It was looking bleak there for a while.
For the second time this month, the Tumbler Ridge Diagnostic and Treatment Centre was going to be on complete diversion due to short staffing.
Earlier this month, the emergency department was closed from 5 pm June 4 to 9 am June 7, due to lack of staffing.
Any emergencies that would happen during that time period would be sent to either Chetwynd or Dawson Creek.
Then on June 11, Northern Health Announced that it had been unable to secure coverage for the emergency department, and the emergency department would be closed in the evenings starting June 14, and would remain closed until Monday, June 21, including the entire weekend.
Again, any emergencies that arose in town would have to be re-routed to Chetwynd or Dawson Creek, and if an ambulance was needed to transport a patient, it would leave the community without coverage for a few hours, as the community is down to one ambulance.
Fortunately, the worst case scenario didn’t arise, and, while the emergency room was closed for three days, an Agency Nurse was found who was able to cover the emergency room for the weekend.
Even better, a diagnostic imaging tech has been hired, and will be starting in Tumbler Ridge on July 5, meaning patients that need medical imaging (primarily X-Ray) will no longer need to go to Chetwynd or Dawson Creek when the one staff currently working is not on duty.
Still, the announcements are just the latest in a longstanding issue the town has faced: how to attract medical professionals to Tumbler Ridge.
Northern Health Spokesperson Eryn Collins says it’s not just Tumbler Ridge that is having the issue. “There’s just not enough nurses to go around anywhere,” says Collins. “You’re going to find the same issue in Northern Ontario, too.”
Elsewhere around the Peace, the Chetwynd Hospital was forced to go on diversion back in March and, Dawson Creek nearly had to go on diversion earlier this year as well.
The health centre has been down to one nurse for the last few weeks, but will be back up to three by this week, two of which will be agency nurses.
WHAT IS AN AGENCY NURSE?
Historically, Tumbler Ridge has had a very stable nursing staff. But with Barb Schuerkamp retiring last year, that stability is no longer there. Which means that, when there is a shortage, Northern Health has to rely on agency nurses to fill in the gaps.
An agency nurse is a nurse who works for a third-party company, rather than for Northern Health directly. They work short term contracts to cover shortages, and will travel from town to town and city to city, filling in where needed.
There are certain benefits to agency nurses. They can quickly deploy to a variety of locations much faster than a new staff person can be hired. So they can go to Chetwynd to cover holidays for a week, then to Dawson Creek, then to Fort St. John, and Northern Health doesn’t have to hire three separate part-time or on-call nurses.
There are drawbacks, as well. Agency nurses tend to be paid higher than hospital staff, and there is no obligation for them to take any job they don’t want to.
Former head of the clinic Charles Helm says it’s not a new concept. “Previously it was never necessary,” he says. “It’s a reflection of the fact that nursing numbers in Tumbler Ridge—and across Canada—are seeing declines. Bringing in agency nurses is plan B. It needs to be seen in that light. We’re lucky we can bring agency nurses.”
CHANGING LANDSCAPE
Helm says he has a photo of the Health Centre team from an event back in the 1990s. “You wouldn’t believe the number of people. There’s full time nurses, part time nurses. How did we end up where we are today? I think It’s symbolic of what has happened across the country. The good news is there are apparently new nurses being hired. This whole thing with diversion is just a temporary thing and there’s light at the end of the tunnel.”
But after this current shortage is solved, how long will it be before the next crisis, then the one after that? While we here in Tumbler Ridge notice when the clinic goes on diversion, the fact is, this is more than a regional crisis. It’s national and even international. In 2014, the World Health Organization calculated a current global nursing shortage of nine million nurses and midwives, while the National Syndicate of Nursing Professionals predicts that could double in the next decade.
And people aren’t exactly clamoring to get into nursing. Nursing is seen as a high stress job, where the nurses work long hours for little pay and even less acknowledgment and support. And when a nurse walks away due to stress, exhaustion and burn out, it just puts that much more of a workload onto the ones that remain. The infrastructure just isn’t there to allow most health care professionals in general and nurses in particular, the ability to balance work and not-work.
“The problem is when you lose a nurse it increases pressure on the rest,” says Helm. “You need a stable work force. There is light at the end of the tunnel. Sounds like we’ve got some good nurses coming in, until then we just have to hope we have agency nurses available. The diversions we’ve had recently is a sign that they are not. It’s unpredictable, meaning it’s uncontrollable, which is never a great place to be.”
FINDING SOLUTIONS
Where does the problem lie? It’s not with the local health centre. “Dawson Creek just about went on diversion a few weeks ago,” says Helm. “A hospital that size going on diversion is unheard of. We managed to squeak through, but it was close. If we complain about diversion in Tumbler Ridge, remember that. Chetwynd just went through a physician crisis. It’s not just us.”
He says the troubles we are facing are not caused by Northern Health, either. “One must never knock Northern Health for this. It’s not a Northern Health problem. They are trying their absolute best. They are heroically trying to do their best, and, for the most part, succeeding. People say it’s a Northern Health problem. It’s not. It’s Canada wide. What we’re seeing from mayor and council is incredibly welcome and helpful.”
And what is mayor and council doing? At the most recent Policies and Priorities, council discussed creating an incentive for nurses to come to, and stay, in Tumbler Ridge. If it comes to fruition, the District could create a program where they will pay nurses $1000 month—or $12,000 per year—to work in Tumbler Ridge, for up to four nurses.
However, this doesn’t sit well with mayor Kieth Bertrand.
“Council’s main role in this is advocacy,” says Bertrand. “And we have been doing quite a bit of lobbying. I meet regularly with Northern Health on Mayor’s Health Needs task force. But when we start putting together dollar figures for NH employees it sets a precedent. If it was just Tumbler Ridge facing this issue, it would be a different story, but it’s all over the north. I’m not really in favour of monetary incentives.”
Instead, he says, that’s something that needs to be solved provincially. “If council puts up a monetary incentive, and it comes to fruition that—hypothetically—Northern Health isn’t a very good company to work for, then in effect, we’re holding them hostage. I believe things need to change within NH. This week, we were short nurses, next week it’s lab technicians, maybe next month we will need a doctor.”
Bertrand doesn’t believe that it’s council’s role to cover the gaps in wages and incentives for the provincial organizations.
Still, he does believe council has a role to play. “We can put together all sorts of attractive things—which we have—which includes the two condos the District owns.”
What’s does Bertrand see as a solution? He says an important first step is the Regional District Health Care Scholarship. “Over the last three years, the Regional District has given out 31 scholarships,” says Bertrand. “We should start seeing dividends on that in next five years. I’m quite happy with that one.”
As part of the scholarship, students would be required to come back and work for two years in the region. Bertrand thinks that, once back, they are more likely to stay, too. “The goal is to provide those to local kids in the region, because if you grew up here, you are more likely to come back here to work. I think it’s no different than trades. We recognized the shortage of trades 10 years ago, and started pushing that. We need to encourage our young ones to get into the medical fields.”
Helm says that when he retired four years ago, one of the things he was proudest of was in the 25 years he was here, there were only a few hours where there wasn’t coverage, and that was only in a few cases when someone was so badly injured, it required both doctors to go with them in the ambulance. “We had never even heard the word diversion. Now it’s the new norm.
“Every time TR faces diversion it’s a tragedy. We’ve been lucky so far, but if this carries on, it’s going to be a tragedy. Unfortunately, it’s going to take a tragedy to wake people up.”
Trent is the publisher of Tumbler RidgeLines.
