Should some rural ERs close permanently if better supports are in place?
Plastic covers now adorn the new chairs in the pristine waiting area of the Carleton Place and District Memorial Hospital’s newly constructed, ‘state-of-the-art’ emergency room (ER). The official opening of this facility in January is a momentous occasion for the rural eastern Ontario community. However, the next challenge that looms is the critical need to keep the doors open, and this hinges on the availability of nurses.
Brad Harrington, the CEO of the Mississippi River Health Alliance, is taking a proactive approach by emphasizing the importance of recruitment and retention strategies. He believes that building a new ER will attract healthcare professionals to the area. This sentiment is crucial as a recent CBC data analysis revealed that Carleton Place is one of 38 Ontario hospitals that have experienced closures of their ERs or urgent care centers over the past three years, primarily due to nursing shortages.
The data further highlights the disproportionate impact on rural and remote areas, with more than 85% of closures attributed to nursing shortages. In some cases, such as the Minden ER closure in 2023, the situation has become permanent. Physicians have raised concerns about the effectiveness of ERs that are only open part-time, advocating for better support services like urgent care clinics and advanced paramedic care to address the inconsistent emergency services in certain regions.
Tim Vine, the president and CEO of North Shore Health Network, manages three hospitals in a remote rural area along Lake Huron. He expressed the ongoing challenge of finding enough physicians and nurses to keep the ER doors open. Vine emphasized the need for policymakers and healthcare planners to determine the necessity of maintaining an ER in specific locations and provide adequate funding to support these services.
Dr. Alan Drummond, an experienced emergency and family medicine practitioner in Perth, Ontario, acknowledged the changing landscape of healthcare delivery in rural areas. While he recognizes the importance of local ERs in stabilizing patients, he believes that directing patients to larger centers for specialized care may be a more sustainable solution given the limited availability of human resources.
As the Carleton Place hospital opens its new ER, concerns arise about the potential impact on nearby facilities like the Almonte hospital. Despite experiencing temporary closures due to nursing shortages, both hospitals are committed to providing essential emergency care services to their communities. Dr. Melanie Fortune, the chief of staff at Almonte, views the ER as the “soul of the hospital” and remains optimistic about its continued operation alongside the new Carleton Place facility.
The ongoing challenge of keeping rural ERs operational in Ontario underscores the need for sustained efforts to attract and retain healthcare professionals. Nurses like Iris Rawlings, who has dedicated 26 years to working in the old emergency department, are instrumental in ensuring the continuity of care for patients. Rawlings’ commitment to the new ER reflects the deep sense of community support and dedication that underpins the healthcare system in rural areas.
In conclusion, the opening of the Carleton Place and District Memorial Hospital’s new ER symbolizes a significant milestone for the community. However, the sustainability of these essential services depends on addressing nursing shortages and developing innovative strategies to support rural healthcare delivery. By fostering collaboration among healthcare providers, policymakers, and community members, rural hospitals can navigate the challenges ahead and continue to provide quality emergency care to residents in need.
