The Nova Scotia Nurses' Union is adding its voice to the growing chorus calling for immediate and focused efforts to improve the state of emergency care in the province.
"We're really at a point where our nurses are getting very frustrated and pretty fed up with 'tomorrow might be better,'" union president Janet Hazelton said Monday during a news conference.
"There is no tomorrow anymore."
Nurses are echoing concerns and frustrations from paramedics, doctors and patients over emergency department closures, long waits and a lack of space to treat emergency cases.
Hazelton said there has been "a loss of conversation" between her union and the Health Department, including Health Minister Randy Delorey. Communication with the Nova Scotia Health Authority has also fallen short, she added.
"This has been a long-standing problem," she said. "We've been talking about this problem for many years and we need, as a province, to decide how important is this issue. We need to decide what are we going to do about this issue."
The union believes much of the problem can be traced back to access to sufficient primary care. It is preparing to release a report on the subject in May, but Hazelton said the situation in the province's emergency departments cannot wait.
A key concern for the union is whether there is a nursing shortage — something health authority officials and Delorey have disputed at times.
While there may be more nurses in Nova Scotia than there were five years ago, Hazelton said they're working with patients who are sicker than ever.
"We used to look after five patients, two of which could basically look after themselves. [Now] we're looking after five patients, most of them can't get out of bed without assistance."
Jen Thiele, an emergency department nurse at the Dartmouth General Hospital, said she and her colleagues are seeing a lot more non-emergency cases.
They are "people who could be seen at their family doctor or at a walk-in clinic, but they don't have access to that," she said.
It all translates to increased frustration, fatigue and risk of burnout for staff, said Thiele.
"We're getting to a point where it's very difficult."
Hazelton said people need to be able to access primary care when they need it and in a more appropriate setting than an emergency department.
She pointed to the VON clinic in Halifax as an example of an outpatient clinic that provides access to some diagnostic services outside of traditional office hours.
'Not a simple, quick path'
Delorey said Monday he understands the challenges nurses and other providers are facing. He said the government has been focused on improving primary care via collaborative care practices and various training incentives for nurses and doctors.
He said collaborative care clinics are an excellent opportunity to use nurses to their fullest potential and in different ways — something Hazelton called for Monday.
The minister said the declining number of Nova Scotians needing a family doctor is evidence the province is making progress. However, he said the reality of health care is that there will always be room for improvement.
"They're the same challenges and pressures my colleagues and counterparts as health ministers across the country are facing," said Delorey. "That means that there's not a simple, quick path to the final stage."
The minister said he and the health authority are trying to have conversations with front-line workers about how to implement improvements to the system.
Watching for Tuesday's budget
Hazelton urged the government to look for avenues to upgrade the education of nurses.
But even that isn't so simple. There's a nursing shortage across the country and converting existing nurses to nurse practitioners, for example, creates further shortages among the ranks.
Hazelton said Tuesday's provincial budget needs to make major steps toward improved primary care and address the state of acute care in the province, particularly when it comes to the number of beds.
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