Vancouver Island emergency room latest to face temporary closure due to staff shortage

This story is part of Situation Critical, a series from CBC British Columbia reporting on the barriers people in this province face in accessing timely and appropriate health care.

The emergency room at Port Alberni's West Coast General Hospital (WCGH) on Vancouver Island could be closed through much of August and September due to ongoing staffing shortages, CBC News has learned.

An employee at WCGH, speaking on condition of confidentiality, warns the ER could be closed for eight-hour periods a day if a solution is not found to fill shifts at the hospital. While the ER is currently operating, the employee said it has narrowly avoided closures in July.

The ER in Port Alberni services a town of over 18,000, and typically receives between 60 and 80 visits per day.

The employee, a health professional, said if the ER does close, people would need to travel an hour and 15 minutes to Nanaimo, or nearly two hours to Tofino for emergency care — resulting in a three-hour period when an ambulance would be unavailable for other calls in the community.

The Port Alberni Fire department and the police detachment said they've been notified of the potential disruption. 

Island Health said in a statement there are currently no planned disruptions at WCGH, and that a closure would occur "as a last resort [...] after every possible mitigation strategy is explored and exhausted."

"Island Health is actively working to ensure the availability of emergency services in the Alberni Valley region and beyond," the statement read in part.

An ER closure in Port Alberni would be the latest in a series of temporary ER shutdowns in small communities.

Earlier in the spring, emergency rooms in Port McNeill — in the island's north region — as well as the province's Interior and northeast closed on short notice because physicians were not available to fill shifts.

As recently as Monday, the ER in Merritt's Nicola Valley Hospital in the Interior closed on short notice after an ER physician called in sick. It re-opened at 8 a.m. the next day.

Interior Health directed people needing emergency care to access Royal Inland Hospital in Kamloops, or Kelowna General Hospital, about an hour to an hour-and-a-half drive away.

Speaking at an unrelated press conference on Monday, Health Minister Adrian Dix said he was aware of the closure in Merritt, but did not comment directly on potential closures in Port Alberni.

"We're going to continue doing what we've been doing — which is hiring and building resources out in our health-care system," he said. 

"We are asking our health-care system to do more and the health-care system is responding." 

Doctors 'in their darkest hour'

Dr. Ramneek Dosanjh, president of Doctors of B.C., said the closures are "incredibly concerning" for both health-care providers and patients, and illustrate a lack of equity in health-care settings in rural and urban communities.

"The emergency room setting is usually a life-saving measure, and if we're saying that we can't have that, can't provide that to a community, what kind of care are we saying we can provide? This is devastating in a country such as ours and a province such as ours," she said.

"It shouldn't matter if you're sitting in Terrace or Dawson Creek or Port Alberni or Merritt — you should be able to access timely care and intervention."

Dosanjh said two years into the pandemic and six years into the toxic drug crisis, doctors across the province are facing burnout and unprecedented burdens on their mental health.

"This is not an easy thing for doctors not to show up, or nurses not to come in, these are decisions being made in their darkest hour," said Dosanjh.

According to the WCGH employee, keeping the emergency room in Port Alberni open would require physicians to work 12- to 16-hour shifts for multiple weeks in a row — a workload doctors are simply unable to take on. 

'We can't pull physicians out of thin air'

Merritt Mayor Linda Brown said when a physician calls in sick, there is little the city can do to keep the ER running. The city also has limited capacity to work on hiring and retaining doctors.

"There isn't anything we can do in this point in time. We can't pull physicians out of thin air. We have to deal with it as a community," said Brown. 

"We're not in a position to attract nurses and doctors at this point in time, we rely on our overall health-care system to provide them for us."

Around four hours northwest of Port Alberni, Port McNeill Mayor Gaby Wickstrom said her community is bracing for more disruptions to emergency room services over the summer.

Port McNeill Hospital has in recent months had its emergency room temporarily closed, or on diversion — meaning walk-ins at the emergency room are treated, while patients arriving in an ambulance are redirected to Port Hardy, half an hour away.

"We're always concerned because we're at minimal staffing without any extras," said Wickstrom, adding that in a rural community, having even one health-care worker out sick can result in a closure.

She said a simultaneous closure of the Port Hardy and Port McNeill emergency rooms would see patients redirected to Campbell River, two hours away. 

"We have been told that from time to time we may end up with either a diversion or a closure because it's just the nature of the staffing crisis that we're in," she said.

"It's probably going to go on for a few months, it's not an overnight fix."