System in ‘dire straights’
Surgeon says basic medical care barely being provided
Nova Scotia's health-care workers are at their breaking point. And patients are suffering.
That's the view of an experienced surgeon in Halifax who asked to stay anonymous, fearful of repercussions from a provincial health authority they say seems unaware or unresponsive to the current crisis on the front lines.
It's not hard to understand why they feel that way.
Previous pandemic waves caused huge, system-wide backlogs in treatment. That increased workload, as well as stress, for health-care providers whose sick patients have been unable to get the care they need.
Omicron has forced hundreds of health-care staff off work after catching COVID-19 or being close contacts of others who became infected.
With the system already short-staffed, those still working are now even more shorthanded, the surgeon said.
“It is to an unprecedented degree right now. We are under so much strain, it's terrible,” they told me. “It's not being melodramatic. We are in dire straits.”
The public may not be fully aware of the terrible toll — physical, mental and emotional — the current wave is taking on health-care workers, they said.
This pandemic has already been hard on health-care professionals, worldwide.
Burnt out from relentless demand, along with fear of catching COVID and passing it to loved ones in compromised health, thousands of healthcare workers, many of them nurses, have reportedly quit the sector in the last two years.
Nurses were leaving their jobs in Nova Scotia in droves last fall, the surgeon said.
The surgeon's fear now is that the current crisis will spark yet more departures from an already struggling provincial system.
What does all this mean for patients?
So far, the surgeon said, the system has done a good job on urgent priority cases, such as cancer. But the public needs to understand that delays in other treatments are coming at a cost, one that can be enormous.
“When people read an article about elective surgeries being cancelled, we're not talking
like breast augmentations and tummy tucks,” the surgeon said.
“We're talking patients with orthopedic issues, and spine issues who are in debilitating pain, who can't go to work, who can't live a functional life, whose mental health is being affected by the fact that they can't have their surgery. Those are being delayed a lot.”
The surgeon's voice tightened.
“Most doctors are caring people. That's why we go into this field. It can be extremely challenging, from a mental health perspective, trying to deal with this. It's tough. I get patients asking me ‘Well, when is my surgery?' I have to explain to them that I don't know.”
And, the surgeon said, as treatments get delayed, patients can have worse outcomes.
Doctors are now seeing cancers that are more advanced due to early pandemic shutdowns of diagnostic imaging, like X-rays and CT scans, and
bloodwork, they said. At least those services haven't stopped, like in the spring of 2020.
Many specialists' office staffs are trying to cope daily with rebooking cancelled surgeries and procedures, as well as handling sometimes hundreds of calls from worried patients.
The Omicron wave has also exacerbated existing problems in health care that were due to the lack of long-term care beds.
Hundreds of individuals waiting for spots in nursing homes, but too frail to live on their own, were already taking up hundreds of hospital beds. Rising staff shortages in long-term care facilities — a phenomenon well before Omicron, instead related to workers being underpaid and overworked — have forced a growing number of nursing homes to stop admitting new residents.
That resulted in emergency rooms often having no inpatient hospital beds for newly admitted patients.
“People are being treated for heart attacks in the hallway in the emergency,” the surgeon said. “Sometimes, they have over 20 ambulances waiting to offload patients.”
Now, Omicron-related COVID outbreaks in hospital may result in wards, or parts of wards, being closed to new admissions, further reducing in-patient beds.
They can't do surgeries if there's nowhere to put patients afterwards.
One controversial solution to deal with severe understaffing that some jurisdictions, including Ontario, is trying is allowing COVID-positive health-care workers to return to work, although only under certain conditions to ensure patient safety isn't compromised.
The surgeon I spoke to said they aren't an expert on that question. But, they said, Nova Scotia's health-care system badly needs its full workforce back.
Provincial authorities have said “that, quote, ‘work isolation is the last resort.' But what does ‘the last resort' mean?" the surgeon asked. "I feel like we are at that last resort now, because we can barely provide basic medical care.”
Omicron may have peaked but that means we're only halfway through the crisis, the surgeon noted. Cases, though declining, will continue for many weeks to come.
For a health-care workforce already running on empty, that's a daunting proposition.