There were some unexpected guests at Monday’s Sackville town council meeting. At the invitation of Mayor Shawn Mesheau, Horizon CEO John Dornan and three other senior staff attended the meeting via video conference, to address concerns raised in a letter from the Rural Action Health Group sent that same day.
The letter was itself a response to an announcement on Friday from Horizon, that they would be converting the acute care unit at Sackville Memorial Hospital to beds for people waiting placement in long term care facilities. The letter from the Rural Health Action group outlined three demands:
● quick action and public commitment to return the Sackville Memorial Hospital to 24/7 ER services and 21 acute care beds, as before
● Horizon budget commitments in line with ours, to continue our collaboration on recruitment
● honest staffing numbers, needs and predictions, so our recruitment efforts will be honest and successful.
At the Monday meeting, Dornan immediately gave re-assurances that Horizon was committed to reopening services at Sackville Memorial.
“I’m going to start things off by saying that we are, as a healthcare corporation, nothing but supportive of Sackville Memorial Hospital,” said Dornan, and promised to deliver in written form a “commitment to supporting 24/7 care at Sackville Memorial, as well as active inpatient care, operating room services, specimen collection and emergency room care.”
“That’s been our goal for a while now since my time as a leader in Horizon as interim CEO, and we’re committed to doing that,” said Dornan. But he also admitted, “that action speaks louder than words.“
The Horizon CEO told council he appreciated and understood the frustration expressed in the letter from the Rural Action Group, but said he and his team were responding to a crisis on Friday when they made the decision to close acute care at the Sackville Memorial Hospital. “It became apparent to us that we could not deliver safe care to acute inpatients,” said Dornan, after resignations from two nurses who had been working at Sackville Memorial. Dornan said the decision Friday was quick but necessary.
The state of affairs at Sackville Memorial
Director of both the Moncton and Sackville hospitals, Christa Wheeler-Thorne, was also at the meeting Monday, and gave a picture of the staffing and patient situation at Sackville Memorial. The acute care unit has ten full time equivalent nursing positions, but has been running with four to five positions filled, said Wheeler-Thorne. In terms of patients, the unit is actually a mix of long term care and acute care beds, with on average four to five acute care patients, and about ten long term care patients. Wheeler-Thorne said it takes 4.2 full time equivalent nurses to keep the unit open, “at a bare minimum.”
“And we were running at 4.2,” she told council. “So a sick call would keep us down a nurse. Someone off for whatever reason would keep us down a nurse. And we couldn’t always fill the shift. But we were getting by.”
To keep up, Horizon had reduced the level of care, and attempted to organize patients to make care manageable for nurses and doctors on duty. But then came some resignations. Two nurses resigned, taking jobs with Extra Mural and the Amherst hospital.
“Those decisions were made for work life balance reasons, rotation, schedules, etc. And for salaries,” said Wheeler-Thorne. (New Brunswick nurses have been without a contract since December 2018, and are currently back at the negotiating table with the province, after voting 92% in favour of strike action last week.)
With only three remaining full time equivalent positions filled, Wheeler-Thorne said maintaining the acute care unit was no longer possible. “There was risk, and [the remaining nurses] were very stressed. And we didn’t want them to leave,” she said.
Wheeler-Thorne said Horizon management met with the remaining nurses to discuss the situation, and the decision was made to transform the unit from acute care to transitionary long term care.
While she said 4.2 full time equivalent nurses could see the acute care unit reopened, “it doesn’t leave us any flexibility at all. Ideally, we would have five or six out of those 10 full time equivalents to get back to some acute care beds, and our long term care patients that have historically been in that unit as well.”
Horizon puts out recruitment call for nurses
After promising action on recruitment at the meeting, John Dornan issued a statement on Tuesday, addressed to “current and future New Brunswick nurses.”
In the statement, Dornan pitches Sackville as a “friendly, welcoming and progressive community” and offers nurses financial incentives for certain eligible positions, including a one-time incentive of $10,000 in exchange for an agreement to work for three years.
