Another note on the door greeted overnight visitors to Lady Minto Hospital last week, advising patients to evaluate the urgency of their needs and consider returning in the morning “when staffing levels improve.”
And while health care staffing shortages on Salt Spring may not be new, island physician Dr. Clare Rustad thinks residents may be shocked at how severe they have been, and how long it’s been going on. Rustad grew up on Salt Spring, and in addition to her practice here also contracts with the hospital; confirming the absence of an emergency care-trained nurse at Lady Minto’s emergency department overnight Monday, Jan. 23, Rustad warned that it had happened before, and likely would again.
“I was informed that there would be no emerg-trained nurse on overnight,” said Rustad, who was called in for an overnight shift. “And that’s not the first time I’ve had that happen.”
After a similar event — from Friday, Jan. 6 until 7 a.m. Saturday, Jan. 7 — Island Health issued a statement acknowledging the hospital had experienced an “unforeseen short notice limited staff availability,” adding that — contrary to reports — there was “more than one nurse on” at the hospital that night, along with “allied health provider support.”
Rustad took particular issue with the word “unforeseen,” saying nurses have been trying to sound the alarm on chronic shortages for years, and that while the pandemic certainly exacerbated the problem, a growing sense that they’re being left unsupported — and the expectation of higher workloads — has nurses leaving the profession at an alarming rate.
“I’ve been [contracted to Lady Minto Hospital] for five years, and our nurses are excellent,” said Rustad. “They’re highly trained, they’re very skilled, they’re really good at what they do. I think I can say I’ve walked into the hospital once and had the nurses say they were fully staffed. This isn’t a new problem.”
Island Health spokesperson Andrew Leyne said that work was underway to improve staffing, and that while there had been a “short-staffing situation” recently, the health authority had the ability to shift personnel quickly, noting long-term care was also coordinated by Island Health staff.
But emergency nurses have specialized skills and knowledge, said Rustad — to be able to treat trauma, injury, and other sudden changes in health that require urgent attention. Rustad, who estimates she would have spent 100 hours at the hospital this month, described emergency medicine as a “team sport,” and feared administrators were spreading limited nursing resources too thin — to say nothing of deemphasizing their importance.
“The formula ‘nurse plus medical school equals doctor’ isn’t true,” said Rustad. “Saying the emergency room is covered because there’s a physician in the hospital completely devalues the role of emergency nurses. They’re two different, highly specialized skill sets. And I can’t do my job safely without them.”
The solution Island Health has apparently come up with — to pay contract physicians, typically on-call from home, to stay overnight in the hospital — isn’t sustainable for staff, or good for patients, according to Rustad.
“Me being in the hospital doesn’t magically conjure up emergency nurses,” said Rustad. “Our goal at the hospital is efficient, safe patient care. This doesn’t make the situation safe.”