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Sackville Memorial Hospital, July 5, 2022. Photo: Erica Butler

There are almost enough nurses hired to fill emergency department (ED) positions at Sackville Memorial Hospital, but the hospital has less than half the doctors it needs.

According to information released recently by Horizon Health Network, nine out of ten registered nurse (RN) positions at the Sackville emergency department are filled, but only three out of seven physician positions are filled.

The two most recent closures of the Sackville ED were due to a shortage of doctors available to work. At least two doctors stopped working in the department after a recent change in Horizon, which lifted a rule requiring them to work ER shifts in order to maintain a practice in Sackville. The change was intended to make it easier to recruit new physicians to the Sackville area, as not all family physicians want to work in the emergency room.

Nurse practitioners and the return of acute care?

In his monthly report to council, Mayor Shawn Mesheau noted that Horizon’s interim CEO, Margaret Melanson, recently reaffirmed a commitment to restore 24/7 service to the emergency room in Sackville Hospital.

Mesheau and other local mayors met with Melanson and new administrator Suzanne Johnston in August. Mesheau reported that nurse practitioners are now working alongside doctors in the Sackville emergency department to help meet primary care needs. His report also indicates that several acute care beds are expected to open in the Brunswick Unit of the Sackville Hospital in October. All acute care beds were upgraded to pre-long-term care beds in December 2021, at the same time emergency department hours were cut by two-thirds.

Coon asks for changes in accordance with the list of doctors in Fredericton

David Coon, MPP for Fredericton and Leader of the Green Party. Photo: submitted

Earlier this month, a Fredericton emergency room doctor released a list of recommendations to help solve New Brunswick’s health care crisis.

Dr. Yogi Sehgal says that to compile the list, he gathered feedback on social media and in conversations with other healthcare workers, members of the public, administrators and government officials. Sehgal’s list contains 45 different fixes, large and small, for emergency rooms, primary care, nursing, and the system as a whole.

Green leader David Coon is a fan of Sehgal’s list, in particular of two recommendations, one to establish primary care clinics to give people access to emergency care that is currently not available outside emergency services, and another to start funding tuition and expenses for nurses who want to upgrade their skills through the province’s bridging program.

In late August, the Green Party appealed to the Higgs government to act on some of Sehgal’s recommendations. CMHA spoke with Fredericton MPP and Green Party Leader David Coon to learn more:

Sensible recommendations, but not necessarily for SMH

Sackville doctor Allison Dysart says he found Sehgal’s list “very reasonable”, although he cautions against applying technical fixes at all levels. “His list was really from the perspective of what would help an urban emergency room run better,” says Dysart. “And I think his list should be interpreted strictly in that light. From this point of view, I really agree with him.

However, fixes for urban hospitals could actually help more rural counterparts like Sackville, Dysart says, where problems have typically been created by problems elsewhere. “The fact that two and a half years ago Horizon wanted to close Sackville at night and get rid of acute care medicine at Sackville Hospital…Those decisions weren’t made because Sackville wasn’t running well or because we were running into terrible trouble,” says Dysart. “Really, they were created because Moncton was not working well, Saint John was not working well and Fredericton was not working well.

“We were kind of doing fine, really, if we had been left to our own devices,” Dysart says. “What we see now is a very artificial situation in Sackville. It was created by management decisions.

To be fair, Dysart says Horizon was addressing significant issues in its city hospitals. Unfortunately, service cuts in rural hospitals have not solved the problems in urban hospitals, and these problems have now spread to rural hospitals.

“Nothing better in urban hospitals. In fact, it’s much worse. And now rural hospitals can’t even do their job properly,” says Dysart.