Fewer people visiting N.B. ERs, but staffing shortages so severe system can’t keep up: advocates

Over the last month, long wait times, closed emergency departments and two deaths have exposed the pressure on emergency health care in New Brunswick – some say, like never before.

Community hospitals in Sussex, Sackville, Oromocto, Minto and Saint-Quentin have experienced temporary closures or reduced hours of their emergency departments. There have also been several warnings by Horizon and Vitalite Health Network to limit emergency room visits if possible, specifically in Fredericton and Moncton.

And while the circumstances surrounding two people who died in ERs remain unclear, it has further highlighted pressures facing the system.

“Our emergency departments are completely overloaded with patients,” said Paula Doucet, president of the N.B. Nurses Union.

“The wait times… the frustration they feel is more than I’ve ever seen in my tenure,” said Anthony Knight, NB Medical Society CEO.

But according to Horizon Health Network’s annual report, the number of visits to its hospital emergency departments are actually lower than they’ve been in years.

Between 2015 and 2020, Horizon hospitals saw an average 358,877 visits to emergency rooms.

When the pandemic hit, visits dropped by almost 100,000 – to 262,335 visits in 2020-21.

Hospital visits remained stable last year, with 270,113 visits reported in 2021-22.

Dr. Mark MacMillan says visits may be lower, but so are staffing levels. Hundreds of healthcare professionals have been forced off work due to COVID-19 infections.

“We just don't have as many physicians. We just don't have nurses and allied health professionals in the ERs to deal with the people coming through, so people end up sitting there waiting longer,” he said.

He also pointed to fewer family physicians in the system able to treat people before they land in the ER.

When asked if the strain on emergency medicine is actually deterring doctors and nurses from the field, he said the specialty is a calling, one that takes a certain skillset.

“I don't think it deters people, I just think it makes people realize that there are a lot of challenges working in the ER,” he said. “What we need to let people know is this is a rewarding field. It is challenging at times, yes, but there are not a lot of jobs in the world where you can come in and save someone's life.”

Horizon’s interim CEO Margaret Melanson said in an emailed statement to CTV Atlantic that the social media posts, notifications and public service announcements encouraging patients who need non-urgent help to seek other options – like virtual care – have worked.

“As a result, the number of lower-acuity patients with non-urgent issues that presented to the ED (such as prescription refills and sore throats) was lower than it was in the years prior,” she said.

But she also points to the severe staffing shortage as the reason why there’s been so many disruptions in the system, specifically emergency medicine.

“We’ve increased our recruitment efforts significantly in recent months to attract and hire nurses, physicians, and other health care workers in New Brunswick. We will provide an update on our progress soon,” she said.

Dr. MacMillan expects it will take five to 10 years to get a handle on the situation, since it takes at least that long to train and educate nurses and doctors. He’s encouraging the N.B. government to listen to doctors and nurses and other healthcare professionals when they suggest strategies or ideas that may help the system in the short term.