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Editor's note: The following letter was written in response to the BayToday story 'Bed crisis' warns North Bay Regional hospital.
It is not our policy to publish anonymous letters to the editor, however, we thought this alarming letter, written by a North Bay physician, was too important to disregard. BayToday has spoken to, and checked on the authenticity of the author and verified their status. The name is withheld as the author fears repercussions at the hospital.
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To the editor:
The recent declaration of “BED CRISIS” by NBRHC may have come as a surprise to some in the community, but for anyone who works at the hospital, it was an inevitable situation.
Physicians, nurses, and other frontline staff have been sounding the alarms for a long time. They all saw the impending disaster and the lack of clear plans to mitigate it.
NBRHC has been suffering from capacity issues for a while.
In 2017, Lady Isabelle was closed, which was a major loss of LTC (Long Term Care) beds. Then in 2022 the government of Ontario legislated changes to LTC, capping ward rooms (There were previously four patients allowed in a room, but changed to a max of two patients). As a result, we lost additional LTC beds.
However, the government has no objection to these very same patients having to stay in the hospital for literally years awaiting an LTC bed; being moved between various 4-patient ward rooms, shower rooms, conference rooms, offices, etc.
The number of patients who are in this situation is rising rapidly. Patients who are too frail to return home, or require home care support that isn’t available, are left waiting in hospital for years hoping an LTC bed will open up. This problem is going to get worse and is now causing no beds left to care for acutely sick patients for whom a hospital is designed to treat.
NBRHC has converted an entire acute medicine unit into an ALC (aka awaiting LTC) unit, while over 30 admitted acutely ill patients sit in the ER or other unconventional spaces, awaiting a bed on the medical floor that will never become available. This means sick patients are being cared for with unsafe nursing ratios, by physicians who are stretched thin, with unsafe patient volumes and high acuity, and are physically in environments that are not set up for the safe provision of acute care.
This is further compounded by the Family Medicine crisis locally.
Although this is an issue occurring across the province and country, the North Bay and area is in a situation where we have no in-person walk-in clinics for unattached patients and tens of thousands of patients with no primary care access. The current family doctors in North Bay are already wearing many hats: having full practices, covering emergency shifts, providing mandatory hospital inpatient coverage including overnight and weekend calls, assisting in surgery, providing LTC coverage, and more! They are being asked to take on even more to help support the gaps in the system, but it is not sustainable long term, especially as patients become more medically complex.
On Nov 12th, while the frontline staff were working hard internally to deal with this unfolding crisis, politicians and hospital management were having a photo op to share a new funding announcement which was posted on Facebook. (Which when you look at the details, is simply a continuation of previous funding, which clearly has not helped. Hiring more patient flow navigators does not help when there is nowhere to “flow” the patients to ALC beds and no homecare services available for patients to return to their homes with support).
This was very disheartening to see when we knew what was going on behind the scenes and the strong efforts being taken by the physician and clinical hospital leadership teams to respond quickly to support our current staff and provide care to patients. Three hours after that Facebook post, the public media release went out sharing the bed crisis.
For those of us on the front lines, it feels like a complete disconnect by the non-clinical leaders in charge of funding and planning, with what we are seeing and experiencing.
The Ontario government is wasting millions of dollars getting beer in convenience stores, bribing Ontarians with $200 for their votes, and planning ridiculous highway tunnels, while Health Care in the North (and frankly province-wide) is crumbling under the weight of their poor planning.
Sincerely,
Concerned physician
