Emergency department closures due to nursing shortage quadrupled in southern Manitoba

Emergency departments in Manitoba's Southern Health region are closing more frequently because there are not enough nurses to work, according to data from the health authority.

CBC News received a document with the data from the Manitoba Nurses Union, which it had obtained from Southern Health-Santé Sud through a freedom of information request.

The data shows that the number of times an emergency department was closed due to a nursing shortage has increased nearly four-fold.

"People are obviously disappointed," said Al Friesen, the mayor of Altona, Man. — one of the towns in the region affected by the closures. 

"People feel strongly about the delivery of care in their community."

The document outlined the frequency of emergency department closures in the Southern Health region from Jan. 1, 2017, to Nov. 9, 2021. Each time a department closes, it's tallied under one of five reasons: nursing resources, physician resources, nurse and physician resources, lab unavailable and overflow.

In 2017, there were 35 closures in the "nursing resources" category, and in 2018 there were 26. But in 2021, that number jumped to 126.

The closures took place in Altona, Carman, DeSalaberry, Lorne, Morris, Notre Dame, Rock Lake and Ste. Anne. The highest number of closures were in Morris and Altona.

Ongoing staff crisis at regional centres: nurses 

A nurse who works at the Bethesda Regional Health Centre, a regional hospital in Steinbach, Man., where patients are directed to during closures, told CBC News that patients are having to wait longer when they arrive because the hospital is already short-staffed.

"This is considered a regional centre and we are not allowed to close our doors, so we get into a staffing crisis and we somehow have to figure out how to make it work," she said. "It's incredibly scary to see emergency rooms closing beds because of staffing shortages."

The nurse said on a typical day, Bethesda's emergency department is short one to three nurses. Many who worked there have left due to medical stress, maternity leave and "greener pastures," she said. 

Another emergency nurse at the hospital said it's stressful to deal with patients who are often getting angrier because of longer wait times.

CBC News is protecting the identity of both nurses because they fear being fired for speaking out. 

The second nurse said being constantly being mandated to work overtime adds to the stress and exhaustion. 

"Sometimes you wonder if this is really worth it," she said. "There are moments where I just want to quit and wonder why I'm doing this, but I also don't want to give up."

The MNU said according to the data from Southern Health, nurses in the region worked a total of 79,846 hours of overtime from January to October of this year. Last year, they worked 72,931 overtime hours. In 2019, that number was 59,397. 

Recruitment continues, says Southern Health 

In an emailed statement to CBC News, Southern Health-Santé Sud said during closures, emergency response services are safely directed and transported to regional centres in Morden and Winkler, Portage la Prairie and Steinbach — and those emergency departments have not been suspended. 

Spokesperson Sylvie Robidoux said recruitment of nurses continues at local and regional levels with their provincial partners. She points to the 259 nurse training seats recently added by the province. 

"We acknowledge the strain that COVID-19 has had on clients and staff right across the province," said Robidoux. 

Robidoux said health-care workers in the region have faced many waves of the pandemic, along with additional stress as communities are divided over public health orders, testing and vaccination. 

"Words cannot express how grateful we are for all of their hard work, determination and dedication," she said.

Altona ER expected to reopen in 2022

Altona's emergency department has been closed since March due to a nursing shortage.

Robidoux says urgent care services continue to be available at the site and it's anticipated the town's ER will reopen in late January and early February. 

She said the decision to suspend emergency services was made to avoid unexpected service disruptions that have been occurring because of a lack of staff. 

"Planned closures or planned changes in hours of service are far safer than intermittent and inconsistent service," Robidoux said.

In Altona, Friesen said the town has created incentive packages to recruit more nurses to move into the area.

"There was some assistance with a car allowance or access to a vehicle. There was access to accommodations and there was also a financial incentive portion," he said. 

Friesen said recruited nurses are provided with something called "chamber bucks," which are certificates created by the town's chamber of commerce that can be redeemable for items within the community.

"It's gone well and we are on track and looking forward to the return of an ER operation in the hospital in the new year," he said.

Emergency department closure data from Southern Health-Santé Sud, obtained by the Manitoba Nurses Union: