Lunenburg emergency department launching protocol to deal with overcrowding

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The emergency department at Fishermen's Memorial Hospital in Lunenburg, N.S., will begin using a new protocol next week whenever the site hits overcapacity near closing time.

Under the protocol, which comes into effect Monday, priority will go to the most emergent or urgent health issues. Anyone else will be offered options, including coming back when the department reopens, going to the nearest open emergency department in Bridgewater, or waiting to see a primary-care provider the next day.

"Safety is our priority. Fishermen's emergency is supposed to close at 10:30 p.m. Our doctors and nurses are frequently working into the wee hours to see patients, and that makes it difficult for them to do their work safely and efficiently," said Dr. John Jenkins, the emergency department's physician leader.

"This becomes even more problematic when those same nurses and physicians are scheduled to work in the emergency department or a family practice office the next day. We need to prevent burnout."

CBC
CBC

The protocol will be triggered if the number of patients triaged, but not seen, is greater than the number of patients who could be seen before the emergency department shuts its doors for the night.

Jenkins said more and more patients have been arriving at the site close to closing time in recent months.

"I think people had been holding back coming to [the emergency department] during the lockdown and people with chronic conditions got worse," Jenkins said.

"Many of them were very ill people who just waited a long time to come in because they were fearful of getting COVID."

A trickle of additional patients soon "became a flood," said Jenkins, as people became more comfortable going to the hospital during the pandemic.

Steve Lawrence/CBC
Steve Lawrence/CBC

With nurses and doctors often following an evening shift with a day shift, it became an issue of safety.

"When you're basically awake until almost when the next shift starts, it starts to present some problems with fatigue and burnout or people start to cut back on their shifts," he said.

The late-night deluge of visitors to the emergency department has been less of a problem recently and Jenkins said the hope is the new protocol won't have to be triggered very often. It follows similar models to what's used at hospitals in Lower Sackville, Glace Bay and North Sydney.

The changes were developed after consultation with clinical leaders, staff, and doctors who provide coverage at the hospital's emergency department.

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