A critical shortage of nurses has prompted emergency services to be cut back this weekend at two of New Brunswick's largest hospitals.
Patients with non-life-threatening conditions are being asked to stay away from the Moncton Hospital and the Saint John Regional Hospital this weekend.
Margaret Melanson, Horizon's interim president and CEO, said she's never seen the situation so dire at these hospitals.
"I don't believe this has been the situation for the last number of years" she said in a hastily called news briefing on Friday morning.
"Similarly, having worked in the health-care system myself, I don't recall the urgency of this messaging in the last several years."
The province's largest hospitals have mostly escaped cuts to emergency services in recent months, although the Dr. Georges-L.-Dumont University Hospital Centre in Moncton was closed on the Canada Day weekend because of staff shortages.
There have been service reductions in Oromocto and Sackville and regular closures at the Sussex emergency department.
Melanson said there are a number of factors that have added to chronically low staffing rates, including vacations for health-care workers, a large music concert in Dieppe, and a number of workers ill with COVID-19.
She also said there are "within our facilities a large number of patients that really do require nursing home level of care." That, she said, is contributing to the "congestion issues that we experience and ... impacts our emergency departments as well."
Melanson said non-life-threatening cases are being asked to stay away so that the remaining staff can continue to provide care for those who are seriously ill.
The Moncton Hospital is the province's Level 2 designated trauma centre and Saint John Regional Hospital is the province's Level 1 designated trauma centre," Horizon officials explained in a news release.
"These facilities must reserve their resources to care for the individuals who present with critical medical needs, including those who have experienced serious injuries, heart attacks, strokes and difficulty breathing. We will provide care for individuals with limb- or life-threatening medical needs."
"We recognize the seriousness of this situation and the difficulties it may bring to Moncton and Saint John area residents, as well as to our staff and physicians," said Melanson.
"We are providing on-site support to our staff and physicians who will be providing care to patients with critical injuries or illnesses over the weekend and are thankful for their dedication to their patients," she said.
During Friday's news conference, Dr. Serge Melanson, an emergency room physician at the Moncton Hospital, said he doesn't expect patients to be able to assess their own medical needs without assistance.
The last thing we want to do is to create a situation where people feel as though they need to make these decisions by themselves," he told reporters.
"I'll tell you that after practising ER medicine for 20 years, I don't expect any patient to be able to self-diagnose serious conditions at home without any guidance or assistance."
Telecare 811 can can help with assessment, while Ambulance New Brunswick paramedicas can treat and release patients. Pharmacists can also provide some advice, he said.
Patients can also visit another hospital emergency department, such as:
Horizon's Sackville Memorial Hospital (40 minutes, from the Moncton Hospital), open seven days a week, 8 a.m. to 4 p.m.
Horizon's Sussex Health Centre (50 minutes from Moncton Hospital and Saint John Regional), open 24/7
Horizon's St. Joseph's Hospital Urgent Care Centre in Saint John (10 minutes from Regional), open seven days a week, 9 a.m. to 9 p.m.
Horizon's Charlotte County Hospital in St. Stephen (1 hours and 15 minutes from Regional, open 24/7
But, within hours of issuing the alternative hospitals to attend, Horizon issued a release saying the Sussex ER would be closed overnight on Friday.
"Due to an unexpected shortage of staff available," the emergency department at the Sussex hospital will close early today. It will close at 5:30 p.m. and open again on Saturday at 7:30 a.m.
"After 5:30 p.m., all patients will need to seek treatment at another hospital," said a note released by Horizon on Friday afternoon.
What constitutes a true emergency?
In general, Dr. Melanson said a sudden onset of acute and unfamiliar symptoms "would certainly constitute a true emergency, and I would encourage people who are experiencing those types of things to make their way to their local ER department and they will be seen and they will be cared for."
Horizon said conditions that would require a 911 call or trip to an emergency department include:
Discomfort or tightness in the chest.
Unusual shortness of breath.
Prolonged and persistent headache or dizziness.
An injury that may require stitches or involve a broken bone.
A child with prolonged diarrhea or vomiting.
A baby under six months of age with a fever of 38 C (100.4 F) or higher.
Examples Horizon provided of when a trip to the ER is not warranted and should be treated in the community include:
Sore throat, toothaches or earaches.
Possible bladder infections.
Rash (such as scabies).
Testing for sexually transmitted infection.
Lower back pain from lifting or twisting.
Flu symptoms such as vomiting, diarrhea, chills, and fever.
Margaret Melanson said it's been a very difficult summer in terms of staffing levels, despite last week's announcement that Horizon had hired 1,300 health-care workers since April. At the time of the announcement, Melanson said she expects to see noticeable changes in the next several weeks because of the uptick in recruitment.
On Friday, she said there have been gains, but a number of factors working together this weekend in the Moncton and Saint John hospitals have delivered a temporary setback.
Horizon spokesperson Kris McDavid confirmed that during the same period, 1,300 new health-care workers were hired, 662 left the system through retirement, resignation or termination. That leaves a net gain since April 1 of 638 employees.
Health minister hints at upcoming announcements
Health Minister Bruce Fitch held his own Zoom meeting with the media later in the day Friday.
He was asked about specific plans his department has to try to improve the system and he repeated the message about the importance of recruiting and retaining new health-care workers to the province.
He also said with the advancement of technology, it's possible to take some procedures out of hospitals and into clinic settings, "which again frees up the OR or the surgical suite to do hips and knees and some of the more complicated operations."
When pressed for more details, Fitch said, "Well, I don't want to usurp some of my announcements in the near future, so why don't I just say 'stay tuned' because there are some … announcements I'd like to make in the not-too-distant future about some of those options."