GREY-BRUCE – The issue of agency nurses continues to be a major topic of discussion by the South Bruce Grey Health Centre board of directors.
At the board meeting Dec. 6, Mandy Dobson, chief nursing executive, said in her report that agency nurses are used at all four hospital sites.
Dobson said in recent months, more agency nurses have become available.
“It’s allowed us to be more selective,” she said, ensuring the nurses hired through the agencies are able to work in medical/surgical and emergency departments.
Currently, there are nine agency RNs and four RPNs.
There were questions about the possible impact of winter weather on the availability of agency nurses. Dobson answered that some of the agency nurses live “within the region,” meaning they’re aware of the weather in this area. In addition, the agency nurses often sign up for two or three shifts.
One member of the board quipped the weather might result in them working more shifts if they get snowed in.
The financial impact of agency nurses was discussed during the presentation of the corporate resources committee report. Board member Doug Harris said that as of October, SBGHC’s financials show a deficit of $400,000 (from a $360,000 surplus at the end of June). This is due to a number of factors besides agency nurses, including the ministry discontinuing incremental COVID expense payments.
CEO Michael Barrett explained in a later interview that during COVID, the province covered the cost of screeners, infection control measures and agency nurses. He said that after two-and-a-half years, the payments ended as of June 30. However, the payments could be extended.
There’s also the money paid to the Chesley doctors while the ER was closed for eight weeks.
A year-end deficit of $1.9 million is projected at this point, including $800,000 for agency nurses, sick time and overtime. This means capital reserves of $4.7 million could see a “cash erosion” of $2 million for 2022-23.
Barrett said in an interview after the meeting that he “anticipated additional revenue” from the province.
“The $1.9 million is going to come down,” he said.
The bottom line is that all four hospital sites continue to be “heavily reliant” on agency nurses, especially Walkerton and Chesley.
The province has announced the expansion of several programs to bolster the health-care workforce including an enhanced extern program, an expansion of the supervised practice experience partnership program, and an expansion of the community commitment program for nurses.
Hospitals prepare ‘surge plan’
In preparation for a possible surge in the number of patients, Barrett told the board that Ontario Health has asked hospitals to prepare a “surge plan” to accommodate 120 per cent existing capacity. This would be accomplished by such measures as scaling down surgeries and procedures and implementing “team-based care.”
It’s not as dramatic as it might sound – Barrett said last week three of the four sites were over-capacity – pretty much that 120 per cent.
It isn’t only to accommodate a local influx of patients, he noted. Freeing up capacity locally means the larger hospitals can ship back patients so they can look after the sickest people. “We’ve been told to be prepared to do this if necessary,” he said. There are no plans at present to scale back surgeries as was done at the height of the pandemic.
Dr. Lisa Roth said in her chief of staff report that every year, plans are made in case there is a surge of patients with the flu at Christmas, into the new year.
“This year we might have to use it,” she said.
Roth referred to the “mini surge” the previous week and commented that “everyone did extremely well.”
Chesley ER partly open
As of Dec. 5, the emergency department at the Chesley hospital reopened on a five-days a week basis, Monday to Friday, 7 a.m. to 5 p.m. While the goal continues to be to have the ER open 24/7, it does provide the community with some emergency coverage.
Barrett said in his report to the board that the “community is looking for more but right now that’s not possible.”
He stressed that communications have been sent out advising people in need of immediate attention “not to wait for the ER to open – go to the nearest ER that’s open or call 911.” Symptoms that demand immediate attention include chest pain and other indicators of a heart attack.
Tracking mental health and addiction
Board member Jim Bagshaw reported on a new indicator that will be tracked for quality improvement purposes, along with such items as wait times in the ER.
The new indicator is people with mental health or addiction issues, whose first point of contact is the ER. He explained that a high number would indicate a greater need for resources in the community.
“Right now, we’re just gathering data,” he said. The target is implementation in 2023.
KROC right on track
Board chair Bill Heikkila reported that the renovations in preparation for the new CT scanner in Kincardine are right on track.
The machine is scheduled to arrive in late February, with startup in late March of 2023.
Good weather in November meant the asphalt companies were still open, and the paving was done, meaning that come spring, the site will be clean.
“The redevelopment is progressing well,” Heikkila said. “Construction could start in late 2025.”
He noted fundraising is swinging into high gear.
A virtual community information event for Kincardine and area residents, and other interested people, is planned for Monday, Dec. 19 at 6:30 p.m. The session will be held via Zoom. To register, contact communications@sbghc.on.ca.
Agency nurses a major topic of discussion at hospital board meeting - pentictonherald.ca
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