Though this isn’t new news, staff at the Health Centre here in town are becoming increasingly worried about having enough nurses to run the facility.
Dr. Charles Helm, one of our local physicians, appeared before the latest meeting of council. “I think it is the fifth time in a year that I have come here to speak with you [council] and let you know things are not going in the direction we want them to,” he says. “We are approaching a real problem situation. Once again today I think we are a bit closer.”
Dr. Helm explains when it comes to recruiting physicians, Northern Health has been “remarkably good”. He says, “I want to be clear that it isn’t a physician issue. In fact Northern Health in terms of physician recruitment is really good. They sent a film crew here before the Emperor’s Challenge to film us to let everyone know what a wonderful event this is and what an amazing community it is. This all goes out there into the world, saying this is the best place to come and work as a physician. Northern Health has gone above and beyond in terms of recognizing the physician shortage and doing something about it,” but he says, “When they come here I thank them, however, where is the similar initiative for the nurses? Because there isn’t one.”
The facility is down to one nurse, one of the two having just went on maternity leave. Karen Strang recently retired but has been coming in to cover shifts. That’s a very short-term option, says Helm. “You can’t operate an emergency room with one nurse. I wish the community would stand up and rebel and call meetings and tell Northern Health and the government especially, this is unacceptable. I haven’t seen it, but I hope it happens.”
So, Dr. Helm has once again come to council, saying, “I hope you will have a role. I think it is reasonable, as our elected representatives to ask Northern Health to come for an emergency meeting to address this, because we are approaching a crisis point.”
So why aren’t nurses coming to work in Tumbler Ridge?
There are job postings for two positions, however, the current description is a point six full time equivalent (FTE). This breaks down to 47.5 regular hours for each of them in a two-week period, but then they do about 120 on-call hours at a rate of about three to four dollars an hour.
Why they would come to a town with relatively high rents and few options for housing with this pay, asks Helm. How could they survive and why would they come?
Dr. Helm says, “There are simple solutions that could be implemented. There is virtually no guarantee to attract people. You have to change the FTE number. This has been put out, but nothing has happened. In my view, this is a degree of neglect that has been allowed to happen. Do we allow this to happen, the crisis hits, it’s a catastrophe and then people try and fix at that point, or do we try and avoid the crisis? I don’t know how much more we can do.”
Dr. Helm explains there are some positive signs. “We had some high echelon representative from Northern Health, come here. They came to speak about critical care. There are lots of great things they are trying to do and we thanked them very much. But we said, that’s great, but that’s not our problem here. Our problem is finding people to man our emergency room, finding an ambulance to transport someone in need. We have the most basic problems here. We explained our situation to them, and they were shocked. They said, you can’t hire for a point six FTE, it doesn’t happen, it doesn’t work,” says Dr. Helm.
He continues, “I think we are having a problem with the people we are dealing with, who aren’t hearing. As things stand, it’s a point six FTE and no one is going to apply for that. The only way we are going to have people apply for those positions is if someone is married to a miner, but they are not going to recruit from out of town for those positions. I think that is the message we need to give Northern Health.”
For physicians there are all sorts of incentives to attract them to rural BC instead of the city. An example is if somebody is prepared to commit for three years, they get $100,000 just on signing. “That is why I don’t have an issue with physician recruitment. There are other incentives as well. There is a lot of need out there and a lot of places that have more to offer in terms of positions, like full-time and no on-call. That is what people want. There are no incentives whatsoever for nurses. Why would we expect nurses to come here for even less, in a community where rent is very expensive or hard to come by?” asks Dr. Helm.
But there is a light. Jaret Clay, Health Services Administrator for the South Peace says, “We are aware of the issue, and we don’t disagree. It makes for a complicated environment. We have a need for people to be on-call and we want the job to be desirable,” he continues, “We are making up new proposals with various types of changes, but it’s a little pre-mature to go public with the outcomes. It is one of our top priorities. We don’t like that we don’t have attractive positions.”
Clay explains until now, it was a stable situation. “When you’re dealing with a small number of people, three positions, it only takes one person not being there for it to de-stabilize what we have. In the province, there is lots of work for nurses and it’s become harder since we’ve had that environment.”
Dr. Helm explains this problem was anticipated and brought forth to council and Northern Health about five years ago.
The solution as we have seen so far is to bring in agency nurses, however this band-aid is very expensive and non-permanent. “They are hiring agency nurses. An agency nurse is someone you can hire for three weeks at a time. It is incredibly expensive to run your facility on agency nurses. It’s not the answer. At the moment we do have an agency nurse who is here for something like three weeks, so in a sense they are providing nurses, but it’s not the solution. I don’t know if there is a guarantee that we can have consistent coverage,” worries Dr. Helm.
Councillor Mackay agrees with Dr. Helm saying, “This isn’t anything they haven’t heard before. They’ve heard this many times now. They realize how we are running is not adequate. Where is the breakdown?”
Councillor McPherson says, “It’s kind of confusing. We sat with Northern Health in the spring and we mentioned the problem with the nurses and their answer to us was if we need nurses in Tumbler Ridge, we will have nurses in Tumbler Ridge. They kind of guaranteed us that.”
Though we haven’t seen any change in the job description yet, Clay explains the wheels are in motion. “The positions haven’t been attractive enough. At this point we have to now deal with that. The level of service has been seen as the correct amount of service, but that doesn’t mean the job will be attractive to people. There are different issues in town; the cost of living, rent, which is very expensive and we understand. Accommodation has come up for us. There are roadblocks in terms of what we can supply because of union rules for compensation. We are talking about those issues,” however Clay says, “There are no guarantees to take care of something like that.”
He also explains Northern Health is looking to work collaboratively with community partners. “We’re working on it right now, it is the issue we are most concerned with in terms of Tumbler Ridge, but we need to have the right people in the discussion.”
Northern Health is also in the process of creating a Master Plan for health care, which is expected to be completed in the fall.