'Live up to your promise': Rural N.S. residents remain frustrated by temporary ER closures

It’s no surprise to those living in rural Nova Scotia that a CTV News survey has found hospital emergency departments across the country have had to close their doors more than 1,280 times so far this year.

It also found most of those closures are in rural hospitals.

“It's very frustrating, and what can we do?” said Middleton, N.S., mayor Sylvester Atkinson.

“We’ve gone to just about every avenue that we feel that we can and nothing much is happening.”

Back in June, Atkinson wrote a letter to Premier Tim Houston calling for urgent improvements to emergency care and ER staffing levels, after volunteer firefighters were called to help a patient in cardiac arrest inside Soldiers Memorial Hospital -- which had no doctor on site at the time.

The patient died.

After facing criticism, the province said proper procedures were followed when hospital staff called 911, and no further review was necessary.

Now, the hospital's ER is only open from 7:30 a.m. to 1:30 p.m. three days a week for the month of September.

“(But) the regional hospital is about 40 minutes away,” Atkinson said. “You better make sure your emergencies are Tuesday, Wednesday, Thursday only.”

He’s upset at the lack of progress.

“I hope it’s going to change; we have a premier who said if we elected him that health care would improve … nothing much has seemed to have happened yet,” Atkinson added.

The lack of emergency department hours is a worry for residents like 78-year-old Albert Johnson.

“I've had a quadruple bypass, little over 20 some years ago, and I worry about my condition, I worry about my grandkids, I worry about my wife,” Johnson said.

“We’re living in a rural area, this is not downtown Halifax,” Johnson added. "In the rural areas it’s very different.”

Nova Scotia’s Department of Health couldn’t provide provincial temporary closure numbers to CTV because the data won't be available until December. The Minister of Health and Wellness, Michelle Thompson, was unavailable for an interview.

The Nova Scotia Health website lists temporary emergency department closures daily -- some overnight, and others for days.

For example, the Glace Bay Hospital’s emergency department is closed until Sept. 11 at 7 a.m.

“We've gone from having very good access to emergency medicine, to very poor access to emergency medicine,” Cape Breton emergency physician Dr. Margaret Fraser said.

She said she remembers a time about ten years ago when the island had had multiple emergency departments open 24/7.

Now, those that still exist are frequently closed.

Others, which have been converted into what the province calls urgent treatment centres, require appointments and aren't open 24 hours.

“Urgent treatment centres are absolutely not comparable to an ED (emegency department) and some of those places that have been turned into urgent treatment centres should be turned back into emergency departments immediately,” said Fraser.

She’s concerned about the effects on patients who can’t access care quickly.

“So it’s really just snowballing to the point where we’re seeing more patients, sicker patients, all the time,” she explained.

Nova Scotia Health said ongoing temporary closures are caused by staffing shortages.

“The two factors are really physician resources and nursing resources,” Brett MacDougall, vice president of operations for the Eastern Shore region.

“It’s difficult to have (ERs) open when there’s gaps in relation to those specialists,” he said.

But he said new provincial recruitment initiatives and the use of new technologies are helping.

“I think there’s a lot of work that’s happening in relation to Nova Scotia trying to create additional resources from within the educational institutions, that will come,” he said. "But there’s been a lot of work and a lot of focus in relation lately with trying to bridge the gap with international professionals.”

MacDougall said efforts to provide primary care options for Nova Scotians, such as pharmacy primary care clinics and virtual care, are taking some pressure off emergency departments.

Fraser said there also needs to be an investment in infrastructure for more hospital beds.

“We’ve had fewer and fewer beds to work with most of my adult life, and yet we know that we have patients that are going to require care, but they’re not getting it because there’s no bed to put them in,” she said.

Atkinson said his community has worked on trying to find additional doctors with “some but not a lot” of success. “We just need to be listened to.”

His message for Houston: "Live up to your promise of improving healthcare, Mr. Premier, we plan to hold you to it.”

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