The intensive care unit serving Port Alberni, B.C. and west coast communities on Vancouver Island has closed with no firm timeline for a reopening, sparking concern over patient care in an already strained health-care system. “The ripple effects of this on the other hospitals in the region (Nanaimo, Comox) are going to be felt pretty acutely,” says Brennan Day, Courtenay-Comox MLA and B.C.’s rural health and senior’s health critic. “Putting any more pressure on an already breaking system in these other communities is not a long-term solution.” Island Health says West Coast General Hospital has fallen short of specialty-trained nurses and physicians to staff the hospital’s three-bed ICU. “I totally understand the concern. I think for people who live in the Alberni Valley, people like me who provide care in the Alberni Valley: Of course all of us want that ICU open,” says Dr. Ben Williams, Island Health’s vice-president of medicine, quality, research and chief medical officer. “And our biggest obligation is to make sure we can provide safe and consistent care. We can’t do that right now.” Williams says physicians at WCGH asked to focus resources where they could “make the biggest difference.” The emergency department remains open, so patients should still seek support when they need it. Anyone who needs to be admitted to an ICU will be transferred by ground or air ambulance to another hospital – until the health authority can hire more people to reopen the unit. “The rate that we’re attracting nurses and physicians into the system is not nearly the replacement rate that’s required,” says Day. He believes one issue is a lack of central co-ordination at the provincial -level causing unintended consequences. “We keep trying to steal from one area to sort out another and it ratchets up the problems,” says Day. “The nursing bonuses for rural retention incentives is a great concept, but that pulls nurses away from areas like this that don’t have that rural retention bonus. So they need to streamline this much, much more and put a lot more thought into unintended consequences of some of these decisions.” The B.C. Nurses’ Union says there’s a global nursing shortage, so the province needs to ensure it has a health-care system where those professionals want to be. “I think there’s lots we can do to make nursing in general more attractive and that is to start with improving working conditions,” says BCNU president Adriane Gear. “When there’s not enough resources, enough staff resources in the system to provide the care that patients require and deserve – nurses experience a lot of moral distress. And after a while they just don’t want to be nurses anymore… We need to create the conditions of work where nurses feel respected, where they have enough resources, where they’re safe, where nurses aren’t fearful of you know violence and thinks like that. That goes a long way.” Island Health’s chief medical officer says hiring will take time. There is no estimate on a reopening for Port Alberni’s ICU, which IH claims sees on average roughly one patient admitted every two days. And about 30 per cent of patients who arrived at WCGH needing intensive care were already being transferred to other hospitals. “That service from my point of view has to be dependable. We have to know what’s going to be our tomorrow if we admit someone today – and our staffing right now just doesn’t allow for that,” says Williams. “We have to do what’s right for patients and what’s safe. And that means getting those patients to the location where we can guarantee them the care they deserve.”
