'A nurse can't be everywhere': Health care staff shortages prompt Ontario ER closures

The recent temporary closures of two Ontario emergency rooms and consolidation of staff at another have renewed concerns over the province's health-care worker shortage, with doctors and nurses calling on the government to tackle the problem.

A hospital in Clinton, Ont., temporarily closed its emergency department Saturday through Monday and a Kingston, Ont., hospital reduced its urgent care centre hours over the weekend to consolidate staff at its ER, with both facilities citing physician and nurse shortages for the moves.

In Perth, Ont., the local site of the Perth and Smith Falls District Hospital closed its emergency room on Saturday, with a plan to keep it shut until Thursday as staff who are already stretched thin contend with an outbreak of COVID-19.

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"It’s unprecedented for our community," Dr. Alan Drummond, an emergency physician at the Perth hospital, said in an interview.

"There is this perfect storm descending upon us – which is increasing volumes of sick patients with diminishing resources to respond."

The Perth hospital has seen its emergency room nurses drop from 15 to five in the last several months, said Drummond, who also serves as co-chair of public affairs for the Canadian Association of Emergency Physicians.

When two nurses contracted COVID-19 recently, the Perth ER was forced to close temporarily, he said. Administrators said last week the hospital was in a "staffing crisis."

Ontario is struggling with health-care labour shortages as workers leave hospital roles or the profession altogether after more than two grueling years on the frontlines of the pandemic, say organizations representing nurses, physicians and public hospitals in the province.

"The staffing shortage is (because of) the burnout and people leaving," said Ontario Nurses’ Association President Cathryn Hoy.

"But why they're burning out is because they come in for an eight or 12-hour shift and they're staying 16 hours. Sometimes they’re staying 24 hours."

Hoy said she has heard from nurses who've reported emergency rooms temporarily staffed with a single nurse to cover 30 patients, some hospitals with dozens of unfilled ER positions and patients cared for in hallways.

"A nurse can't be everywhere," she said.

The nurses' union wants the government to expand fast-track programs that help registered professional nurses become registered nurses, as well as cut wait times for internationally trained nurses to obtain their licenses, Hoy said.

The Ontario Hospital Association said staff shortages and capacity issues are creating backlogs across the hospital system, with an increased number of patients waiting for home care as well as a high number of patients in acute care beds who don't require those resources.

Workforce shortages appear most pronounced in critical care and emergency departments, the association said, with rural and northern Ontario bearing the brunt.

"The situation in these communities continues to be fragile," OHA President and CEO Anthony Dale said in a written statement.

Ontario had 609 registered nurses per 100,000 residents in 2020, according to data compiled by the Canadian Institute for Health Information. That was notably lower than statistics for Alberta and Quebec.

Meanwhile, the length of time patients spend in emergency rooms is at a 14-year high, aside from this January, the OHA said. Ambulance offload times – how long it takes for a hospital to take over a patient from paramedics – are at a 12-year high, it said.

The Ontario Medical Association said the government must consider setting up specialist centres focused on specific surgeries or procedures to help alleviate hospital burdens.

"We know health care doesn't run on an election cycle," said Dr. Samantha Hill, a past president who was speaking on behalf of the association. "We need to … commit to more forward-thinking systems design and more forward-thinking healthcare designs."

A spokesperson for Ontario’s Ministry of Health said the province was working to bolster workforce capacity, including with lump sum retention bonuses and funds to recruit nurses to target areas across the province.

This report by The Canadian Press was first published July 5, 2022.