GUYSBOROUGH – Ninety-four-year-old retired public health nurse Kaye Williams was given the first question at the healthcare forum in Guysborough on July 10. And that, Guysborough Memorial Hospital Foundation Chair Bill Innis said, was only fitting, as it was her suggestion that the forum be organized.

Williams had one question about the provision of healthcare in the Strait area: why emergency department (ED) closures can’t be better coordinated, so as to not have all EDs within one area closed simultaneously, as was the case earlier this year when she required emergency care and found the departments closed in Richmond, Guysborough and Canso.

That question and many others were put to a panel of representatives from Nova Scotia Health (NSH) and elected officials, including Nova Scotia’s Minister of Health and Wellness Michelle Thompson, by a room of approximately 100 people from the catchment areas of Eastern Memorial Hospital in Canso and Guysborough Memorial Hospital in Guysborough.

Brett MacDougall, NSH vice president of operations for Eastern Zone, answered Williams’ question, stating, “Unless we have the physical presence of a trained physician, the other things that we put in place, or tried to pilot [such as virtual physician presence and EHS management of less severe patients] will provide some level of urgent access, but it would not be a full emergency response….coordination in relation to the three sites is, again, very complex. Trying to plan physicians’ schedules to be available on the days so that there is no hole in the Swiss cheese so to speak. We are working on it diligently…but it’s going to take time.”

Thompson added to MacDougall’s comments, noting that failure to plan for retirements in the past decade has diminished the capacity of the healthcare workforce. But efforts are underway to increase both physician and nursing graduates in the province. The answer to the healthcare crisis is people, she said.

Another way the province in working to increase the workforce is to make it easier for nurses to practise, when they arrive from outside of Nova Scotia. Nurses from other provinces can now receive their licence within five days. For those from one of seven countries that most frequently apply to come to Nova Scotia – Nigeria, India, Philippines, Australia, New Zealand, United Kingdom and United States – the wait time to begin practising has been reduced from several years to several months for a conditional licence.

Most often the emergency department closures are due to physician shortages. NSH Eastern Zone Medical Executive Director Dr. Don Brien said, in terms of physician recruitment, certified physicians from the United States can automatically come to Canada. “There’s a bit of paperwork but you can start working basically immediately in Canada. And that is just new as of three months ago…before, an equally trained American would almost have to go through a full rigorous process of examinations. So that is one way that the well-trained physicians from the United States can come and work here with very little paperwork.”

Mary Cook was next up at the microphone to ask a question that has puzzled many Guysborough area residents: Why, when we have four doctors in Guysborough, can only two work in the emergency department and are the other two learning to work in the ED?

“We’re supporting that,” answered Brien, adding, “They’re providing other services to the community…they are spending a lot of time in primary care and, in fact, the work they are doing in primary care is helping people probably avoid having to go to the emergency department…They’re serving the community in that sense.”

Guysborough resident Marie Brymer asked a question regarding the protocol for obtaining medical test results. MacDougall answered that, in general, it was expected that the physician ordering the test would contact the patient, if there was anything of note found. However, he said patients should seek clarity, if no further communication had occurred after a test was performed.

“I would take the initiative and make a call,” advised MacDougall.

Municipality of the District of Guysborough (MODG) councillor and Upper Big Tracadie resident Mary Desmond asked the panel if they had considered amalgamating the resources of Guysborough Memorial Hospital and Eastern Memorial Hospital in a new location to serve the area, as between the two facilities there was ample staff and equipment to meet the needs of the population.

The short answer was ‘no.’ MacDougall then stated through a consultation process headed by Dr. Mary Jane Hampton in the years prior to the pandemic, it was clear there was no appetite in either Guysborough or Canso for such a move.

Ursula Ryan, who founded and runs the Guysborough and Area Dementia Support Group, asked what supports and strategies the province was putting in place for the predicted future wave of people suffering from dementia in Nova Scotia.

Thompson said that this government had created a ministry of seniors and long-term care and within that are doing research into strategies to cope with dementia. Also, as one point of the Action for Health strategic plan, the government will address the factors affecting health and well-being, which will look at the determinants of health.

Ryan responded, “I’m concerned about what the future brings and what are we doing now? How are we helping these people?…We can’t wait.”

Retired family physician Barbara Bell posed her question to Emergency Medical Care Inc.’s [the company that manages and operates ground ambulance service] Executive Director of Provincial Operations Charbel Daniel. She began by giving some details of her experience as a doctor in Guysborough accessing ambulance service to transfer patients and went on to describe a dream she’d had recently that her husband was having a heart attack at home with no ambulance in the area.

“That’s a nightmare; but it’s the dream that I had because one of the things that gives me that pit in my stomach, it did when I was working and it does now, is to drive by our local [EHS] base and see it dark, no vehicle there meaning there’s no staff. And I happen to know that many times any ambulance in the area may be in New Glasgow, which is going to do me no good if my husband has a cardiac arrest,” Bell said, asking what Guysborough-area residents can expect in terms of availability of EHS services.

Daniel had told those at the forum, prior to this question, the EHS system was undergoing modernization which would increase the capacity to respond to emergency calls by reducing the number of ambulances tied up with such things as patient transfers.

In response to Bell’s question, Daniel added, “One of the things that we’ve done to update the system to meet the current demands is now we’ve locked resources to their local areas. So, there’s actually a minimum threshold in each of the rural areas whereas ambulances are moved to provide coverage, no further ambulances will move. And the goal of that is to keep those units and those resources in their local communities in rural Nova Scotia and not have them all pulled to where the call volumes are higher, where they keep drawing them into a vortex, type of thing.”

Bell replied, “Thanks, I’ll sleep better.”

Many others took the opportunity to ask questions or provide suggestions to increase healthcare capacity in the Guysborough and Canso areas. Guysborough Memorial Hospital physician Dr. Jean-Marie told the panel she had applied to have medical residents attend the hospital; she’s ready and waiting for them to arrive. Mary Connolly suggested more programs to pay tuition fees for return of service agreements for physicians and other in-demand healthcare providers – of which there are a number of programs already in place. MODG Warden Vernon Pitts voiced his opinion that healthcare could be fixed and that hospitals in the area had to be open 365 days a year, something the municipal government has actively worked to secure through the creation of recruitment bonuses for both nurses and doctors.

As MacDougall stated in his comments addressing ED closures, “Our work will never be done.” The forum demonstrated that measures have been taken to improve healthcare services in rural areas, but it will take time to see the fruit of those investments.

By Lois Ann Dort, Local Journalism Initiative Reporter

Original Published on Jul 12, 2023 at 04:47

This item reprinted with permission from   Guysborough Journal   Guysborough, Nova Scotia
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