NRGH ER doctor shortage won’t improve without funding

NANAIMO – Departing doctor will leave 30 shifts a month open, already overworked staff asked to fill the void.

An already beleaguered emergency department staff at Nanaimo Regional General Hospital will face increased workloads at the end of the month with the announcement of a doctor leaving the rotation.

The departure means an additional 30 shifts per month that may not be filled by an ER doctor indefinitely.

“We’re hoping some people can pick up some extra shifts if they’re willing to do that but otherwise we’ll be short,” said Dr. Drew Digney, emergency department chief at NRGH. “It’s a bit tricky because we’re already working full-time, well, more than full-time in most cases. We’re given a certain number of full-time employees to staff a department but that number hasn’t gone up in three years despite the fact [ER patient] volume has gone up significantly, somewhere between 15 and 20 per cent.”

In 2011 at NRGH, ER visits amounted to 53,534. That increased to 57,400 in 2012.

An extra shift, which required a cut in pay and heavier workload for NRGH ER doctors, had already been put in to meet that demand.

That increased workload, said Digney, has caused “critical stress” and has resulted in one doctor leaving.

By voluntarily taking on increased workloads and decreased pay, he said it will be difficult to attract any doctors to join the rotation.

“We’re not competitive with anybody else,” said Digney. “But we’re doing our best to look after our patients. Temporarily we’re going to keep it going with the hopes that eventually somebody will have enough smarts to do the right thing.” He added the lost shift may never return without funding.

With an upcoming provincial election, increased funding or even an attempt to solve the problem through the Health Ministry is not likely any time soon.

Health Minister Margaret MacDiarmid has already stated no direct funding for more doctors is coming, though the government has negotiated a $90-million physician master agreement with the B.C. Medical Association. About $20 million is slated for new services, which can be used to address emergency room concerns if the association chooses. Across the province, doctors have been asking for $10 million to address ER staff shortages as patient use increases.

Emergency room doctors across the province have gone public with the challenges they are facing at www.bcemergency The website is a forum for doctors to vent some frustration and give the public an inside look as to the challenges they face on a daily basis.

One NRGH doctor, Kevin McMeel, expressed his frustration on camera after an extended shift earlier this year.

“My shift started at six in the evening and was supposed to end at 2 a.m.,” said a tired-looking McMeel. “It’s now 5 a.m. and I’m standing outside the newest emergency room in the province that we opened in October. It was built about three times the size of the last one, bigger because we’re seeing way more patients. Despite that we don’t have any extra staff.”

McMeel continues to say he arrived for his shift to “a sea of people” waiting for attention, and one patient who waited for 5.5 hours had a seizure before he could be assessed.

The website gives the NRGH ER department a failing grade for overcrowding and understaffing.

Digney said other provinces employ successful staffing models that adjust funding every six months based on patient visits.

“We don’t do that here in B.C.,” he said. “You have to have a big fight every time you have to do anything. The solution here is they say we’ve got a pot of money and we should just reallocate it, so take it from another department. That’s not a really good idea.”