On September 7, a trio of representatives from Northern Health came to town to speak to locals about the decision to close the Emergency Room on evenings and weekends with just one day’s notice.
Speaking for Northern Health was Lisa Zetes-Zanatta, Vice President, Clinical Operations, Angela De Smit, Vice President, Professional Practice / Chief of Nursing and Allied Health, and Celia Evanson who is Medical Director for the South Peace.
The meeting began with an apology from Zetes-Zanatta. “I want to start with before I start the presentation by first apologizing that a notification went out before we were here having a community meeting,” says Zetes-Zanatta. “The intention was to meet with the community first, have conversations, understand concerns, before that announcement went out.”
The problem, she says, is Tumbler Ridge was already not being covered due to physician shortages. “The physicians had already stopped providing night coverage, and that announcement had to go out because we wanted to make sure that people knew to call 911.”
She says that healthcare is not static, but always changing. “We are in a different situation today than we were. Would we be having a different conversation in the future? Very possibly so. That announcement talks about now. And right now, this is what our situation is. What it will look like in the future will depend on our recruitment efforts. It will depend on the models of care and additional supports available.”
Moving forward, she says, it is a conversation that Northern Health intends to have.
With physician coverage at half of what it is supposed to be in Tumbler Ridge, she says, “our goal is to make sure that daytime services are sustained. We are in an extreme health and human resource challenge. This is no different in Tumbler Ridge than it is in Hudson Hope, than it is in Dawson Creek, than it is in the Interior, or in Vancouver, or the Fraser Valley, or on the Island. These stories are in the news, across BC, across the country, and honestly across North America. Given the polarization in the States, we have been successful in some cases to recruit there.
“So supporting the change, BC Emergency Health Services (BCEHS) is putting an additional ambulance in Tumbler Ridge and an additional ambulance in Dawson Creek. The Dawson Creek paramedics will be advanced paramedics, which have a wider scope then other paramedics. It’s the first time that this is being put into place in the northeast. The goal is faster response time and turn around to appropriate care.”
She says she has heard stories from people in the community that they go to the health centre at night and they’ll wait hours to be transported to Dawson Creek. “That’s because when you’re already presented to a hospital. You’re being moved by the patient transport network; it’s interfacility transfer facility to facility. And they look at higher acuity of patients. You are triaged as either a red or a yellow, and then they take available resources and move people. When you call 911, you do not go through inter facility transfer. The goal is transfer to the most appropriate level of care for the presenting concern of the client that’s in front of the paramedics.”
Zetes-Zanatta says the reality of ER is “90 percent of the people who present at night to the emergency department are not emergency level patients. They are people who could be seen in clinic, but they’re attending outside of office hours. So the ask would be for that group of people to come during the operating hours. The people who are presenting that do require a higher level of care—who have chest pain, who have shortness of breath, difficulty in breathing—we want them to be treated in a facility where we have the laboratory services, the surgical services, the diagnostic services to be able to support the care of that person. All of those people would have come here, and then be transferred through interfacility transfer. That can delay access to going to a hospital that actually does do that care.”
She says there are some things that can be done locally. “They can initiate support for the patient en-route, so you’re not waiting to get to the next hospital before when you have a critical event that you’re being cared for. You’re being cared for in that ambulance. In the event that it is a critical, life limiting concern, we’re working with BCEHS to send the Advanced Care Paramedics, to meet clients halfway so that we can do even more in the ambulance while we get the patient to Dawson Creek.”
Despite the closure, she says, there is zero funding decrease to Tumbler Ridge. “Your budget is your budget. I can say that 100%, because I am responsible for your budget. There will be not one cent removed from your budget. I am happy to invite the mayor, perhaps a designate from his council and a couple community members who have interests. I would be happy to open that up to you, so that you can see what the budget is and ensure and hold me accountable that I am not moving a penny from your budget.”
Indeed, she says, this is not about budget, it’s about human resources. “Money is not the issue here. So I don’t want people to think they’re just going to claw back the budget, and it’ll never exist again. That is not what’s happening. Not one person will be laid off. We need more people. Our goal is to retain our physician and nursing and allied staff.”
She says one of the issues with keeping people in Tumbler Ridge is the on-call model for the emergency room. “Physicians and nurses can work in other communities where they do have to be on call. Here, when they’re on call, they have to have a certain number of hours between coming in on a call and then going back to work. This means we wind up closing during the day, which is when the majority of people are presenting, and the staff feel extreme moral distress.”
Trent is the publisher of Tumbler RidgeLines.
