hospitals are open every day from 7 a.m. to 7 p.m. Updates will be provided to the public weekly regarding the emergency department closures and will be posted on the Nova Scotia Health website www.nshealth.ca. Signage will also be posted at the impacted facilities.