The BC Nurses’ Union has warned the 24-hour closure of the Elkford emergency department this month is a sign of a health system in crisis as a global nursing shortage looms.
On July 10, Interior Health issued advice stating the Elkford Health Centre would not be able to offer emergency department services that day due to unexpected limited nurse availability.
Residents requiring urgent care were advised to call 9-1-1 or travel to Sparwood or Fernie, between 25 and 50 minutes away.
Christine Sorensen is president of the BC Nurses’ Union (BCNU), which represents 47,000 nurses across the province, including about 80 in Elkford, Sparwood and Fernie.
She did not know the exact reason for the July 10 closure but said Elkford was one of a number of sites affected by “poor decision-making on recruitment and retention” and the nurses were not to blame.
“The nurses are working very hard. They are trying to cover all the work and provide good, quality, safe patient care to the best of their abilities,” she said.
“But they can’t do that when the Interior health authority has not recruited enough nurses to work there, to cover the amount of shifts that are required to keep the emergency department open.
“The blame needs to be shifted back to the employer who has failed to recruit and retain nurses to work in that community.”
The last time the Elkford emergency department (ED) closed due to staffing was August 9, 2016, according to Interior Health community manager Christine Neal, who described the July 10 closure as “an unusual situation”.
In a statement provided to The Free Press last week, Neal said one person visited the health centre that day but did not require urgent care and arranged to return when the ED reopened the following day.
The department is staffed by two permanent nurses with multiple casual staff who fill in and are supported by five physicians who share the equivalent of two full-time positions.
While all ED nursing positions are currently filled, Neal said Interior Health is always recruiting new casual staff to cover shifts when permanent staff are on vacation or away for other reasons.
Sorensen believes this strategy is unlikely to attract new nurses to the area.
“Nurses need regular, permanent positions, full-time positions, so that they can establish themselves in the community,” she said.
“You can’t get a mortgage if you have a casual position, so you can’t buy a place, you can’t rent a place, you can’t be guaranteed an income, so that you can live in the community and ensure that you can provide your accommodation (and) support your family.
“People are not going to move to a community to complete casual work.”
In February, B.C.’s Auditor General Carol Bellringer handed down a report, which recommended Northern Health work with BCNU on new recruitment and retention strategies for registered nurses in Northern B.C., where there was a critical shortage.
Sorensen admitted that while the situation in the Elk Valley did not appear as dire as in the north, the Elkford ED closure showed there was a need for a new approach.
She claims the union has repeatedly reached out to management at Interior Health with proposed solutions to address staffing shortages, but their suggestions have fallen on deaf ears.
One such solution would be to create a rural float pool of nurses, whereby nurses in a defined area move from one site to another according to shortages.
“Those nurses tend to be often more experienced, they’re trained in many different areas, they can care in many complex situations and they can be deployed to go to those communities,” said Sorensen.
“The employer then would be responsible for providing them with temporary housing, providing them with living expenses while they’re providing support to that community.”
Sorensen said proactive strategies needed to be put in place as a global nursing shortage looms.
These could include early recruitment, a student loan forgiveness program to encourage graduates to move to underserved communities, housing support and continued education opportunities.
“There are a number of things that need to be looked at along the timeline of nurses entering the workforce and keeping them in the workforce, right up to the time that they look at retiring,” said Sorensen.
“We have seen creative solutions in other countries and I think that B.C. needs to become very proactive or we will be in a really difficult situation very quickly.
“It’s already starting to show signs of crisis, such as the closure of the Elkford ED, and I’m imploring citizens and mayors of small communities to really speak up and start asking their MLAs – what will they be doing to ensure safe patient care in their community?”