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No sense of urgency as emergency department closures worsen, says physician | CBC News


Staffing constraints have forced the closure of some rural hospitals across Ontario and the Ottawa area has been no different, but one physician says he’s not seeing any short-term solutions to address the current crisis.

The Carleton Place & District Memorial Hospital’s emergency department has closed 10 times since the beginning of the year, including four times in July alone, something the hospital blames on staffing issues.

“The Emergency Department has a very small staff with two nurses working on each shift. If one of them is sick, there is a big impact as there is not a large pool of specially trained staff to draw from,” said Mary Wilson Trider, president and CEO of the Mississippi River Health Alliance, in a written statement.

Dr. Atul Kapur, an Ottawa emergency room doctor, said the current problems speak to a wider issue without any short-term, concrete solutions.

“All the conditions that have led to [emergency department closures] last year haven’t gotten any better, in fact they’ve probably gotten worse,” said Kapur, who is also part of the public affairs committee with the Canadian Association of Emergency Physicians.

“I’m not seeing a recognition of the extent of the crisis that we’re facing.”

Part of that crisis, he said, is the exodus of nurses and doctors — a problem plaguing urban hospitals as well.

“What you’ll see [in urban hospitals] is parts of the department will be shut down, you’ll have longer waiting times, but you won’t see the entire department shut down.”

At a rural hospital, with only a few physicians and nurses staffing the emergency department, when one or two call in sick there is little choice but to close, he said.

Cascading effect

He said when one emergency department closes it shifts the burden to nearby hospitals, which are often unprepared to bear the extra pressure on short notice, “which may cause those employees to burn out and ultimately result in that emergency department closing,” he said.

Ultimately, he said more needs to be done in the short term to tackle what’s driving nurses and doctors away, including burnout from stress and patient violence.

People sit in a waiting room.
When there are staffing shortages in urban hospitals, the emergency department won’t close, but wait times may increase. (Chaikom/Shutterstock)

Almonte General Hospital had to shutter its emergency department four times in the last seven months.

And the Kemptville District Hospital had to make a deal with The Ottawa Hospital to borrow physicians to avoid having to close its emergency department over the summer.

Trider said the Carleton Place hospital has been working on attracting more nurses, including collaborating with colleges and universities to attract students.

The hospital has also offered 14 nurses an incentive under the province’s community commitment program, which gives $25,000 to eligible nurses for a two-year stint at certain hospitals and long-term care homes.

But Kapur said a new nurse doesn’t have the same wealth of knowledge as someone who has been practising for years.

“A student nurse is not a trained emergency nurse and that is a very advanced set of skills,” he said.

“We’re not seeing our leaders do effective things to keep those staff and entice some [nurses] back.”


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