While the Sackville hospital was experiencing a last minute closure of its emergency department last Thursday, Horizon’s CEO John Dornan told those gathered for the network’s annual general meeting that staffing issues at the hospital have been improving, and that the hours for the ER might see an increase in the not-too-distant future, possibly even this fall.

Sackville’s emergency department hours were cut by two thirds to just eight hours per day about a year ago. Then in December, acute care beds at the hospital were converted into alternative level of care (ALC) beds for those awaiting placement in long term care homes. The move accomplished two things: it reduced the staffing pressures to keep acute care open, and it opened up beds for some of the backlog of people awaiting placement in long term care facilities in the region.

New Brunswick’s hospitals are housing many people in the ALC category, generally waiting for a long term placement in a more appropriate facility. Horizon’s annual report says the network averages about one quarter of all its beds allocated to ALC patients.

At Thursday’s annual general meeting, CHMA asked Dornan whether the need for those transition beds would pose a challenge to the return of acute care to Sackville, and how that measured up against the continuing challenges in staffing.

Dornan replied that the issue is still mainly a lack of staffing, and that the Sackville hospital has not been “assigned to be an ALC facility exclusively.”

“While Sackville Memorial has been a big contributor to the care of alternate level of care of patients, they’re not the only ones to own that responsibility,” said Dornan. “All of our regional hospitals have them.” Sackville Memorial Hospital has “not been determined to not do that,” said Dornan. “In other words we hope to get back to that at some point in time… That is our goal. I won’t back away from that.”

Staffing still the biggest challenge

Dornan said staffing of the Sackville hospital is the biggest obstacle to overcome in order to be able to restore services, and he says those issues have been improving. “We have had more staff join us,” said Dornan. “We have had better stability of our daytime hours in the emergency department. And frankly, we’re looking forward to increasing those hours in the not too distant future, possibly by the fall.”

Horizon VP of Clinical Services Margaret Melanson said a new nurse manager as well as licensed practical nurses and registered nurses have been recruited recently.

“One or two have begun, and others are in the midst of their orientation at this time,” said Melanson. “Additionally, we have recruited new nurse graduates from this spring to join the staffing at Sackville Memorial Hospital, and those individuals will begin imminently and have their orientation completed before the end of the summer.”

Melanson shared Dornan’s optimism. “We are very pleased with the recruiting that has been undertaken, and we are feeling very confident that we will move quite quickly to be able to support overnight care by two registered nurses at all times in the facility, which will allow us to begin to reintroduce some acute care patients at that site.”

Physician situation “tenuous” for the summer

In terms of physician recruitment, Melanson said that although the summer looks “tenuous”, in the longer term “we are feeling very comfortable with our move in the correct direction, and to be able to, some time hopefully in the fall, begin to increase the hours of service at the Sackville Memorial Hospital emergency department.”

Thursday’s closure of the Sackville emergency department was due to a lack of physicians, and recently the department has lost at least one, and likely two doctors working in the emergency department. CHMA reached out to Horizon for confirmation on the physician staffing situation, but did not hear back before publishing time.

“Listen to the frontline” to turn tides on “negative recruitment process”

On Thursday, Mirimachi Leader reporter Nathan Delong asked Dornan to talk about the measures the network has taken to address its system-wide staffing issues. “We have to change the culture on our front lines,” said Dornan. “We have to make our hospitals places where people want to work.”

Dornan mentioned Horizon’s “negative recruitment process”, whereby more staff are leaving than are being recruited, though the past year’s annual report shows small increases in staff numbers across the board as compared to 2020-21.

“The first, early part of addressing that culture is start to listen to people. Listen to the frontline, not just managers or VPs or CEOs,” said Dornan.

Dornan indicated Horizon has been doing that through orchestrated “listening sessions”, and one of the things they’ve heard is concern over adequate pay. Pay scales are set by the provincial government, but Dornan said Horizon’s chief nursing officer, Brenda Kinney, has been participating in discussions, and that the pay scale has improved for nurses. “We’re more likely to bring nurses from Nova Scotia here than the other direction,” said Dornan.

Horizon offering cash for help in recruitment

Horizon has also started a campaign to inspire all New Brunswickers to help in the recruitment process, by offering them cash rewards. Currently, the program is targeting Class A Registered Nurses, and anyone who refers an RN that ends up taking a job with Horizon will make $1,000. If that RN ends up working in a critical care or emergency department, the reward goes up to $2,000. The network says the referral reward program will extend to other positions in the future.

The effect is twofold, said Dornan.

“It helps us recruit. It allows our community to participate in recruitment. And it helps change the conversation. If you’re recruiting people, you’re not going to speak poorly of the organization, you’re going to concentrate on the positive things about Horizon.”

Hear this story as reported on CHMA's Tantramar Report: