Doctors warn of limited rural ER service

Neepawa’s Dr. Nichelle Desilets has a warning for people in rural Manitoba about unstable emergency room hours of operation this summer — and she’s urging people to plan ahead.

Desilets, the president of Doctors Manitoba, says only 20 rural hospitals — about one-quarter of the total — will have their emergency rooms reliably open, 24 hours a day, seven days a week.

“Twenty-four more ERs are expected to operate with reduced hours of operation or periodic closures, and this is often due to physician or nurse shortages,” Desilets said from her office at Neepawa’s Beautiful Plains Medical Clinic during an online news conference on Thursday.

The problem has been building for many years, she added, with the “prolonged uncertainty and short-staffing taking a toll.”

The Prairie Mountain Health region has 33 hospitals, but only seven have ERs that are reliably open 24-7. They are Brandon, Dauphin, Killarney, Neepawa, Russell, Swan River and Virden.

The schedules for all health-care facility emergency rooms within PMH are posted on the health region’s website.

This weekend, there will be no ER services available in Boissevain, Carberry, Grandview, Hamiota or Treherne.

Four communities will be open on Saturday and Sunday with hours that range from 8 a.m. to 8:30 p.m. They are Glenboro, Roblin, Souris and Ste. Rose.

Some of the schedules can change unpredictably, Desilets said, “but if people are going to be travelling to a new area, maybe on a camping trip or to visit family, they could look ahead to see what the resources are in that community or the nearby area.

“I can’t speak for all rural Manitobans, but what I see when I’m working in my local emergency room is that people are noticing that it’s a bit of a guessing game,” she said.

“And I do hear stories of folks who were in an emergency situation and got their family member to drive them to their local emergency room and find a closed sign on the door. And I recall stories of them feeling quite distressed by this and not knowing what the next step is.”

In Carberry, the hospital’s ER was only open one day this week, on Monday.

This is in contrast to last May when Premier Wab Kinew and Health Minister Uzoma Asagwara announced the reopening of the emergency department in front of dozens of locals and alongside Carberry Mayor Ray Muirhead.

Muirhead said he’s “not mad at the government” about the limited ER hours, adding, “At least the ER is not closed.”

“At some point, though, the province and Prairie Mountain Health — it’s their thing. They have to step up to make sure. We can’t continually be the watchdogs. But we’re not stepping away from it.”

Desilets also cautioned Manitobans not to overload emergency departments that they know are going to be open more consistently, like those in Selkirk, Morden-Winkler and Brandon.

“We’re hearing more calls for help for the bigger hospitals, the hospitals that in my mind never close,” she said.

“While they stay open, they are sometimes short a staff line and not at the capacity that they would like to be, and how that ends up showing up is sometimes diverting patients to other locations.”

The emergency department coverage is stable across PMH, with staff vacations and scheduling gaps being managed so that Brandon Regional Health Centre’s ER stays open 24-7, health region official Janet Twerdoclib told the Sun.

“Emergency department wait times have many factors and are not strictly tied to staffing. It’s important to note that physician, nursing and diagnostic services are all critical components of a functioning emergency department — all three must be in place to ensure safe and effective patient care,” said Twerdoclib, the PMH regional lead acute care and chief nursing officer.

“Our teams prioritize patient care and work proactively to manage holiday schedules while maintaining service levels.”

Closing rural emergency departments will have a “domino effect” and lead to staff burnout in the regional centres, said Progressive Conservative MLA Kathleen Cook.

“I think the blame for this situation really lies with the NDP government,” Cook said.

“We’re seeing no improvement from last year when it comes to the number of rural emergency departments that are reliably open 24-7, no improvement in the number that are open part-time,” said Cook, who is the PC health critic.

“I’ve been in situations with family in rural Manitoba where somebody fell on the ice and was injured, and you’re having to call the local hospital and say, ‘Oh, hey, are you open today?’

“And those are situations that those of us in Winnipeg, I think, find it hard to imagine, but that is the reality for people throughout rural Manitoba.”

The Sun reached out to Health Minister Uzoma Asagwara for comment on the rural ER situation, but there was no response by press time.

Doctors Manitoba said it conducted a survey of its member physicians earlier this month and found high levels of burnout and distress.

“Nearly a third of emergency room doctors indicated they are considering reducing their working hours or resigning their ER duties completely if their work conditions don’t change,” Desilets said.

The No. 1 priority is spreading the workload by adding more physicians, nurses and allied health resources. Doctors also want fair and competitive pay for working in smaller hospitals where there are more demands than in a bigger centre.

“When it comes to rural emergency rooms, some physicians are concerned about risk,” Desilets said.

“I feel really privileged to do this type of work. My colleagues and I are really passionate about maintaining services to our community, but it’s hard work for the one doctor in town who is on overnight with only two nurses for the entire hospital, including their inpatients and whatever the ambulance brings in,” she said.

“So, we have to really find those individuals who are keen on this type of work.”

» mmcdougall@brandonsun.com

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