GUEST COLUMN – Is it time to ask for Canadian Forces medics?
By LYNNE STONIER-NEWMAN
Guest Columnist
OUR RURAL COMMUNITIES’ established medical services are collapsing. Emergency wards in their hospitals are repeatedly being closed from 6 p.m. until 7 a.m. The Interior Health North Authority administrators report: “That is necessary due to lack of Emergency ward staff.”
Lynne Stonier-Newman here, worried for our neighbours in Clearwater, Ashcroft, Merritt, Chase and other small communities surrounding Kamloops.
My two questions to readers: Does IH’s ordering those temporary closures demonstrate a lack of astute management? Two: Are those closures recognized by IH and B.C. Ministry of Health as dire emergency medical failures?
To me, the closures demonstrate medical care for our regional population is on a downhill slippery slope.
The Canada Health Act, created jointly with all provinces, states universality and accessibility are core Canadian rights. But by statute, providing health services and medical personnel is each province’s responsibility. Closing rural hospitals’ Emergencies in this region is our Interior Health Authority’s decision. What’s their potential to fix this ‘temporary’ shortage of staff? Perhaps it is time for CF medics?
Because … what are the consequences of IH’s directing that injured or sick people have to travel to the overcrowded Royal Inland Hospital Emergency ward and overflowing wards?
All the caring staff there, especially the doctors and nurses, are already struggling to meet the medical needs of the almost 100,000 people living within Kamloops. Monthly, the numbers of sick and injured patients they treated in both Emergency and on the wards, increases. And, as often reported by media, many of those professionals wonder how long they personally can keep going.
The log jam of patients is exacerbated because of two realities. First, an estimated 35,000+ Kamloops residents do not have a family doctor. And most walk-in clinics here have closed as well as a number of GPs are retiring or closing their practices.
The only choice for an injured or sick person has is to go to RIH Emergency and sit in its waiting room, sometimes for many hours. From my personal experience, that crowded and uncomfortable space is so inadequate and antiquated, it could be used for a 1970s movie set.
So how can RIH’s emergency services deal with even more patients? Especially as those patients being advised to come are from 100+ kms away and many without local support?
Just how do the administrators of IH and RIH emergency services expect those overstretched professionals to cope with an even denser patient load? And the halls of RIH’s wards usually have in-patients waiting to be moved into a room. The nurse-to-patient ratio is reported to be past safety and the medical personnel’s energy limits. Isn’t that also an emergency?
Although IH’s mission statement states, “provide needed health services in a timely, caring, and efficient manner, to the highest professional and quality standards,” are the administrators not acknowledging the depth of emergency our region has currently reached?
We need outside help to patch in and repair these staff shortages problems … and keep all rural hospitals’ Emergencies open.
Sure, we’re in dire straits because earlier B.C. governance by the B.C. Ministry of Health bureaucrats and the MLAs of earlier decades screwed up their forecasts about length of life and about population growth. They created these staffing shortfalls. But recognizing that history is not a solution.
What is?
And are our health care administrators and trustees going past perceived ‘that isn’t possible’ barriers to find solutions?
Would assistance from the Canadian Forces medics temporarily bridge the gap, enable our smaller hospitals’ Emergencies to remain open 24/7? Would that give IH, B.C. Ministry of Health and the board of the College of Physicians and Surgeons of B.C. time to do emergency problem-solving and to eliminate red-tape delays?
Those bureaucratic roadblocks are preventing many former MDs, who have come from elsewhere and gone through B.C.’s expensive and arduous re-qualifying process, to receive their B.C. licences to practice in a timely way.
That affects filling residencies in our short-staffed hospitals. Who knows how many medical residencies at RIH are unfilled because of bureaucratic delays?
Similarly, how long is needed to confer with, listen to and revamp the working conditions for the B.C. nurses who are turning down shifts? Problem-solving does necessitate making changes.
And we all seem to agree that B.C.’s most pressing health system problem is the lack of general practitioners. Well, would any of the B.C. Ministry of Health’s senior bureaucrats work for the reported average of $31.62 for the average visit that our GPs gross, and then have to pay all his or her office expenses?
Sure, the recent $118M announcement in short-term funds to help stabilize family physician practices and clinics will help. But isn’t needing that bandaid like the tip of an iceberg?
Who set up that financial inequity, what team is responsible? Because the numbers of GPs leaving B.C. means that our health system of having our own doctor, of our health needs being cared for with compassion by someone who knows us, is in deep jeopardy. And who can make the deep changes required to regain a balanced B.C. health system within the challenges Covid dumped on us?
Interior Health administrators must be stressed right out, and I appreciate how hard they are working. But, in my opinion, their decision that closing rural communities’ Emergencies is an acceptable solution is wrong, and dangerous. Because without local emergency services, the most seriously ill regional patients cannot be provided with treatment within the golden hour.
That’s the hour when chances of patient survival is the highest, and the injuries suffered may best be repaired. After Hour One, both factors decrease rapidly. And why all medical and paramedical training and rescues are based on the golden hour.
And what about the mental stresses added if someone has to travel to receive medical help?
If you lived in Ashcroft, fell off a ladder while painting and sustained multiple breaks to your leg and an ambulance transferred you to RIH’s overcrowded Emergency, how would you manage?
You don’t have your cell phone, wallet or reading glasses or any clothes except the ones you were painting in … and you don’t know anyone who is able to make the expensive trip to Kamloops to bring your stuff. What then?
And may I share the conversation I had yesterday in a slow-moving bank line-up? The elderly man in front of me, who was also using a walker, told me about bringing his wife to RIH from Clearwater.
“Hell of a trip, left at 1 a.m. and didn’t get here here until 6 a.m. An 18-wheeler jack-knifed … now she’s in that zoo of an Emergency ward in a tiny cubicle, waiting for a belly specialist. And I’m exhausted … need to find a motel next.”
I sympathized and asked if they had lived in Clearwater long.
“Fifty-three years, raised five children in the big house we built on the North Thompson. Three of them are raising their kids there … we are all so angry our hospital’s Emergency is closed again. Started first with two nights, then five and, currently, it is closed for eight. Guess we don’t count. Our doctor’s away for a week, what was I to do?”
He blew his nose and muttered, ‘We all have family doctors, you know. Different than in Kamloops, eh? And our hospital is friendly, my wife has helped make it so, still volunteers there. And she’s fund-raised since before it opened.
“So how come is she on a stretcher bed here, far from home?” he asked me. “And she’s furious I made her come down to RIH. She’s 83, damn feisty and adamant that if it’s her turn, she wants to die in Clearwater.”
I was relieved the teller waved him over because I didn’t know what to say …
I’d watched the morning news, seen the Interior Health’s list of which rural emergency rooms were being closed next, and when. And muttered to my husband, “How damn misleading. The reporters make Clearwater sound like a little village in the midst of nowhere. Sure, it has under 3,000 residents but why don’t reporters tell their viewers about what’s beyond those borders?”
Clearwater is the gateway to and support community for B.C.’s Wells Grey Park, whose amazing 41 waterfalls and pristine mountainous wilderness has attracted visitors from many countries for decades. In 2019, over 100,000, according to the visitor stats from the Wells Grey Provincial Park Welcome Centre in Clearwater.
And what’s the count for Hwy 5 trucker traffic, let alone the RVs and passenger vehicles, going between Kamloops and all points north? It is the only main highway directly connecting southern B.C. via Kamloops to the north, Edmonton, etc. So those drivers and passengers are also whom the Dr. Helmcken Memorial Hospital’s staff in Clearwater patches up, or transports, if necessary.
Our Interior Health North region is teetering on the brink of disaster, I ranted to myself. Then I began wondering how many Canadian Forces medics would be needed to keep IH’s rural communities’ Emergencies open?
My two questions to readers: Is this a dire emergency situation? If so, why aren’t Interior Health North administrators seeking help from outside sources?
In my opinion, before more individuals die before their time, why can’t we have assistance from Canadian Forces medics?
Because if not now, when?
And if our current federal laws and statutes say our Canadian Forces can only serve needy individuals offshore, that needs changing, now!
Perhaps by a parliamentary cabinet’s Order In Council … Because all archaic and colonial precepts can be changed.
And we are a democracy, have the rights and responsibilities to holler, “Find the medical staff necessary to keep our regional Emergencies open!”
Lynne Stonier-Newman is a resident of Kamloops. She’s a social marketing and communication consultant, and a B.C. historian and author.
The writer makes some very good points. The other elephant in the room, is the shortage of ambulance drivers, and the fact that the ambulances in these areas have to cover a lot of territory, and may not be available when needed close to home. And Ian, you seem to forget that it was the previous government that limited spaces in med school, and started this whole mess through their own meddling, and indifference.
And then of course to add to the congestion on highway 5 is the pipeline construction involving hundreds of workers and heavy equipment being moved. And what if there is an accident at the construction site – big or little accident? IH seems unaware of all the possibilities- and tragedies that could result from the ER closure and highway 5 traffic and closures. .
Hyper specific to the idea of Canadian Forces medics being stationed in BC civilian health care facilities … theres a plethora of issues with that.
– I’m not positive, but confident that the only way to deploy Canadian Forces personnel in parallel civilian positions is by way of the declaration of a provisionb of the emergency act, either a federally initiated declaration country wide or a provincial request for emergency supports from the federal government.
Although we would like to think that the medical personnel shortage is a viable reason for the declaration of an Emergency, it is by calm preponderance of the situation, just not justified. We are NOT experiencing an armageddon. In addition, no Province is going to reach out to the Feds and say that they have completely failed in the provision of health care to citizens and request initiation of the Emergency Act in their province … talk about political suicide.
– As well, an individual Canadian Forces persons medical accreditation is likely not recognised in the provinces. Canadian Forces medics and nurses are trained in house, by the Canadian Forces at a base in Ontario, a jurisdiction that is outside of any provincial accreditation jurisdiction.
A nurse in Manitoba can not work in BC without an exam to ensure they are in alignment with BC policy, practice and protocol. The same is at the ‘medic’ level. An OFA3 in BC cant work in another province without the appropriate accreditation in that province to do so. Same for a Paramedic. Now … there have been movement (leaps and bounds) towards amalgamating all like positions in the country to allow for seamless movement between provinces … but were not there yet.
One more add-on; Canadian Forces medical classifications (positions) are far, far from being in alignment with any provincial hierarchy, they have their own scope of practice scale, and few of those classifications transfer easily to civilian facility use. ie; a nurse, is not a nurse, is not a nurse when comparing these 2 worlds.
What these points do is simple; When something goes horribly wrong, and if a civilian is maimed or dies at the hands of a Canadian Forces medic … who is legally responsible? If there is a declared Emergency Act, the feds are. If the province does so, they accept the risk. Without any of that, the legal responsibility would end at the individual. Thats a situation that the Canadian Forces and individual medics are not about to take.
Things are never as simple as … “we shoulda aughta do that”.
We have laws, rules, policies and protocols and they cant be sidestepped at a whim, if we want to be a law based democratic society.
She has a number of apparently unanswerable questions here, unless IH starts to organize a miracle, which is their responsibility. I’m thinking that it’s going to require a change of provincial government before we get the sweeping changes that may answer a few of her questions.