SHELBURNE/DIGBY, N.S. – There doesn’t appear to be any end in sight to the closures of emergency departments at the Roseway Hospital in Shelburne and the Digby General Hospital due to physician unavailability.
“Yes, it is true we are experiencing ongoing challenges with the emergency department schedules at Roseway and Digby Hospitals,” said Fraser Mooney, regional spokesperson for the Nova Scotia Health Authority (NSHA). “Past experience tells us we face more scheduling challenges over certain times, such as Christmas holidays, summer months or long weekends. We have found these are times when locum doctors may choose to work in their own practices or find locum shifts closer to home.”
With staff at Roseway and Digby already scheduling emergency department shifts well into next year, “looking ahead, we do have some gaps, especially over the upcoming holidays,” said Fraser.
“We expect that a number of these gaps will be filled. We will be following up with our regular locum doctors and sharing our schedule with others across the province,” he said. “Staff will work to try to fill any gaps right up until the last minute, usually the day before the closure. From time to time we are faced with last-minute situations. For example, if a physician who is scheduled to work has to call in sick, or they are unable to make it because of the weather, it is tougher to find a locum to fill in on short notice, but it has happened.”
With the exception of the dedicated, full-time emergency doctor at the Digby hospital, for the most part the NSHA depends on locums or temporary doctors to staff the ERs at Roseway and Digby hospitals.
“One thing we are doing to maintain emergency department services is working to identify new locum doctors,” said Mooney. “For example, one of the recent Dalhousie Family Medicine Residency graduates based in Yarmouth has been doing some emergency department shifts at Roseway. For the long term, we are focusing our recruitment efforts and working to create strategies that will allow us to maintain emergency services in places that have seen closures, like Roseway and Digby.”
Aside from recruitment efforts to find physicians to provide emergency department coverage, the NSHA is still recruiting for family doctors, nurse practitioners and others to provide primary care, including recruiting for the positions of the doctors who are leaving Digby, said Mooney, noting there has been some success in recruiting primary health-care providers to the tri-county area.
“Earlier this year, a new nurse practitioner began seeing patients in Digby and at the Islands Health Centre on Long Island. As well, Shelburne got a new nurse practitioner when Maria Ceschiutti joined the family practice team back in September,” said Mooney. “While the new nurse practitioners do not work in the emergency departments, they are providing primary health care to more people in Shelburne and Digby. These patients who are part of a collaborative practice will not have to go to the emergency department for some basic primary health-care services.”
A new family doctor is also now practising at the medical clinic in Weymouth.
“While we have seen some success, we know there is plenty of work to do,” said Mooney, noting they’d just had a site visit of a doctor who is very interested in practising in Shelburne County. “It is still a few years before the doctor will be in a position to make the move, but we are hopeful to make a positive announcement in the future.”
Mooney said in both Shelburne and Digby counties the health authority’s primary health-care team has been meeting with municipal leaders, local foundations and others to talk about how to improve access to primary health-care services and to better share information with the community.
“One of the big topics discussed at these meetings has been recruitment and retention of health professionals and how we can work together to promote the local area,” he said.
Mooney said the NSHA is adding resources and additional support to the doctor recruitment team in the zone, has recently launched a new NSHA doctor recruitment website as part of a larger marketing strategy and has a renewed focus on international medical graduates.
“As a provincial health authority, we are in a better position to do planning across the zone and across the province for issues like recruitment and emergency services,” he said. “I have said before that it is important to understand that emergency departments in Nova Scotia are part of an integrated network of emergency care.”
While certain sites can be closed from time to time, the overall emergency system is never closed.
“This is due to access to Emergency Health Services such as 911, and transfers and collaboration between facilities. One example of this is working closely with neighbouring hospitals, such as Digby and Annapolis, to co-ordinate schedules as best we can to help make sure there is emergency department coverage in the region,” Mooney said. “So, there will continue to be challenges in staffing emergency departments, but the work and planning towards maintaining services continues.”