Consider nurse practitioners to solve ER crisis

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This article was published 06/01/2024 (725 days ago), so information in it may no longer be current.

It is a tale of two worlds in crisis, one urban and the other rural. And yet, they may share the same solution.

Yesterday, the Sun reported that “The Canadian Association of Emergency Physicians says it is concerned about comments made by Quebec Health Minister Christian Dubé, suggesting that unnecessary emergency department visits significantly contribute to ER overcrowding. If patients feel they need emergency health care, they shouldn’t hesitate to go to the ER, the association told The Canadian Press on Wednesday.”

Dubé told reporters in Montreal that “there is a large percentage of people who consult at the emergency department who don’t have an urgent problem … I’m not saying they’re not worried, but they don’t have an urgent problem.”

The same report quoted Dr. Michael Herman, an Ottawa-based ER doctor, as saying that “The issues around emergency medicine volumes are really more to do with flow through the hospital than it is to do with individual patients presenting.”

The concern expressed by Minister Dubé is hardly unique. We have heard it many times here in Brandon, where patients often show up at the ER with ailments that could be treated at a walk-in clinic, if one was open at the time.

Viewed from that perspective, the issue of ER overcrowding and excessive wait times are a luxury compared to what residents of Roblin and several other Westman communities are currently experiencing.

As the Sun reported on Thursday, Roblin residents are worried that the emergency department at the Roblin District Health Centre will be closed some days, and have reduced hours on other days.

For example, it is open from 8:30 a.m. today until 8:30 p.m. tomorrow. Next week, however, it will only be open on Monday and Thursday.

That’s a concern for Roblin resident Cole Nickell, who has close friends with severe heart issues. He’s worried about how long it would take an ambulance to get them to the ER in Russell (55 kilometres away) or Brandon (236 kilometres away).

“Imagine the terror of waiting over 40 minutes for an ambulance during a life-threatening emergency,” Nickell wrote in a letter to Premier Wab Kinew. “If our ER closes, the delay to the next available hospital could be a fatal two hours.”

Nickell is still waiting for a response from the premier and, quite frankly, so are communities throughout Westman. That’s because just eight of 20 health care facilities within the Prairie Mountain Health Region have 24-7 ERs — Brandon, Dauphin, Killarney, Minnedosa, Neepawa, Russell, Swan River and Virden. Carberry, Grandview, Melita, Shoal Lake and Winnipegosis have no ER services at all.

How do we solve this problem? How do we keep local ERs open for longer hours, saving more Manitobans’ lives?

Adding more doctors to rural Westman communities is the obvious answer, but there is a continent-wide doctor shortage that is likely to worsen over the next several years.

Manitoba Nurses Union president Darlene Jackson has a suggestion that could make a positive difference. She told the Sun that “I don’t understand why they wouldn’t be using nurse practitioners. As far as I’m concerned, nurse practitioners are incredibly valuable and very underutilized.”

“Their scope is very similar to a physician’s,” she added. “They can prescribe, they can diagnose, they can order lab tests.”

That would appear to be an obvious solution for Roblin, as there are nurse practitioners living in the community who are willing to take shifts to keep the ER open during the weekends and evenings. The problem, says Robert Misko (the head of council for the RM of Roblin) is that the Manitoba College of Physicians and Surgeons says they are not qualified.

If that is the bottleneck that is causing rural ERs to be closed so often, or contributing to unreasonably long ER wait times in Brandon and Winnipeg, it needs to be resolved immediately.

Nurse practitioners are currently working in ERs all over North America. If they can provide competent patient care, shorten ER wait times here in Brandon and help keep rural Westman ERs open for longer hours, the Kinew government must do what is necessary in order to make that happen.