Some northern Ontario ERs, hospitals grappling with staffing shortages

Northern Ontario may be on the verge of seeing hospital emergency rooms close as staff shortages show no signs of abating.

Dr. Sarah Newbery, a family physician and associate dean of the physician workforce strategy for the Northern Ontario School of Medicine University (NOSM) said that across the region, staffing levels are "really quite tenuous."

"I think a big part of it right now is burnout,"  Newbery said. I think people have been working very hard in health care for the last two years as we have worked to manage the pandemic and continue to provide all of the usual care that people expect and deserve."

"So I think staff are tired."

Also creating a pinch in staffing levels are resignations or retirements which have hospitals struggling to fill in those gaps left behind by experienced staff.

Newbery said that most hospitals rely on locums, or temporary, short-term staff to keep levels at pace, but as all facilities deal with their own staffing shortages, there's been fewer locums to go around.

Compounding the issue are leaves of absence by staff infected with COVID-19.

"Unfortunately, across the north, we just do not have the margin of capacity to be able to bring in people quickly to be able to replace staff who are off with illness," Newbery said. "And sometimes what that has meant is service closures."

Mike Baker, president and CEO of the Temiskaming Hospital, said it's been challenging making sure the emergency room stays open and functioning.

"This is something that we've been dealing with for several years now," Baker said. "That's because of a growing alternative level of care problem in our area."

Baker estimates that 50 per cent of the hospital's patients should be in long-term care but there is a shortage of beds. The pandemic just put extra pressure on the already-present cracks in the health care system. That includes an occupancy rate that exceeds 100 per cent. 

"The average for all of 2021/2022 was 108 per cent and the average for this past July was also 108 per cent," Baker added. That's forced the hospital to turn to agencies to help ease the pressure.

"We've been dealing with this for years now, and that started us looking at agency nurses as a solution," he said. "It's a very expensive solution, so we don't like to use it."

Agency nurses, Baker said, perform the same duties as hospital nurses, but are paid more through a third party, or private agency, often from southern Ontario. Despite their costs, demand for agency nurses skyrocketed during the pandemic, Baker said.

It's an expensive alternative.- Mike Baker

That becomes expensive as these traveling nurses require room, board and travel costs.

"It's an expensive alternative and in a perfect world you wouldn't use those resources," Baker said. "But when you're talking about emergency medicine and keeping a hospital open when there's already shortages in other sectors of the health care, and you're carrying that load, for example, of long term care, then you really have no choice." 

"The alternative of shutting down departments because we don't have enough staff is just not something we can afford to do, given our geographic location and the distance to other, bigger centers."

In Sudbury, a spokesperson with Health Sciences North, the region's largest hospital, said its emergency department remains open for urgent care needs.

"Like other hospitals in Ontario, HSN has been experiencing significant staffing challenges across our organization particularly over the last two months in acute, emergency and critical care areas," the statement reads.

"There are many reasons for the current provincial staffing situation including retirements, people choosing other employment options and a limited number of new graduates to recruit."

"Staffing shortages make it challenging for patients and families as they access care at HSN. Staffing shortages also create difficulties for our front line staff particularly when the volume of patients and the acuity of illness has returned to pre-pandemic or higher levels."

Sault Ste. Marie has full state of doctors

A statement from Ila Watson, Chief Executive Officer of the Sault Area Hospital and Dr. Silvana Spadafora, the hospitals' chief of staff said that despite an "ongoing fragility" in the health care system, staff continues to be at the ready to deliver care in the community.

"Our emergency department is seeing a return to pre-pandemic patient volumes as individuals who delayed accessing care address their health care needs, and individuals who are unable to access urgent care with their primary care providers or are without a family care provider come to the Emergency Department for care," the statement reads.

But the hospital may not, for now, be as hard-hit as some other facilities in the north.

"Our emergency department has a full slate of physicians, lessening the risk of physician shortages as seen elsewhere," the statement reads. 

"We are reassured by this stable component of our care team. However, like many communities across Canada, our nursing and clinical support services teams have experienced shortages impacting care delivery."

"To lessen this impact, as our emergency department provides many levels of care, we redeploy staff and physicians within the department to address the most critical patient care needs."