11 minute read
Island Health checkup
BY FRAN PACCHIANO
On August 26, a member of the Ladysmith community fell down several stairs at her house. Her face was damaged, and her friends took her to urgent care. A nurse cleaned up her face, and after learning about the fall, they decided to check if anything was broken.
“I actually didn't think I had hurt my wrist because I could still move my fingers. … They said that they wanted to take an X-ray just to confirm. And so they did take the X-ray, and it showed that my wrist was broken. … I would need a cast.”
Normally, the X-ray technician would check for a break and, then finding one, would set a cast. However, the patient arrived at the Ladysmith Community Health Centre around 5 p.m., and the technician left at 6 p.m. and didn’t have time to set the break.
“They sent me home with a broken wrist and told me to come back the next day at three o’clock.”
The patient insists that she should not have been sent home. “What they should have told me was to proceed to the Duncan Hospital to have my arm set. They should never have sent me home, not with my wrist broken like that.”
When she returned the next day, the clinic’s scheduled hours were between 3 p.m. and 6 p.m., but she wasn’t attended to until nearly 4:30. Her bone was reset in what she described as “not a painless procedure by any stretch of the imagination,” and a first cast was put on her arm.
The cast, however, was put on incorrectly, and the doctor took it off and asked the technician to stay so it could be recast. “He was in a hurry to put the second cast on so that the X-ray technician didn’t have to stay late. They made the cast too long. … I had no room for swelling. I felt like my arm was in a vice, and my bones were being crushed.”
She went to Duncan for a routine check-up a week later, and the surgeon could tell it had been a rushed job. “My problem is the hours,” she said. “If they knew that they weren’t going to have time to do it properly, they should have sent me to Duncan.”
The closures at the Ladysmith and Chemainus Community Health Centres’ urgent care facilities have been a regular occurrence for many months. Scheduled hours fluctuate between full days of operation to as few as three hours, or none at all when the clinic is “at capacity.”
In a statement to TAKE 5, Island Health said of the issue, “We are committed to addressing the situation and continue to work closely with multiple partners to recruit and retain care providers, as well as develop processes to support our teams in managing increased patient volumes and complexities.”
The statement goes on to direct people either to the Nanaimo or Duncan hospitals. However, these facilities are often overwhelmed and have long wait times. These long wait times drive people to the smaller communities of Chemainus and Ladysmith to avoid the lines, which is a vicious cycle.
TAKE 5’s own Bob Burgess was not immune to the Island’s healthcare crisis. After suffering for nearly a month with what he thought was a “bad cold,” he was diagnosed at Ladysmith Urgent Care with pneumonia and kidney failure with only about eight per cent functionality left.
“All the triage, the bloodwork — everything was all done at Ladysmith. And [the doctor] said, ‘Go, we’ll get you in right away.’ I waited seven hours at the ER in Nanaimo before they called me in. And then I spent [a] day in a recliner. The rest of the time was on a stretcher in the hallway.”
Bob spent a total of five days on a stretcher in the hallway of NGRH. “They were overwhelmed. The hospital was overwhelmed. The staff was doing everything they could. They ran out of I.V. poles, and I [heard] them [say] they couldn’t find I.V. poles; they couldn’t find wheelchairs. Everything was being used.”
Bob was moved around four times in the five days he spent there without privacy. The hospital was running at 130 per cent capacity, and Bob was transferred from hallway to hallway, depending on what level of care he needed. He described the scene as “rows and rows of stretchers.”
Despite the staff being overwhelmed, Bob said the care he received was excellent. “The nurses were very concerned and caring, but there wasn’t much they could do. They can only handle so much at any given time. I wasn’t the only sick one there, obviously.”
The problem is that hospitals in BC have been overwhelmed and running at max capacity for over a decade. In 2019, the Nanaimo Medical Staff Engagement Society called for a change in their fiveyear plan outline. They outlined that at the time, the NRGH had 345 beds and treated approximately 400 patients daily.
Today, those numbers are growing. The NRGH currently has 354 base beds, and the CDH has 158 base beds. While exact patient numbers are difficult to pinpoint, Island Health spokesperson Dominic Abissi stated that hospitals are “almost always running at or above 100 per cent capacity, especially during respiratory illness season.”
Access to healthcare is a growing concern on the Island. In April of 2024, the Fair Care Alliance launched as a “coalition of medical, business, Indigenous, municipal, philanthropic and regional leaders and community at large” and is fighting for fair access to healthcare for people living north of the Malahat on Vancouver Island.
Donna Hais, spokesperson and founding member of the Fair Care Alliance, is calling for physical changes for the NRGH. The current facilities are outdated and too small for the volume of patients. She says the hospital needs a new full-service hospital tower and a catheterization lab. Changes to the hospital can take up to a decade, but the quality of care should not be lacking in the meantime. “We’re actually working on what that looks like as we move forward with Island Health and with all the other partners at the healthcare ecosystem table.”
A big problem with attracting doctors to the hospitals north of the Malahat is that Victoria still controls the hospitals. “Currently our program structure out of NRGH is all based out of Victoria. That has limited and tied our physicians’ hands. It’s made it hard to attract physicians to a system that is not run from the facility in which it operates.”
This period of crisis and rebuilding presents an opportunity to move in a new direction emphasizing more inclusive and diverse care. Achieving this requires systemic changes to ensure culturally appropriate access to healthcare. This issue in our current system cannot be neglected or treated as an afterthought anymore. It must be intentionally integrated from the start, and Hais confirms that progress is being made.
“As new infrastructure is planned, the conversations and the strategic partnerships that are required to exist to have a healthy community and culture moving forward have to happen at the beginning of [the] project. They can never be afterthoughts. … We’re already talking to and engaging with the First Nations Health Authority.”
The media has been key in getting the Fair Care Alliance’s messages out to the people and the community leaders. While healthcare was a key topic during the provincial election, it’s important to keep the conversation going.
This also isn’t just on the shoulders of the media outlets and politicians. To keep the momentum and the pressure on the medical and political leaders, the people in the smaller communities need to speak up.
“Someone has to make sure that we’re digging holes and building the projects, that we’re actually hiring the people that we need … and that we’re growing our programs. And Fair Care will continue to work, and we can only do that with [the] community supporting us. … We’re going to need to be telling our incoming MLAs, our new Minister of Health and our Island Health officials that this is a priority, and we’re not prepared to back down.”
There are some practical steps you can take to have your voice heard. First is to sign a petition. A signature seems small, but it makes a big impact. A petition is a unified message that get the attention of politicians. Following that, Hais says that writing direct letters to MLAs will continue to show the community’s support. The Fair Care Alliance has links to their petition, emails to politicians and helpful instructions on how to write the emails on their website. “The sad thing is healthcare shouldn’t be about politics, [but] about human beings. And it’s about patients getting fair and equitable access to the treatment they need. Unfortunately, it’s funded and controlled through politics. And so we need to make sure that our numbers stay strong and stay loud.”
Loud voices are one of retired nurse Jackie Moad's suggestions for bringing change to this systemic issue. “When you get a lot of voices together and say, ‘This has to stop,’ that’s when you get change.” The decision to make a difference is personal and often comes with tragedy, but there is hope in the midst of this grief. “When a crisis hits, that’s when change happens.”
The problem of not having enough healthcare professionals was an issue long before the COVID-19 pandemic exacerbated it. Jackie, who retired in 2017, said that they were short-staffed for a lot of her years in practice. “If a nurse was sick and they couldn’t replace her, the nurses that were there took on more patients. [When] you take on more patients, you start to burn out, and when you burn out, you call in sick. … It just gets worse and worse, and that’s what’s happening with the urgent care.”
“The light at the end of the tunnel is … nurse practitioners.” In a system where doctors are scarce, allowing nurses to step up and fill in where they are more than qualified to do so can alleviate the issue. “Nurse practitioners can and should be able to do a whole lot of stuff that doctors can do. They can see a person and say, ‘You need an X-ray’ ... and they have doctors they can refer to.”
Another way to release some pressure is by bringing more people into the medical field. “There needs to be a better system to let foreign doctors come in [and work as doctors] instead of having to take jobs as janitors in a hospital.” Jackie pointed out that many immigrants have years of school and practical training when they arrive in Canada, hoping for a better life. Still, the Canadian medical system requirements prevent them from working. “Even if doctors from different countries … had to do a test — big deal. Let them do a test.”
In the midst of all the difficulties, it’s important to have support. Her husband, Laurie, was her biggest supporter. “I had him to lean on and to reflect on why it was important to keep going.” Jackie also spoke about how meaningful receiving notes of encouragement from patients was in those dark and hard moments. “Many times, I would come back from my job in tears and [would say], ‘I can’t do this anymore. It’s just too hard.’ He would make me sit there and read some of [the cards], and I’d think, ‘Okay, all right. I can do it.’”
“It doesn’t have to be your partner; it’s support from your community that’s important.” Supporting friends and family members who are doctors, nurses, and health professionals can make a huge difference. Notes of encouragement, little treats or a coffee could be the bright spot in someone’s day.
It can be hard to have patience when the system negatively impacts your healthcare access. But the professionals who are working are not the problem. So, when you’re stuck for hours in urgent care, remember to breathe, save your complaints for a letter to the local politicians and be kind.
