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Horizon criticized for low overnight physician staffing at ERs

Horizon criticized for low overnight physician staffing at ERs

Horizon Health's decision to leave only one doctor working overnight at the emergency rooms of the hospitals in Fredericton, Moncton and Saint John is "terrifying," according to one woman who waited for 10 hours with a broken bone.

Doris Scrimgeour wrote to John McGarry, the president and chief executive officer of Horizon Health, expressing her frustration about the lack of doctors on staff between 1 a.m. and 7 a.m.

"I have to tell you that I find this terrifying, possibly dangerous. Five nurses and a doctor confirmed that this situation is not acceptable, and that both doctors and nurses, have left because of it," wrote Scrimgeour.

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The Maugerville woman said health officials are playing a very dangerous game by keeping the ERs thinly staffed overnight.

"This feels like Russian roulette to me," she wrote.

"How many unnecessary complications have occurred because medical situations weren't dealt with in time?"

Dr. Graeme Young, the chief of the emergency departments in Fredericton and Oromocto, said Scrimgeour has a right to be concerned.

"Yes, she does have a legitimate concern as a quick answer, but there's unfortunately a very long answer to her questions as well," said Young.

"There's no question that more doctors in the emergency department would probably increase the throughput in the emergency department, there's little question that that does happen. But there's other limiting factors."

The other factors that affect the decision of how many physicians will work overnight at an emergency room revolve around limits to nursing staff and a lack of space to accommodate patients.

Young also said there is one overriding issue that impacts these decisions.

"At the end of the day I think it is about money. If money was no object then we would have I think probably more staff," said Young.

ER isn't staffed in 'haphazard way'

Even with the emergency department only having one doctor late at night, Young said that staffing is well thought out.

"We don't staff the emergency department in a haphazard way," he said.

"It's done on a very methodological way, by looking at the amount of patients that show up each and every hour."

That being said, when a situation arises where another doctor may be required, that is a tall order.

"The backup plan is very difficult on a good day to find additional physicians that are one capable of doing the night shifts at a regional facility, and two that are willing to do that, because it is a very busy shift," said Young.

Young did say there is a mechanism in place to bring in another doctor if staffing levels become unsafe.