St. Marys will have its say on its hospital’s future on Apr. 29.
That night, the Huron Perth Healthcare Alliance (HPHA) will host a community forum  to discussion the proposed changes to St. Marys Memorial Hospital, which could include a reduction of emergency room hours, as well as realigning the hospital’s 20 beds to focus more on rehabilitative care.
Time and location for the forum are yet to be announced, but Andrew Williams, CEO of the HPHA, said the forum would be structured with a formal presentation, then a question-and-answer period.
The forums were originally set to happen last fall, after workshops which took place in August. The workshops, however, were poorly attended by the public.
While Williams told the Journal Argus that the original scheduling of the forums was “overly optimistic,” he says the HPHA hopes to have final recommendations in place by June, the board’s year-end.
Community forums will also take place on Apr. 28 in Huron East, May 4 in Stratford and May 5 in Central Huron, to address the potential changes at the HPHA’s other  three sites, in Stratford, Clinton and Seaforth. Look for more details in a future issue of the Journal Argus.
The dates of the community forums were released at last Thursday’s regular monthly meeting of the HPHA board, which took place in St. Marys.
At that meeting, the petition presented by the community access group to the board at the Feb. 18 meeting of the local advisory committee  was also discussed -- but this was limited to two specific names.
Local advisory committee memeber Brock Hueston told the board that the petition was reviewed to find out who the two doctors were who signed it; CAG member Jan Mustard had mentioned this in her presentation.
After reviewing the petition and discussing it with Mustard, it was determined that the one physician had been retired since 1988.
As for the other, while it couldn’t be confirmed, it was believed that it was “a name that is similar to a doctor in town, but the first name is different, and the address is different,”  Hueston explained.
At the same meeting, St. Marys Memorial Chief of Staff Dr. Fred Jewson, in his report to the board, said that four physician shifts in March and four in April still needed to be covered in the emergency room (each calendar day has two shifts; a 10-hour day shift, and a 14-hour night shift).
This past weekend was originally not covered, Jewson noted, but doctors who were scheduled to cover shifts later in the month “moved up” their coverage to take care of the weekend -- leaving a weekend later in the month without physician staffing.
“We’re hoping that, with some more time, we’ll be able to find people,” Jewson  told the board. “Putting a sustainable plan in place remains a pressing challenge for us all -- (the hospital) is not a  happy place when you’re dealing with this kind of stress.”
These thoughts echo a discussion that Jewson had with the Journal Argus prior to the meeting.  He says that the goal of Vision 2013 is “to look at something that is sustainable,” rather than “looking every day for someone to work tomorrow for nurses,” and physicians as well.
He adds that “on a given day, St. Marys Memorial site administrator Shirley Veneendaal (who also is the emergency room coordinator) for the HPHA) can spend 80 per cent of her time filling shifts someplace.”
Jewson notes that this last-minute scheduling of nurses causes two main problems. First, “it makes staff feel guilty” by taking time off, causing other nurses to “work short” by handling eight patients each instead of six.
“Their already busy day is busier and they don’t feel like they can do as good a job, so the job satisfaction begins to diminish,” he says.
Secondly, “after a while, after you’ve been called every weekend you’re supposed to be off for six weeks in a row, you think, ‘why do I do this? Why don’t I work some place were I’m anonymous where they can call 50 people instead of three people and I can have my life back,’  so then they go work somewhere else.”
Jewson says that the reduction of emergency hours to 12 daily in Seaforth is due to a lack of nurses -- one was retired, and another was critically ill, and a replacement could not be found.
“We’re always one nurse way from being in that situation (in St. Marys),” Jewson says. “Right now, touch wood, as far as we know, we have enough nurses.”
In a 30-day average month of 60 emergency shifts, Jewson says that family doctors cover about 33. Contracted locums cover about 20 shifts, “and after that, there’s six to eight shifts a month that we have to find somebody for.”
Jewson says that it’s not just a matter of having the five family doctors who cover emergency shifts cover more.
“If a doctor covers three shifts a week in the ER, their time in the office is really impacted... (it becomes a question of) how do I balance the needs of my practise versus the needs of the emergency department, and which should take precedence?”
Secondly, if a family doctor covers an overnight emergency shift, they can’t do family practise the following day, Jewson says.
While the HPHA’s recruitment of a new emergency-specific doctor is promising, Jewson says that “most of the ER docs would want to work at least half their time in Stratford in order to get enough volume with enough sick people to maintain their skills.”
By way of example, he says that “in St. Marys, if you only see one punctured lung a year, it’s hard to recall how to put a chest tube in... but if you see once a week, it’s easier” in terms of maintaining confidence in life-saving skills.
He predicts the ER physician would fill in at the other hospitals as needed. “One of the things about emergency medical skills is that they’re very portable,” Jewson says.