North Cumberland Memorial Hospital in Pugwash.

Almost daily closures to the emergency room in Pugwash is a cause for concern for the facility’s site manager.

Barbie Cook, who is also the site manager for the Lillian Fraser Memorial Hospital in Tatamagouche, said she’s been doing everything she can to prevent closures to the emergency department.

“We’ve been trying for only one day, sometimes two days a week at best since September, but that hasn’t been the case,” said Cook. “It’s a huge concern, especially going forward for people of the community here to not have a place to go.”

Cook said there are two physicians serving the Pugwash area – one full-time and one part-time – however neither do the emergency department rotations.

“We rely fully on locums. It’s a large pool of locums, but it’s a provincial pool and they tend to gather in the Halifax area,” she said, adding many move to condensed areas of opportunity upon graduation from medical school. “They all seem to have preferred sites to work in. We can’t tell them where to go.”
Cook said there is active recruiting happening for a new doctor, and there has been some interest, especially with a return of a resident that’s due to graduate in 2018.

“We’re very hopeful with that. The new physician in Tatamagouche (who started over the summer) was a return of resident from last year, and we seem to be in a similar position for Pugwash. I’m hopeful we’re just going through this in the interim.”

One of the two locums who would regularly fill in those emergency department shifts has been off on medical leave, but she has since returned back to work and Cook is optimistic some of those closures will be alleviated.

“We’re hoping they’ll become less than they are now, but I don’t expect we’ll have the ability to offer fulltime coverage in the near future,” she admitted. “We’ve had some interest from some new locums. With one (regular) back to work, we should have more coverage in November and December than we’ve had.”

Cook said locums are offered incentives, such as mileage, to cover the shifts, however it seems like the ones interested in the area have the interest because of a prior connection to the community.

The closures have only been affecting the daytime hours, as a paramedic, registered nurse and oversight physician team has been able to cover the evenings. Cook said those teams are through Emergency Health Services, and it is something that’s been brought up as a possibility for daytime.

“But right now, it’s not an option,” she said. “As of right now, they only have the capacity for the overnight hours, but it is something that’s been brought up to possibly plan for in the future.”

With the frequent closures in Pugwash, and even a change to a walk-in clinic in Pictou County, Cook said many people have been travelling to Tatamagouche for care. The volume of people in emergency has increased, which is why Tatamagouche saw a recent change allowing those physicians to still offer primary care to their regular patients through appoitnments.

“In Pugwash, it’s a different scenario. We don’t have enough providers,” said Cook.

One way Cook has been trying to keep the emergency department open is by offering shorter shifts to locums. Instead of 12-hour shifts, she said she’ll take them for eight if possible.

“Eight hours of coverage is better than nothing. We’re working with them. With one (locum) coming back, they’ll be doing some eight-hour shifts in the interim.”
Along with the frequent closures, Cook is also extremely worried about people putting off seeing a doctor when they do become sick because they may have to travel.

“I really feel people aren’t going to the ER or calling 911 when they should be,” she said. “Then, they’re sicker when they do see a doctor because they waited. I really worry about people.”

She stressed anyone suffering a medical emergency at any time should call 911, or go to the nearest open facility – even if it means traveling to a regional centre. Those with non-medical emergencies can call HealthLink (dialing 811) where advice and information is available around the clock. The Mental Health Crisis Line also operates 24 hours a day, seven days a week, and someone can be reached at 1-888-429-8167.

“People experiencing anything shouldn’t put things off, they shouldn’t wait. I know it’s not most ideal to have to travel to a regional centre, but they shouldn’t wait,” she said.