Northwestern Ontario hospital ERs continue to undergo strain amid staff shortages, burnout

As hospitals across the country continue to undergo staffing shortages and burnout, it's no different in northwestern Ontario.

This past Sunday, the emergency departmentat Wilson Memorial General Hospital in Marathon was closed for the day due to staffing difficulties.

Dr. Sayali Tadwalkar, a rural family doctor and chief of staff at North of Superior HealthcareGroup in Marathon, said while it was unfortunate the ERhadto close, it was shutto ensure people would get safe, quality care.

"Without the nurses that we needed to run the hospital, we didn't think that was possible and had to close the emergency department," she said.

Tadwalkar said the health-care system is "hanging by a thread," and there are a lot of different factors behind the current situation.

"I feel like this is the first time we've had to close the emergency department. I'm sorry to say I don't think it's going to be the last," she said.

"Every single shift feels like this could be the day that we close again and that's the unfortunate part."

Respiratory illnesses add to pressure

The ER closure in Marathon cameduringa challenging year for health care, as hospitals across Ontario and Canada have foundthemselves overwhelmedleading to an unparalleled wave of staff shortages they say is reaching a breaking point.

Last month, health leaders from across northwestern Ontario warned that the situation was direand the region's fragile health-care system could buckle under the pressures of a spike in respiratory illnesses filling emergency rooms with patients.

Unlike in southern Ontario, where there may be another hospital close by if an emergency room closes, in northern Ontario, the next closest emergency room could be a significant distanceaway if an ER shuts down.

There aredays when we are a missed flight away or a sick call away from tipping over to closure.- Sue LeBeau, Margaret Cochenour Memorial Hospital

In Marathon, if a patient wasn't able to access the emergency room, they would have to go 45 to 50 minutes in either direction to the closest hospital, Tadwalkar said.

"Essentially someone would be left without care. If our ambulances were to take somebody to these hospitals, they also have to travel now and they'll be out of commission for two hours."

It's a situation similar to what the Margaret Cochenour Memorial Hospital in Red Lake, Ont., went through earlier this year, when officials also had to shut down their emergency department temporarily.

Sue LeBeau, the hospital'spresident and CEO, said she feels the pain resulting from Marathon's difficult decision.

"I certainly empathize with the difficulty of making such a decision and the implications that come with that," LeBeau said."You know, in terms of where are patients going to go, who's going to bring them there, how are we going to let them know and, you know, how can we minimize the impact of such a closure?"

For LeBeau, the recent closure showsRed Lake isn't alone in dealing with shortages in the northwest and it's alarming to see emergency departments in remote and rural areas have to close.

WATCH| Head inside a rural ER to see the impactof these shortages:

Rural ER struggling to stay open 24/7 and the staff who never stop caring

2 years ago

Duration 6:58

The extreme staffing pressure on Canadian hospitals has forced some to temporarily close their emergency rooms. The National spent a day with staff at the Chelsey, Ont., hospital up until the moment they had to close the ER overnight because of staff shortages.

'These closures happen by surprise'

Navigating staffing shortages and burnout has been challenging, LeBeausaid, addingthat on occasion, the hospitalwill carry onshort-staffed if it can be done safely or have leadership step in tofill gaps when needed.

But LeBeau said that isn't sustainable in the long run.

"Our physicians are working long hours or more shifts than would be ideal. It means that primary care sometimes is being sacrificed to be able to keep emergency open, which is not sustainable in the long term because primary care is what prevents patients from needing emergency in the first place," she said.

It's an ongoing struggle, which LeBeau said the staff work on one day at a time. But to help alleviate some of the pressure, she said they've hired agency nurses and have been able to hire a nurse practitioner to help with patients who have mental health and addiction issues.

On top of that, LeBeau said, hospital officials are listening to their staff when it comes to their recommendations on what can be improved.

In terms of whetheran emergency closure is likely in the future, both LeBeau and Tadwalkar say it is a possibility but not a decision they take lightly.

"I would say it's a possibility in multiple hospitals across northern Ontario," LeBeau said."There aredays when we are a missed flight away or a sick call away from tipping over to closure. So it is a precarious situation right now.

"We try and build a buffer into the system as we can, but we know that sometimes these closures happen by surprise through circumstances that are out of our control because we don't have a lot of extra courses. Our nurses have worked a lot of overtime already."