By Don Crosby
CHESLEY – The Chesley hospital continues to face difficult challenges in order to re-open its emergency department full time.
The emergency department has been closed between 8 p.m. and 8 a.m. since September after two nurses left, leaving the hospital short staffed.
Hospital CEO Michael Barrett said its difficult filling the positions. There’s a shortage of nurses province-wide, Barrett said, and unlike urban hospitals where nursing is specialized, rural hospital nurses need a wide range of skills.
Barrett adds they can’t just hire new nurses and drop them into the job. They need to be supervised and mentored before they can fully take on the job.
“You can’t have a junior or intermediate nurse, or a novice nurse, working in a small emergency department because the staffing levels are very small, very low and need to make sure that they have the experience to respond to any type of emergency that shows up at the door, whether it’s a cardiac event, a stroke, or a broken leg… they need to be prepared for everything,” said Barrett. “The challenging thing is that in small emergency departments they may only see one of two of those more challenging cases every six months, whereas in a big emergency department they would see them on a regular basis.”
The hospital has been trying to recruit using the new graduate initiative funding program, which provides the hospital to partner a new nurse with an experienced nurse.
“So, when we are training or mentoring a new nurse, we have to pay for two people to do that – the new nurse plus the person that is doing the mentoring,” said Barrett.
Barrett said an additional issue facing the hospital is retaining the nurses they already have.
“With the labour market so tight, nurses have lots of opportunities to go to other employers, so if they can get a full-time job they can go to the city or another employer. We need to make our Chesley site and all of other sites an attractive place so they want to stay here,” said Barrett. “That’s our goal; to retain the nurses we’ve got and recruit new experienced nurses to fill that void.”
Barrett noted the depth of caring and affection that residents have for their hospitals.
“Hospitals have been here for generations… we’re simply stewards for a period of time. We need to make sure we leave the hospital in better shape than from the time we took it over, whether a nurse, physician, board member or CEO, we all have an obligation that the hospital is in better shape than when we came,” he said.
Barrett said they’re doing everything they can to get the ER re-opened round the clock, but it will take time.
That was reiterated Angela Stanley, vice-president of clinical services and chief nursing executive, who recently took over at the organization’s four hospital sites in Chesley, Durham, Kincardine and Walkerton on Jan. 14. She told an over overflow crowd at community meeting in Chesley on Jan. 28 that hospitals are not allowed to offer incentives to attract nurses.
The government will pay the tuition fees of a graduating nurse in return for a commitment to work for five years in an underserviced hospital.
Hospital officials stated that exit interviews of nurses leaving the hospital revealed the two main reasons that nurse leave is to follow their partners or to take a full-time job elsewhere.
A member of the audience asked why nurses couldn’t be offered a full-time job at Chesley hospital. They were told it has to do with collective agreements and that has to be negotiated.
Steve Schauss, head of Bruce County EMS, said there have only been four to five calls per month at night since the restrictions were imposed. The EMS has an agreement in place to take patients to other nearby hospitals such as Hanover or Walkerton.
“We’re very fortunate in this part of the province that we have a large number of emergency departments in a relatively close area, but the community of Chesley cares deeply about the hospital; they want to make sure it re opens to 24/7,” Barrett said.
No one could say just how many more nurses were needed. There are currently three nurses on duty during the 8 p.m. to 8 a.m. shift, but that is not enough to safely operate the ER.
Board chair John Gilbert dispelled a myth that the Chesley hospital was being turned into a nursing home with the addition of 10 beds for senior centre of care needs in addition to the 18 acute care beds.
Stanley said she took the job at Chesley because she views the situation at the hospital as a challenge rather than a problem.
She said hiring more nurses wouldn’t solve the problem. She said the vacant positions are two part-time nurses.
“We need more nurses, but we also need a really good structure in place to replace those nurses who leave,” she said.
She said plans are to partner with the nurses at the Chesley hospital and see if there are opportunities to shift things around.
“I don’t have those answers right now, but we’ll get them,” said Stanley. “We’re going to take the time to get them… I think what’s important now is take the time to understand the problem now so we are putting in the right solutions that will sustain us for the next period of time.”
Stanley stressed that this is not a problem unique to Chesley.
The Chesley hospital emergency department will remain closed from 8 p.m. to 8 p.m. for the foreseeable future. Administrators expect to hold another public information meeting in May to bring residents up to date on the progress in the past three months.