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New guidelines, incentives to fix healthcare

Stephenville Mayor Tom Rose says the the town’s financial incentive package has already attracted four new doctors to that area. – File photo

By Jaymie White Local Journalism Initiative Reporter

Editor’s Note: This is Part 2 of a series taking a closer look at the direct impact of the healthcare crisis and its affect on services and staff in our region.

WEST COAST — In the Sept. 19 edition of the Wreckhouse Weekly, nurses discussed frustration and feeling burnt out, largely due to understaffing and increased pressures from the pandemic. Two individuals employed by Western Health shared how hard things have gotten for those on the frontlines every day.

In response to email inquiries based on that article, Western Health recognized the current challenges of the healthcare system, especially given the toll taken on personnel due to the pandemic.

“Recognizing the tremendous strain in our healthcare system through the pandemic, Western Health endeavoured to provide staff members a well-deserved vacation this summer, which did create additional staffing challenges. To address this, there were a number of strategies Western Health implemented to ensure staffing levels were adequate to meet patient needs.”

Among those strategies were asking volunteers to work extra shifts, calling in casual nurses, and weekly emails to managers who supported frontline staff on the weekends by stocking carts or speaking with patients and their families.

“There were weekly meetings with leadership from across the region to assess areas with greatest need for staff and based on that assigned RNs to units which required more staffing as per the collective agreement. For LPNs, Western Health sought volunteers to move to a unit when there is a need for additional staffing.”

Western Health continues to work to recruit for vacant positions. In 2021-22, they recruited 20 permanent full-time RNs from Western Regional School of Nursing and hired 19 new permanent full time LPNs. They recruit casual, temporary and permanent nurses, with the aim to secure permanent full time RNs. Related to recruitment challenges, Western Health has had to avail of travel nurses to help fill nursing vacancies in the region.

“On August 2, 2022 the Provincial Government, in collaboration with the Registered Nurses’ Union Newfoundland and Labrador (RNUNL), announced a number of financial incentives and employee supports to help address the immediate RN workforce challenges and help stabilize the system see here, Western Health is involved in the planning and implementation for these incentives and views this as a positive step forward in helping to address the recruitment and retention challenges for RNs.”

Due to collective agreements, casual RNs are not required to answer calls to work, though shifts are still offered.

“Safety of our clients, patients, and residents as well as our staff is a priority for Western Health. There are situations, based on staffing levels, where staff may be mandated beyond their regular shift to ensure the safety of our patients. Once a staff member is mandated, work continues to try to find staff to enable that staff member to go home as early soon as possible, after appropriate staffing is in place to safely care for patients and residents.”

Western Health has established guidelines for managers that outline the need to check in with staff for their well-being and ability to safely care for patients and residents.

“Throughout the summer outpatient procedures were reduced as they have been in other years, to accommodate staff vacation. Some outpatient procedures were reduced to urgent or emergencies only.”

Western Health also stated that it offers resources to help staff who are feeling burnt out or stressed. These resources include a handout that direct staff to psychological health and safety supports, an employee assistance program, and a virtual peer support group.

“Western Health also established a Regional Psychological Health and Safety Committee in April 2022 to oversee the full implementation of the National Standard of Canada Psychological Health and Safety in the Workplace and implementation of the actions from the Guarding Minds Survey, this committee includes representation from frontline staff and leadership.”

Unfortunately, nursing burnout is not the only issue plaguing the healthcare system.

David Brazil, PC Official Opposition Leader, has called for short term actions to relieve the pressures of the healthcare crisis in the province in relation to all healthcare professionals.

“The responsibility for short-term solutions to our healthcare crisis falls to the Minister of Health and the Department. The Health Accord provides a long-term blueprint, but the people of our province are suffering with long waits at both emergency departments and community health clinics alike,” said Brazil. “Now is not the time to let doctors willing to work in our province face barriers to practicing in our province. Regulators have a job to do, but the fact of the matter is our province needs healthcare professionals of all stripes to assist during the crisis unfolding in our healthcare system.”

Brazil added that it is time for the premier to outline ways in which processes can be streamlined.

“We simply cannot afford to allow barriers to remain in place which prevent healthcare professionals

from practicing in our province. If Nova Scotia can set records for doctor recruitment, then we have to work even harder to attract healthcare professionals to our province. We can’t wait a decade to solve the problems we’re facing today.”

The standards and licensing processes in the province fall under the purview of the College of Physicians and Surgeons. The College consists of 15 members who have various duties including setting qualifications for registration and licensure, conducting rigorous licensing processes, and setting standards for medical practice in the province.

In response to email inquiries, Elyse Bruce, Corporate Counsel and Director of Professional Conduct with the College, clarified that recruitment itself is not within the mandate of the college, but they are currently looking into the processes they have in place. Bruce added that many of the standards in place in the province are Canada-wide.

“Generally, there is an effort to achieve consistency in standards across Canada, where possible. Some standards are set out in legislation which varies by Province.”

MHA Andrew Parsons (Burgeo– LaPoile) said he knows there are ongoing efforts on behalf of the government to consult with the College to discuss barriers.

“There’s a fine line between saying ‘get everybody you can,’ and making sure standards are met, but I also don’t think we can sit back and think we can take our time with this. Given what we’re dealing with, just in this province, when you’re talking about ER closures, shortages, doctors leaving, knowing the fact that it is happening worldwide – it’s happening right next door in Nova Scotia – we have to give it a little bit of urgency. Just today (Sept. 14) reading a story about doctors volunteering to come here and can’t get their licensure, there’s something about that, that rings oddly,” said Parsons. “I do take the fact that when I read that article, at no point did it say the government is not doing enough or the minister is not doing enough. They actually recognize that (Health Minister) Tom Osborne, the premier, they are trying to do what they can. So, yes, there is absolutely consultations ongoing because this is not a government decision, this is a College decision.”

The conversations in question have begun to yield results as it was announced on Tuesday, Oct. 18, that there are proposed amendments to the Medical Act (2011), which will allow for additional pathways for physicians to practice in the province.

Tom Osborne, Minister of Health and Community Services, said the proposed changes will alleviate some of the pressure.

“The changes we have introduced today allow the province to be nimble in our response to health care recruitment and retention issues. It is not the intention of this Bill to lower the standards for medical practitioners who are registered and licensed in the province, but rather to expand the pool of qualified individuals who can still make meaningful contributions to health care delivery. These legislative changesallow for another avenue to address our challenges.”

Representatives with the Department of Health and Community Services also responded to email inquiries by issuing a statement.

“Solving these universal healthcare shortage challenges requires collaboration among all parties and we must continue to work together with our stakeholders. Our government has implemented both short-term and long-term measures to help alleviate the strains in our health care system.”

The department and the College have been consulting with doctors and nurses to identify solutions, and Minister Osborne has also met with doctors from the Ukraine.

“Recently, we launched the Ukrainian Physician Licensure Support Program to assist displaced Ukrainian physicians in obtaining licensure to practice medicine in Newfoundland and Labrador. Eligible Ukrainian physicians can receive up to $10,000 in funding to offset the costs associated with obtaining licensure in Newfoundland and Labrador, in exchange for a two (2) year provincial service agreement.”

There is a list of eligibility requirements that must be met in order for incoming healthcare professionals to qualify. The Department also offered a list of recent measures put in place to address the shortage of healthcare professionals. These include a 1-year pilot project to entice retired family physicians to return, new collaborative community team clinics, and increasing virtual care services, among other initiatives.

On Tuesday afternoon, Oct. 4, Minister Osborne, announced an additional incentive program on behalf of the province, to attract healthcare professionals; Come Home 2022, for those who were born or trained in the province, or performed their residency here or have other ties. Once the criteria is met and the professional is approved, they would be eligible for financial incentives.

If an individual doesn’t have ties to the province originally, they can still qualify for additional financial incentives. In order to qualify, the applicant must have a job offer from one of the Regional Health Authorities, private clinic, or private ambulance operator, or a letter of intent is required for physicians who intend to open their own clinic.

While the province has their own incentives, Stephenville has one of its own, and Mayor Tom Rose said it has been quite successful.

“I’m glad to announce that we have actually signed up four doctors and we’re courting another one. We are just waiting for Western Health to allow a surgeon to come to Stephenville, and that’s been taking forever,” said Rose. “I would go on the record to say we are probably the most successful community in recruiting doctors in the province of Newfoundland and Labrador.”

Rose said it makes no sense that there are three surgeons in St. Anthony, eight surgeons in Corner Brook, and none in Stephenville.

“It makes no sense, so that’s a little frustrating to me, because having a surgeon in Stephenville is critical. Sometimes you need surgery now and you can’t wait an hour. People will die or have further complications if you have to wait too long, so I am pushing hard as well as my council, and I can’t say enough about Councillor Laura Aylward. She is my champion when it comes to healthcare.”

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