Closing system

Hundreds stranded in NS hospitals due to a lack of staff in long-term care homes

Nova Scotia hospital staff and administrators are growing increasingly frustrated that they are not doing more to free up the beds currently occupied by people waiting for places in long-term care facilities.

As of January 11, 355 hospitalized patients were eligible for discharge if a long-term care facility was willing to take them. About 100 of those people are in the province’s largest hospital, the QEII Health Science Center in Halifax.

Amidst the Omicron wave, the QEII is under pressure, where only the most serious cases get an ER room and everyone else is treated in the hallways.

The transfer of ambulance personnel to emergency personnel has also slowed. Wait times range from a few hours to half a day.

“Getting patients into long-term care is a real challenge right now and it’s only gotten worse because long-term care faces the same challenges we do,” said emergency physician Dr Kirk Magee. , which also oversees emergency services in the Halifax area.

“Anything that can be done to speed up our ability to get patients out of hospital into long-term care would certainly be good news.”

Dr Kirk Magee, an emergency physician in Halifax, says freeing up beds is extremely important right now. (Craig Paisley/CBC)

But COVID-19 has also affected long-term care homes, causing staffing shortages across the province.

The Nova Scotia government is currently unable to provide a figure on how many seniors’ homes beds will be closed as a result, spokeswoman Kristen Lipscombe said.

“The number of unoccupied long-term care beds due to COVID-19 is also a very fluid number that changes rapidly based on current staffing pressures and outbreaks, so we cannot provide a truly accurate picture at this time. “, Lipscombe told CBC News. .

As of Tuesday, 50 nursing homes and two residential care facilities were facing COVID-related absences or infections, she said.

“Of those 52 facilities, 18 are classified as having an outbreak,” Lipscombe said.

“The public health definition of an outbreak is two or more laboratory-confirmed cases in residents and/or staff over a 14-day period, and there is an epidemiological link between the cases and at least one case may have contracted the infection at the facility,” Lipscombe said.

“The number of nursing homes currently affected represents 70% of beds in the province.”

Appearing before the Legislative Assembly’s Standing Committee on Health on Tuesday, Paul LaFlèche, deputy minister of long-term care, said hospital transfers were a priority and the province was aware of the problem.

Indeed, long-term care homes have been accepting transfers from hospitals on a priority basis since March 16, 2020.

“We have personnel issues in everything we do,” he said. “We have to do something about it, especially we have to do it quickly in long-term care.”

“The pandemic has really strained a system, long-term care that was already under pressure.”

The pandemic has lengthened and made wait times so difficult to predict that the province has simply stopped posting expected wait times for placements on its webpage.

“Given the waves of COVID, the waitlist doesn’t become that significant,” LaFleche said in his closing statement to the committee. “I’m told we’re just somewhere over 200 days now for (community admissions) and around 45 days for those in hospital.”

“But again, it’s totally dependent on COVID and the guidance we get from public health…so these numbers shouldn’t be taken to heart.”

In fact, Nova Scotia Health told CBC News on Wednesday that the average stay is now 91 days for a long-term care admission from hospital.

Paul LaFleche, deputy minister of long-term care, says hospital transfers are a priority and the province is aware of the problem. (Tom Ayers/CBC)

In an interview with CBC after his appearance before the committee, the deputy minister rejected a suggestion that the province could do what it did during the first wave of infections – send patients who no longer need hospital care in a hotel as an interim measure to free up hospital beds.

“It’s an option, maybe it’s not a quick option,” LaFleche said. “And we are looking for quick options.”

Setting up bridging units outside of hospitals in places like hotels would not work this time due to the current shortage of healthcare workers due to the highly contagious variant of Omicron, Katelyn Randall said. , director of long-term care for the province.

“The problem is you always need staff,” she said. “Our facilities that are closing to admissions have no staff.”

“We’re looking at where is the best use of that staff. You might have beds, but you need staff to support them.”

She said the 25 facilities currently not admitting or severely limiting the number of new residents have staff vacancy rates in the range of 25-30%.

She said the province needs up to 1,400 continuing care assistants (CCAs) and 600 nurses to meet demand.

It’s unclear where the province can find many people wanting to work in the sector, especially when it comes to CCAs.

There are about 800 seats per year for CCA training available at community colleges across the province, according to LaFleche.

He said only 300 people signed up for the program this year. The union that represents thousands of continuing care workers, CUPE Nova Scotia, says the reason people are no longer interested in training is because the work is seen as low-paying and backbreaking.

Last month, the province announced it would provide free training to up to 2,000 people who want to pursue a career as a CCA and they could learn on the job in a 10-month accelerated program. rather than the current one-year program offered to the community. colleges.