Hospital Service Reductions Due to Nursing Shortages

We hear and understand the strong desire of the community and our partner organizations to return the Chesley ED to 24/7 service, and to provide a date by which that will happen.

Since returning the Chesley and Walkerton hospital sites to full service in the spring of 2022, we have been very clear that our plan to reopen did not come without risk of a future temporary, time-limited reduction in service should the agency nurse pool dry up, and/or the provincial health human resource situation deteriorate further.

Although our team of incredible nurses has made a significant effort to try and fill as many vacant shifts as possible, and our leaders have dedicated a large majority of their time to stabilizing nursing staff levels within our organization, including working some shifts, the reality is that there just are not enough nurses in the system to continue providing the level of service that has been provided to date.

The same non-negotiables that resulted in our Board of Director’s decision to reduce services in September 2019 are still at play.  We will not provide care in a manner that is unsafe, and we will not provide care that further deteriorates our staff.  As the provincial health human resource situation continues to be challenging, it has become clear that service reductions are an unfortunate, but necessary step.

Nursing staff shortages are not unique to SBGHC, or the Chesley hospital. There is an overall shortage of nurses in the province, and the large majority of hospitals in Ontario are experiencing staffing challenges. SBGHC made the decision to reduce services to ensure we can continue to provide care that is safe, and to ensure that we do not further deteriorate our staff.

In recent months, many hospitals across the province have had to implement ED closures due to staffing challenges, including local hospitals such as Listowel, Wingham, Clinton, Seaforth and St. Marys.  Other services, including obstetrics, are also being impacted.  The Palmerston and Mount Forest hospitals, and the Listowel hospital have been redirecting labouring moms to other hospitals at different times throughout the summer months due to staffing challenges, and this will continue into the fall.

The majority of the vacant nursing shifts in the fall schedule are at the Chesley site.  Although there are some nurses that work at other sites that have declared availability to work at the Chesley site, moving staff from another site would in turn destabilize that site.  The collective agreement we have in place with our union partners does not allow the hospital to move staff to a site where they do not have declared availability.

Since January 2022, the following steps have been taken by SBGHC to stabilize nursing staff resources.

• Utilizing Agency RNs to fill vacant shifts.
• Adding Casual RN language to the ONA Collective Agreement and hiring Casual RNs.
• Hiring 10 nursing student externs to provide extra support to our nursing team over the summer months, and other holiday periods.
• Creating nursing externship positions for Internationally Educated Nurses (IENs). 140 IEN applications were received, 50 applicants identified and screened, 1 qualified candidate.
• Participating in the Provincial IEN program, but with little uptake
• Utilizing Registered Midwives as contracted staff to fill vacant shifts in the Family Birthing Centre.
• Active recruitment for nurses to fill vacant positions at SBGHC.

In order to keep services operational, SBGHC has relied on the use of agency nurses to fill vacant shifts.  This is not an ideal or preferred solution, as agency nurses are costly and not committed to our hospital sites.  SBGHC would much rather be putting the extra cost spent on agency nurses into the pockets of our own staff, who have worked tirelessly to support our organization and our communities.  The unfortunate reality is that without using agency nurses at this time, we would be looking at closing sites, not just reducing services.  We continue to actively recruit for nurses to come and work at SBGHC, however, the pool of available nurses is very limited in the current environment.

SBGHC is committed to ensuring four, strong, viable hospital sites in southern Grey and Bruce Counties now and into the future. The Chesley hospital is a model example of an excellent small, rural hospital, with a very successful and reputable restorative care program.

There are no plans to close the Chesley hospital. These service reductions are not signs that the hospital is closing or that it will be closed. It is our hope that once we have the necessary number of nurses we can return to providing 24/7 ED service in Chesley.

Yes. Working in a small, rural emergency department requires extensive training and orientation.

Offering incentives to recruit nurses is outside of the collective agreement we have in place with our union partners, and also outside of an agreement that SBGHC has with other South West regional hospitals not to offer incentives.  Recruiting nurses away from other partner organizations will only create staffing pressures somewhere else within the system.  The nursing staff shortage is a system-wide issue that requires a system-wide response.

There is an overall shortage of nurses in the province, which is being compounded by burn-out caused by the COVID-19 pandemic. Recruitment and retention of Registered Nurses (RNs) is also very challenging in rural communities. Nurses are required to develop a high degree of competency in a number of clinical domains and specialties, and new graduates can often be unprepared to work in a rural setting without significant orientation and mentorship.

Based on the current staffing environment, there is a strong potential for future reductions in service.  We will continue to monitor our staffing levels, and if we do not believe that safe care can be provided in any of our services, we will consider further reductions.

No. SBGHC did not implement a mandatory vaccination policy. SBGHC’s COVID-19 Vaccination Policy was implemented on September 7^th, 2021 for staff and professional staff that provided three options:

• submit proof of full vaccination against COVID-19;
• submit written proof of a medical reason for not being vaccinated against COVID-19;
• complete a mandatory education module, and rapid antigen testing must be completed within 48 hours prior to coming to work. All new staff, physicians, students and volunteers must be vaccinated.

The reduced hours of operation will go into effect Friday, September 9^th at 5:00 PM.

• The Chesley Emergency Department will be open daily from 7:00 AM to 5:00 PM, and closed from 5:00 PM to 7:00 AM.
• EMS (Ambulance) will be on bypass after 5:00 PM to transport patients who require Emergency Department services to the nearest 24/7 ER.

If you are in need of immediate medical attention, call 9-1-1.

The closest 24-hour Emergency Departments to Chesley are listed below:

Hanover (19km)

Walkerton (26km)

Durham (36km)

Southampton (42km)

Markdale (44km)

Owen Sound (46km)

Kincardine (60km)

Mount Forest (60km)

Palmerston (60km)

We fully recognize that the reduction of services can have an impact on recruiting physicians and keeping them in our communities, and we are working closely with them to ensure they are engaged and informed about these decisions.

We also know that closures have an impact on surrounding hospitals as they face increased patient volumes.  The physician group in Chesley will be working to support their physician colleagues in surrounding hospitals.