The CEO of Health P.E.I. says chronic staffing shortages and a rise in COVID-19 cases in the province, have made the first few weeks of the summer "extremely difficult" for health-care workers.
About 135 Health P.E.I. staff were off last week with COVID-19. Dr. Michael Gardam said that is a lot for the province's system, which was already feeling the strain.
"We're in the peak of summer holiday season and of course, we have many more people on the Island than we do during the winter, so we have more people potentially who can get infected and who need to access health care," he said.
"It's been a pretty miserable summer."
Working with COVID-19 in critical situations
Gardam said in rare circumstances — fewer than 10 times — COVID-19-positive health-care staff have been brought in to work in order to keep the system running and avoid closures.
He said in those situations, the workers must be past their fifth day of isolation and must feel and sound well enough to work.
"And, of course, they have to be absolutely essential," he said. "We're not just bringing people back for the fun of it."
Gardam used the example of a trauma-trained nurse returning to work if they were symptom-free and there were no other trauma-trained nurses available that day.
"Most of the health-care workers that I've spoken with who have had COVID have not been well enough to work," he said.
Gardam, whose background is in infectious disease prevention and control, said the risk of these health-care workers spreading COVID-19 is overwhelmingly unlikely.
Some [nurses] ... that's the only recourse they have: to turn the phone off. - Barbara Brookins, P.E.I. Nurses Union
"The infection control protocols we use have shown over the last two and a half years that despite all the COVID out there, we are very good at actually controlling spread in health care. We're not perfect, but we're very good at it," he said, adding that keeping services running is the most important thing.
Over the past few months, Health P.E.I. has announced dozens of overnight closures of Alberton's Western Hospital emergency room, citing staffing shortages.
"We're trying to be very, very intelligent about if we do have to close the service, it's one that's going to have the least impact for the least number of people just to try to keep the rest of the system running."
'Everybody's running short'
But the province's nurses union said staffing issues have been critical for months, and the calls from nurses about the problem to the union are only increasing.
"I'm glad to hear that [Health P.E.I. is] acknowledging it publicly so that the staff actually know that that the employer is hearing it, but the thing is, it's not just COVID. We had a large number of vacancies even before the summer started," said P.E.I. Nurses Union president Barbara Brookins.
"Our frustration is that it doesn't seem like there's been any direction for what happens when they can't fill shifts."
She said nurses are constantly getting calls to work on their days off, or have no one to relieve them at the end of their shift.
She said that could be due to burnout, COVID-19 or vacant positions.
"It's been very hard on the mental health," Brookins said.
"It's frustrating because, you know, they have their friends left at work, so they can't even turn their phones off. And some of them, you know, that's the only recourse they have: to turn the phone off. "
I'm not going to pretend that we're in great shape, because we're not. — Dr. Michael Gardam, Health P.E.I. CEO
The union said some Health P.E.I. facilities have been experiencing critical staffing shortages since February, and many nurses are being moved around in the system on a weekly basis.
"There's rumours that there's going to be more moving about within the system just to kind of support the areas that we really need to focus on, like your emergency rooms, but inpatient, long-term care, everybody's running short" she said.
"What I would like to see done is just kind of an earlier recognition … they know now the shifts that are empty, that were empty even before COVID … but we want to know now where the holes are and what the employer's going to do to address them."
Focusing on ERs
Gardam said while it might surprise Islanders, P.E.I. is in better shape than many other jurisdictions. He joined the province's health authority last year from Ontario, where he said many hospitals now regularly run at 120 per cent capacity, while P.E.I. rarely exceed 100.
He said the first priority must be protecting emergency departments.
"We try to move admitted patients out of the emerge and up into the inpatient units. And there we're facing struggles because with enough staff illnesses, we have to close beds because we can't actually have a nurse there to look after somebody," he said.
"We're doing better than other places, but I'm not going to pretend that we're in great shape, because we're not."
But Brookins said she still wants to see more from Health P.E.I. She said the health-care system is losing nurses daily.
"We've got a large number of them that are ready to retire this fall, and when they're not getting their leaves and they're having a higher workload when they are at work, it's going to happen sooner."
"When nothing works and you still have holes, you need to have a plan for what you're going to do … and it's not just 'good luck on the weekend.'"