‘This is not about funding or money’: Closing of this Ontario ER is another symptom of crisis in nurse staffing

“Enormous pressure” caused by staff shortages, has caused a rural Ontario hospital to close it’s emergency room permanently and it is the latest example of the deepening human resource crisis in health care, nursing advocates say.

The Minden emergency department of Haliburton Highlands Health Services (HHHS) will be closed on June 1, and emergency services will be consolidated at Haliburton Hospital, 25 minutes away from the Minden location, also operated by the HHHS.

The decision was directly related to staffing shortages, said Carolyn Plummer, president and CEO of HHHS.

“We would not have made it through another summer under these circumstances, and we had to act to ensure we could continue delivering emergency services,” she told the Star in an email.

The dire need for nurses and physicians existed before and was exacerbated by the pandemic, Plummer said, but it turned into “a near-constant crisis in the last 18 months, causing enormous pressure,” on the existing staff.

Nursing advocates say the closure in Minden is symptomatic of a larger issue.

“Unfortunately we are not surprised as we have alerted employers and government of the deepening crisis in nursing,” said Doris Grinspun CEO of the Registered Nurses’ Association of Ontario (RNAO).

“RNAO has been warning the province for well over a decade that we have a looming registered nurse crisis due to the government’s inadequate funding. The pandemic, exacerbated it into a full-blown crisis due to workload exhaustion.”

“Our government knows emergency rooms have faced capacity pressures year after year. We know the status quo is not working and more needs to be done,” said Hannah Jansen, a spokesperson for the Ontario Minister of Health, to the Star in an email.

“That is why earlier this year we launched Your Health, a plan that gives Ontarians more options for convenient care to avoid unnecessary trips to the emergency room and eases the pressures our hospitals have been facing,” she said.

While the province acknowledges the problem, the provinces measures don’t do enough to fix it.

“This is yet another example of the consequences of failing to fix the strain our hospital system is experiencing,” said Ontario Nurses’ Association (ONA) interim provincial president Bernie Robinson, in a recent statement.

The closure of the Minden site is a preview of additional permanent ER closures in the future, Robinson said.

According to the RNAO, 24,000 more registered nurses are needed in Ontario, just to close the registered nurse-per-population gap between Ontario and the rest of Canada. There are 10,195 registered nurse vacancies in Ontario, up from 9,050 last quarter.

A Star analysis found that hospital emergency departments across Ontario were forced to close 158 times in the past year, resulting in some 4,430 hours — the equivalent of 184 days — when the urgent care needs of many communities could not be met locally. In many cases, like in Minden, the closure of emergency rooms or the increase in wait times, is not caused by lack of funds.

“This is not about funding or money. It is a result of global staffing shortages and the incredible pressures that has created for our staff and physician teams,” said Plummer.

A March poll commissioned by the Canadian Federation of Nurses Unions (CFNU) revealed that four out of 10 nurses are now considering leaving their job, mostly due to high workloads and poor staffing levels. More than 75 per cent of nurses report workplaces that are regularly overcapacity, according to the poll. Statistics Canada estimated in 2021 that 32,295 registered nurse positions were vacant.

“After years of wage suppression and disrespect, tangible evidence is needed that their work-lives must improve in order to retain them,” Robinson said.

Ontario offers bonuses of $10,000 to nurses in return for a commitment to practise in “high need” health-care facilities for a year; and incentives of $25,000 for out-of-province nurses to relocate and work in general practice for one year; as well as up to $75,000 for ICU or critical care nurses who commit to two years.

But experts say nurses are more concerned about the working conditions at their destination.

Building up primary care and home care could relieve some of the pressure on hospitals, as well as implementing more tangible solutions for nurses, said RNOA’s Grinspun.

“Bonuses are not conducive to retention, and retention is a must,” she said.

“(We need) Safe workloads that enable nurses to deliver excellence in practice; competitive compensation; health work environments; career advancement; and respect for diversity,” Grinspun said.

“We need this now.”

Residents of Minden, Ontario gathered at Queen’s Park on Thursday protesting the decision and submitted a petition with over 5,000 signatures, urging the provincial government to delay the closure for at least one year.

Losing this emergency department in the midst of cottage country will affect the community beyond the anticipated health consequences, according to Minden Hills Mayor Bob Carter.

“We will have an increased demand for our paramedic services and ambulances. This demand will need to be paid for by the county. On top of that, if the paramedics are busy due to their increased workload, the responsibility for answering medical calls will need to be answered by our volunteer fire departments.”

NDP health critic France Gélinas said she was “saddened but not surprised,” to hear the news.

“The Ford Conservative government is focused on opening private for-profit surgical clinics owned by investors and corporations. That an ER in a rural hospital that supports thousands of people and sees a tripling of its population over the summer months has no choice but to close does not even hit their radar,” she told the Star in an interview.

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