Changes to Glace Bay ER triage hours 'a necessary evil,' says doctor

Emergency room doctors are getting a break in Glace Bay, N.S., starting next week.

The Nova Scotia Health Authority says on days when the ER is only open during the day, patient triage will end at 4 p.m., beginning May 15.

This will allow doctors to finish their 12-hour shift without incurring overtime.

Chris Milburn, an emergency doctor and ER chief for the health authority's eastern zone, said having doctors work past the end of their 12-hour shift can lead to burnout and put patient safety at risk.

"Now that this is becoming more of a regular thing, and will be for a while by the look of things, we have to try to find a way to get the doctor out of there more or less on time and try to keep it to a 12-hour day, which is already a long enough day," he said.

Nova Scotia is short of ER doctors, and Milburn said emergency departments across the province have had to adjust their hours.

The practice has been already in place since December at the Northside General Hospital in North Sydney and has been implemented at other community hospitals across Nova Scotia, he said.

"We'd love to provide full 24-hour emergency care, ideally, so it sucks," Milburn said. "It's not something that we want to do, but given the overall picture ... it's a necessary evil."

Cape Breton's situation is unique in Nova Scotia and in most of the Maritimes, because it has two 24-hour emergency departments at community hospitals within a short distance of the main 24-hour ER at the regional hospital in Sydney, Milburn said.

Cape Breton ER service falling in line with other Nova Scotia hospitals

"What we're seeing is Cape Breton move towards having the other emergency [departments] more run in the daytime," he said.

"It's not what we wanted or planned, but ... our level of service was actually much higher than anywhere else, and we're seeing it fall to a level that is more comparable with other areas now," he said.

Brett MacDougall, eastern zone director of emergency care, said cutting off triage early on days when the ER is not open at night has worked elsewhere.

Patients who arrive after 4 p.m. on those days when the ER is closed at night won't simply be turned away, he said.

Some patients may still be seen in a true emergency, MacDougall said.

"We look to try and provide the patient with options of either returning the next day, going to the emergency department at the Cape Breton Regional Hospital in Sydney and/or following up with their family physician," he said.

If the complaint is not an emergency, patients can also call 811.