Some rural ERs closing, changing hours over holidays

WINNIPEG — Rural Manitobans should check their local hospital’s emergency room schedule for the December holidays, with only a quarter of ERs outside Winnipeg expected to be open 24-7, a Doctors Manitoba analysis found.

“For anyone who is planning on travelling or gathering with loved ones around the holidays, it’s a good idea to take a few minutes to plan ahead,” said Doctors Manitoba president, Dr. Nichelle Desilets, who practises in Neepawa.

“It’s hard to know when you or someone may need medical care, but it’s pretty easy to check out what your local resources are.”

The organization said 18 of Manitoba’s 71 rural and northern ERs are expected to be reliably open 24-7, while 25 are expected to have limited hours or periodic closures and 28 are fully closed (considered suspended or a long-term closure).

The figures are similar to last year. Desilets said Killarney’s ER had 24-7 coverage last season. This year, the ER will be shut for 24 hours from 8 a.m. on Christmas Day, and it will close at 8 a.m. on New Year’s Eve, an online schedule showed.

Vacation leave or sick days can result in reduced ER hours or temporary closures in smaller communities, Desilets said.

“The issue always comes down to a shortage of staff, and that might be doctors, that might be nurses, that might be other allied health professionals,” she said.

Doctors Manitoba, which represents more than 4,000 physicians and medical learners, recommended people check their local health authority’s website for ER schedules. The organization has a website, RuralCare.ca, that puts the links, guidance and other information in one place.

Regional health authorities said people should continue to call 911 in an emergency.

In western Manitoba, Roblin’s short-staffed ER is scheduled to close from Dec. 23-26 and Dec. 30-31, with limited hours when open.

“We’re disappointed.” said Municipality of Roblin Mayor Robert Misko. “Sadly, it’s getting to the point where it’s not shocking anymore because more than three-quarters of the time, we don’t have emergency service.”

Misko doesn’t fault staff who take time off over the holidays to rest and spend time with loved ones.

Two physicians recently joined, but two more are needed, he said, noting the hospital had only one doctor at this time last year.

When Roblin’s ER is closed, the nearest alternatives are about 30 minutes away in Russell (which is scheduled to be open 24-7) and Grandview, where an ER will be closed Dec. 27-28 and open limited hours other days.

Northern Health said no ER closures are anticipated between Dec. 20 and Jan. 3. Interlake-Eastern, Prairie Mountain and Southern regions said this season’s schedule changes are consistent with those last year.

The four regions said temporary ER closures are considered only as a last resort when there isn’t enough staff to ensure safe care for patients.

All four said they make “every effort” to cover shifts and provide safe and appropriate care to patients.

Doctors Manitoba said a recent study underscores the need to focus on improving retention efforts. While Manitoba had a record-breaking net increase of 164 physicians last year, it loses more doctors to other provinces than it gains and appears to be retaining fewer local graduates, the organization said.

Desilets said the vast majority of new recruits work in family medicine and are probably based in larger communities.

“Colleagues of mine out in rural areas might not feel the difference of those recruits in their own clinics and ERs,” she said.

Health Minister Uzoma Asagwara said the NDP government is taking steps to recruit and retain health-care staff, and it will take time to see the full benefits of those measures.

Asagwara pointed to a restored rural physician retention and recruitment fund, a new nursing float pool and efforts to expand team-based care as examples.

“We’re going to keep working really hard to continue to add more capacity so we not only continue to stabilize, but that we can see more improvements in terms of hours of operation and renewal of service,” the minister said.

Progressive Conservative health critic Kathleen Cook said the rural ER situation is troubling and speaks to a “lack of focus” on retention by the government.

“For communities who have had 24-7 ER services to now have that be made unavailable, it’s going to be very distressing for them,” said Cook, the MLA for Roblin. “I would say things are moving in the wrong direction under the NDP.”

Cook said potential measures such as expanding team-based care to rural hospitals, where staff have voiced concerns about the isolation or pressure of working alone, should be prioritized.

» Winnipeg Free Press