Rebecca Brewer and Rob Miller, Valley-based doctors and co-founders of Make Emergency Great Again (MEGA), are frustrated but not deterred.
A GoFundMe initiative they started has fallen short of its intended goal of raising $100,000 for long-term care beds, but it was about more than just money.
The initiative was a statement about the situation doctors and frontline health-care staff are facing.
“It’s more of a symbolic gesture,” Miller explained, adding that the messages aligned with the launch of the campaign reached thousands through provincial media coverage.
Each of the doctors participating in the GoFundMe campaign donated some money themselves.
At the time of publication, the initiative raised a total of $2,744.
MEGA and the GoFundMe initiative, were inspired by a day that lingers in Miller and Brewer’s minds – March 7, 2018. That day, they admitted 24 patients into Valley Regional Hospital’s 20-patient emergency room.
The lack of long-term care beds is one of many factors contributing to the stressed system in place.
Miller and Brewer are adamant that the Nova Scotia Health Authority (NSHA) needs to do more to address health-care shortages in the Valley. With a coming flu season that is anticipated to be rough, they’re concerned about the work overload they face, along with the many potential stressors on an already overburdened health-care system.
“It could be a worse situation than we faced last year easily,” Miller said.
Brewer said doctors in the Valley are operating at over 100 per cent capacity – something untenable for any length of time.
“You can’t operate at 100 per cent efficiency all the time, because you have no ability to deal with surges,” she said. “They should be up-staffing and adding hours to make sure we’re prepared for winter, but they don’t.
“They know it’s coming every year, but there’s nothing done to prepare.”
Miller said that kind of overwork is not only unhealthy for the doctors – it’s dangerous.
“Physicians can only put up with so much danger in their workplace at the level we’re working at; when we have 24 patients in a 20-bed department,” he said. “We’re operating at a huge personal risk. There is no recognition of this.”
Make Emergency Great Again has three main demands.:
· The government must declare a health-care emergency
· The government must commit to the creation of 1,000 long-term care beds by 2020.
· A citizens’ assembly must oversee and enforce the necessary changes to the health-care system.
A way forward that both Brewer and Miller identified was more accountability on the part of NSHA.
“Time is spent defining the problems, and when you suggest solutions, it just sort of hits a stone wall,” Brewer said.
“The NSHA has to start listening to frontline physicians and frontline nursing staff,” Miller said. “They are familiar with the problems and are applying solutions at the grassroots level.”
Brewer said she’d like to see NSHA start addressing the problems they’ve outlined, even in small ways.
“I would argue then, at least something’s being done,” she said.
Finding solutions for the root causes of hospital backlogs at Kentville’s Valley Regional Hospital and Middleton’s Soldiers’ Memorial Hospital would be a good start, Brewer said.
“More long-term care beds would help our emergency department, because each long-term care patient sitting in a hospital bed is generally going to be in that bed for much longer than everybody else,” Brewer said.
While patients in acute care will stay in the hospital for a few days, she noted, long-term care patients can occupy bed space for months.
She said a hospital is not the place for long-term care patients because hospitals, by nature, can be chaotic and disruptive, leading to detrimental effects on their health.
Miller said there would be cost savings if space that already exists – like the old inpatient unit for addictions in Soldiers’ Memorial Hospital – was utilized for long-term care beds.
“They don’t use those beds; they just sit empty,” Brewer said. “The infrastructure is there, they would just need to staff it, and allow those long-term care patients to come in and stay there.”
Brewer said NSHA ought to consider other means of helping long-term care patients as well, such as more continuing care assistance a more mobile nursing workforce.
Miller stressed that control over health-care administration should be locally-based, rather than administrated by a large bureaucratic body.
“Whenever you have these amalgamations, they never work out. We know this, because we see it all the time,” Miller said. “They say, ‘This is going to save us all sorts of money,’ and it never does. It’s always bigger bureaucracy and bigger dysfunction.”
If health-care administration were to be once again broken down to a local level, Miller believes that would solve a lot of the disconnects between local needs and what the NSHA is doing to address them.
“Control should be at the local community level.”
Heather Fairbairn, a spokesperson for the Nova Scotia Department of Health and Wellness, wrote in an email to Kings County News that the department is investing in long-term care in a way that means Nova Scotians can “be cared for in their homes as long as possible.”
Financial contributions include more than $40 million in increased home-care funding, $37 million in facility infrastructure needs and expanded access to caregiver benefits.
“It’s not just about the number of beds in long-term care, but also the quality of care. That’s why we engaged the Long-Term Care Expert Advisory Panel to better understand the quality of care in our facilities,” Fairbairn wrote.
As the result of that consultation, Fairbairn said the government will allocate $2.8 million in long-term care, wound care, prevention and staffing.
Fairbairn said the waitlist for long-term care placement within Annapolis and Kings counties has dropped 35 per cent since April 2013.
“The number of people waiting in hospital for placement in long-term care continues to be an area of focus,” she wrote. “We recognize more work is needed.”
Carla Adams, a spokesperson for the NSHA, acknowledged that there are specific concerns related to Valley Regional Hospital’s emergency department.
“Some of these have been discussed at local quality committees, and some addressed at the western zone emergency department services council,” Adams wrote in an email.
Since some concerns were unresolved, Adams said the NSHA heeded a request from physicians to secure external expertise. An emergency physician and nurse team was appointed to conduct an external review of the issues.
“We look forward to receiving this report and acting upon its recommendations.”
Adams said Nova Scotia’s integrated network of emergency care compares well to other provinces. She added that Nova Scotia is “seen as a leader” in trauma care, integrating air and ground ambulances and emergency knowledge for youth.
“Having said that, NSHA realizes that there are many issues that must be addressed to support our teams and, ultimately, to improve patient care,” Adams said. “Overcapacity in acute hospitals can often spill over into emergency departments and reduce our teams’ capacity to offload ambulances and respond to emergencies in a timely manner.”
Adams emphasized that the NSHA is committed to working with the Department of Health and Wellness to “turn the tide” on the complex issues affecting patient care, overcapacity in acute care in hospitals and spillover into emergency departments.