Medical staff shortages have led to numerous closures of Dr. Helmcken Memorial Hospital’s emergency room, prompting residents of Clearwater and surrounding areas to wonder what will happen in an emergency.
The ER was most recently closed over the weekend, from 4 p.m. Friday, Oct. 15 to 7 a.m. Monday, Oct. 18.
Although some are blaming the COVID-19 pandemic, government spending and a recent vaccine mandate that will come into effect on Oct. 26, health officials say the shortages were looming long before the pandemic.
“There’s just not enough (nurses),” said Dr. John Soles, a local physician and former Chief of Staff at Dr. Helmcken Memorial, before retiring earlier this year. “That’s the real problem…it’s not a new thing, but it’s worse than it’s been.”
The shortages are not unique to Clearwater, as other small towns in Interior Health, including Barriere, Ashcroft and Merritt, have had some form of department closure in a hospital or clinic in the last few weeks. Similar situations have also been experienced at hospitals and clinics across British Columbia.
Clearwater Coun. Shelley Sim noted during the regular council meeting on Oct. 5 that B.C. is in need of roughly 600 doctors. That doesn’t include shortages in nursing or other allied health care professionals such as x-ray and laboratory technicians, positions Clearwater has had a hard time filling.
Mayor Merlin Blackwell confirmed the District of Clearwater has tentatively filled one registered nurse position in the emergency department for the beginning of December. But the hospital is still in need of one full-time RN position, two home health nurses plus home supports casuals, two more physicians and medical office assistants for the nearby clinic. He added there’s also always a need for casual and on-call RNs and Licensed Practical Nurses.
The medical staff currently employed at Dr. Helmcken Memorial Hospital are becoming stressed and overworked, he said, as they try to cover as much as they can. While Clearwater has seen a low number of COVID-19 cases, the pandemic is still having an effect. Blackwell noted nurses are also working the immunization clinics.
Soles said as more shifts open, there are more requests for staff to work overtime and take extra shifts.
“To a certain point that’s okay, for some nurses who want to work an extra day or whatever, that’s fine,” he said. “It does get wearing after a period of time.”
Soles added many health care workers may also feel guilty if they aren’t filling shifts, and may end up working more than they prefer because they’re meeting a need. But this also contributes to burnout and stress levels.
“I can’t speak for other people, but it’s certainly true of physicians sometimes,” he said. “Certainly true in my experience where…you work because you’re needed, not because you really want to work.”
The decision to close the ER isn’t one that’s made lightly, especially considering the next nearest hospital is at least about an hour and 20 minutes away.
Interior Health told the Times the recent closures were due to staffing shortages due to vacancies and employees calling in sick. The health authority also noted the shortage is country-wide, and includes vacant positions for nursing, physicians, diagnostic imaging and laboratory.
“Before making the difficult decision to close the emergency department, we pursue all options to fill empty shifts, including pursuing casual and contract nursing options in the region,” the health authority said in a statement.
Recruitment and retention of staff in Clearwater
Blackwell said one major factor contributing to the shortage in Clearwater, and many other rural and remote towns, is appropriate and affordable housing.
“We can get apartments and basement suites for people,” said Blackwell. “But while that’s great for the single people coming to town, it does nothing for the families.”
Home and lot prices have skyrocketed in the last few years, not only in Clearwater but in many cities and towns in southern B.C. In August 2021, the average home price in the Thompson-Nicola region was $706,750.
Clearwater has about 200 subdivided lots ready to be developed, he added, that are either currently available, awaiting final approval or in the planning stage. The demand to build new houses is there, but the town lacks the people to build them.
“We just don’t have the physical contractors and crews to build houses. the trades are missing right now,” said Blackwell. “Even if we can attract them to town, ironically, we don’t have houses to put them in.”
But houses are just one piece of the puzzle. If the District were to recruit medical staff and find housing for them, the next step is retaining them. One way to do this is by helping the newcomers feel welcome and a part of the community.
Re-establishing “welcome wagon” initiatives would go a long way in helping health care workers and their families to feel welcome and comfortable in a new town, by connecting them with others who enjoy the same hobbies, or introduce them to other families, he said.
Soles agreed, adding the pandemic and its ongoing restrictions have made it tough for many people to socialize. Imagine being a health care worker who came to the community in the middle of the pandemic and what effect that would have on a social life or how well you get to know the area, he said.
The effect of the pandemic on hospital shortages
While the medical staff shortage is not a new phenomenon, Soles said it has been exacerbated by the COVID-19 pandemic. Staff burnout caused by rising cases of the virus, patients filling hospitals and the government vaccine mandate all affect the already large shortage of medical professionals.
Those who have worked non-stop throughout the pandemic, putting in extra shifts and overtime, have been doing so for about 20 months now.
“Your ability and your willingness to do that is going to be impaired, so I’m sure it has an effect,” said Soles. “In Clearwater, it’s not the fact we have lots of cases, because we haven’t, we’ve been so very fortunate, but I think it’s the system as a whole is strained.”
When the closest city centre with an ER is experiencing its own shortages and increases in COVID-19 patients, he added, it hinders the local hospital’s ability to transfer patients, as well as the creating longer wait times.
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