Deputy Minister of Health Says ‘Now is the Time for a Change’ in Nova Scotia Emergency Rooms

As emergency department staffing shortages and overcapacity issues continue to plague Nova Scotia hospitals, the province’s deputy health minister said change is needed and that it was a priority to remedy this.

“The reality we face in Nova Scotia and across the country is that our emergency services are facing greater demand than ever. It’s not as simple as adding more staff to existing emergency services,” Jeannine Lagassé told the Legislative Assembly Public Accounts Committee on Wednesday.

“Our health care system is complex and interconnected. To alleviate the pressures on the province’s emergency services, changes are needed in several areas.

The committee’s agenda focused on the impact of government spending on understaffing in emergency departments.

Ms. Lagassé told committee members that she is “very aware” that “much more” needs to be done to create a health care system that Nova Scotians “need and deserve.”

“The time for change is now”

“We learn from our challenges to create opportunities, to do things differently, to provide better care,” Lagassé said. “The way we’ve always done things doesn’t work. Now is the time to change. »

Noting that emergency services “need to be there” for people in an emergency, Lagassé outlined a number of initiatives and changes that she says will ease the pressures the system currently faces.

These include mobile primary care units, a temporary after-hours post-triage unit for patients presenting to an emergency department requiring non-emergency care, and a program that enables paramedics treat low acuity patients on the spot without hospital transport.

“And most importantly, it means training, recruiting and retaining health workers,” she said. “These are simple things to say, but they require a huge boost from the entire healthcare system.”

“Budgets were not a limiting factor”

Eileen MacGibbon, vice president of central area operations for Nova Scotia Health (NSH), also addressed the committee. She said staffing and ensuring medical coverage for emergency services is a priority.

“I want to assure you that budgets have not been a limiting factor. We have the funds available to fill vacancies and ensure shifts are fully staffed. It’s the actual human resources that have been scarce,” MacGibbon said.

“Sometimes it is necessary to bring in nurses and other staff from external recruitment agencies, either to fill gaps or to ensure that our own staff can take a well-deserved vacation. It comes at a cost, but we believe it’s the right thing to do to be able to provide care when other alternatives have been exhausted.

MacGibbon said overcrowding in emergency departments often comes down to an inability to admit patients to hospital beds. She said the issue is being handled locally and system-wide.

“Our system is in a period of transition. And like in other parts of Canada, there are tensions that affect our staff, doctors and patients,” MacGibbon said.

“However, we believe the actions we have underway are creating the foundation for a reliable and sustainable emergency care system in Nova Scotia.

work-life balance

The issue of spending $18.4 million to hire traveling nurses (also known as agency nurses) to fill vacancies in long-term care was raised by NDP MP Susan Leblanc.

Leblanc pointed to a CBC report on the practice published last week. She asked if the province also hires travel nurses for hospitals, and specifically to fill vacancies in emergency medicine.

Bethany McCormick, vice president of operations for the North Zone, said they hire travel nurses or agency staff when all available internal options have been exhausted.

This has a cost, of course. We use them in the emergency department as well as in other areas of our hospitals and departments as needed,” McCormick said.

“We have spent in 2022-23, year-to-date, $11.4 million on travel nursing.”

Leblanc pressed McCormick about agencies in other provinces actively advertising and recruiting Nova Scotia emergency department nurses.

“These nurses could earn almost triple their salary by switching to agency work with the added benefits of greater flexibility and autonomy,” Leblanc said.

She also asked how NSH remained competitive to keep nurses in the province.

“We are looking at a number of factors within Nova Scotia Health, such as scheduling, flexibility, flexibility around FTEs. So if someone maybe wants to work 80% of the time instead of 100% of the time to improve their work-life balance,” McCormick said.

“We are also working very hard to ensure that we can allow people to have their planned and planned breaks and vacations as requested. These are some of the factors that we know have a real impact on a nurse or healthcare provider’s ability to balance work and personal life.

Lagassé also weighed in on the issue of nurse retention. She said her department was open to “new ways of doing things”, pointing out that salaries were only one aspect.

“We think there are a number of other things outside of collective bargaining that we can do as well,” Lagassé said.

“We are all concerned”

New Democrat and Liberal members of the committee expressed disappointment that answers were not immediately available for several questions they posed to those who appeared before the committee.

Liberal MP Brendan Maguire said while he didn’t blame anyone in the room, he found it “disturbing” that he couldn’t get answers to the first six questions he asked.

“These are very simple questions that I would say people in senior management positions within the Department of Health and the Nova Scotia Health Authority should be able to answer,” Maguire said.

“I think there’s a problem when we can’t get a definitive answer in this committee on things like emergency room closures, emergency room access, the IWK, things like that.”

Leblanc agreed, echoing Maguire’s disappointment that he couldn’t get the “short snapper” answers.

At a press conference last week, the IWK Health Center Chief and Chairman of Pediatrics, Dr. Andrew Lynk, and Chief Medical Officer of Health, Dr. Robert Strang, addressed the overwhelming impact of a season Early influenza and increased cases of respiratory syncytial virus (RSV) had on hospitals.

Maguire asked those who appeared before the committee about their level of confidence in the system’s ability to accommodate more emergency department patients as the province enters peak flu season.

” We are all concerned. I think across the system we’re worried because we’re seeing unprecedented levels…in terms of the demands being placed on the system,” McGibbon responded.

“I will say that the IWK…and the Nova Scotia Department of Health have had tremendous success with the recent clinics we have held to be responsive.

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