A veteran ER doctor at the Nanaimo Regional General Hospital is sounding the alarm about a backlog of patients waiting to be admitted to the hospital due to a shortage of hospitalists. Photo: Mick Sweetman / CHLY 101.7FM.

A veteran emergency department doctor says a contract dispute between hospitalists, who are doctors who work in hospital settings, and Island Health is creating an unsafe situation at the Nanaimo Regional General Hospital (NRGH).

Dr. Chris Rumball said the number of hospitalists at NRGH has fallen from 24 to 16 as negotiations for a new contract with Island Health drags on. This means that some people who go to the emergency department can’t be transferred to other floors where they would get ongoing care.

“We had 15 people on stretchers in hallways and a person in a closet,” Dr. Rumball said about his shift on Wednesday. “It's pretty dysfunctional, unfortunately.”

According to Island Health, what is happening at NRGH is that the hospitalists have reduced the number of patients they will take on at a given time, based on the capacity they feel they have as a group of physicians.

Dr. Rumball said that while the ER is able to provide emergency care, they are already stretched thin with wait times averaging from four to six hours.

He said ER staff need to prioritize the people in the greatest medical distress and can’t provide ongoing care to people who can’t be moved to a different floor due to a lack of hospitalists. He said it’s taking a toll on patients and their families.

“It’s pretty hard to just see your 90-year old mom on a stretcher and nobody can get her bed pan on time,” he said. “Those are the kinds of difficulties that are stressful morally, and psychologically, for the staff. You're just not able to provide the care and there's not a sense of safety.”

According to Dr. Rumball, this is the first time in his 47 years in emergency medicine that he’s had to admit patients to hospital when there’s no doctor available to supervise their ongoing care.

“The problem is that the longer you wait to be seen in an emergency department, and the longer you remain in the emergency department as an admitted patient, the greater the morbidity and mortality,” he said. “That’s a scientific fact.”

Island Health said people who need emergency care should not hesitate to go to the hospital and that no one is being left without care.

According to Island Health, patients who are too sick to leave the ER are being treated in an acute care space next to the emergency department staffed by a different care team while they await assignment to a hospitalist. The health authority said that ER doctors are there to support those patients if their condition worsens.

Island Health said it is working with the Ministry of Health and the Health Employers Association of BC to come to an agreement with the hospitalists at NRGH that would lead to better recruitment and retention.

“We don't understand why this wasn't an anticipated thing,” said Dr. Rumball. “VIHA and the ministry knew that this was coming, that they needed to settle with the hospitalists and be sure that there was the provision of services. So it is frustrating that, from our point of view, that ball has been dropped and it's like gas on fire.

Funding Note: This story was produced with funding support from the Local Journalism Initiative, administered by the Community Radio Fund of Canada.