NWO hospitals using nurse practitioners to help ER docs

By Eric Shih
Local Journalism Initiative Reporter
Thunder Bay Source

NORTH WESTERN ONTARIO– Hospitals in the Northwest are trying a new way to help lessen the workload of emergency room doctors by using nurse practitioners and physician assistants

The approach came from a pilot project started at the Geraldton District Hospital earlier this year. Now that hospital as well as ones in Dryden, Fort Frances. Red Lake, Kenora, Sioux Lookout and the Thunder Bay Regional Health Sciences Centre are getting permanent funding from the Ministry of Health to hire either a nurse practitioner or a physician assistant for emergency room work.

Leah Galusha is the nurse practitioner who was involved with the initiative from the beginning. She has now been hired full-time at the emergency department in Geraldton. She said it started as an idea of taking on a few shifts last summer because of the shortage of physicians. “We found it really worked. Nurse practitioners can look after the lower triage patients…NP’s do that every day. So it really helped take the pressure off, so the physicians were freed up to see… cardiac patients, the head injuries, the severely injured,” she said.

Galusha said those few shifts last summer turned into a pilot project that ran earlier this year.

Darryl Galusha, the CEO of the Geraldton District Hospital, said the idea of nurse practitioners working in the ER is not a new concept. [It should be noted that Darryl is Leah’s partner and she said he was not involved with her hiring decision.] Galusha said he’s seen the successes with this type of model in different health jurisdictions he’s worked for in the past including Northern Saskatchewan and New Mexico. “Once I brought [the idea] to our board, our board was supportive and our chief of staff was supportive. We had to do something to find a work life balance for our physicians group,” he said. “So this was a viable option.”

Galusha said an NP can take care of 88-92 per cent of the cases that come into the ER, which can allow the hospital to maximize resources at hand. He added funding came about three weeks ago and the hospital has now hired two nurse practitioners which means that in September when they are fully in place, 16 to 18 24-hour shifts are now covered by nurse practitioner with physician support.

“People seeing the need. And recognizing the need.” he said. “We just happened to be the first [hospital] that really brought it forward and had a supportive group of people wanting it to work.”

Other hospitals in the Northwest tried it out as well. Sue LeBeau, the president and CEO of the Red Lake Margaret Cochenour Memorial Hospital said they brought in Leah to try out that model of care earlier this month and found it to be a really positive experience for all involved.

“She assessed patients as they came in if they needed some treatment that was within her large scope of practice, she was able to assess and support those patients in going back home healthy. Or support physicians in more complex cases.“

She said the reason it hasn’t been tried here before was for a variety of factors including a lack of base funding for the positions. “We’re in a different place now. We’re in a place where we are risking [emergency department] closures and we have experienced the closure and come close to many others” she said. “That’s happening a fair bit in northwestern Ontario, because of that, there’s an openness to looking at funding models that didn’t exist before and looking at solutions that maybe didn’t fully exist before.”

LeBeau said hospitals in the Northwest are often early adopters. “I think it’s the willingness to try something that is new. That is outside the norm, maybe. But that can meet patient’s needs, and so that’s what Darryl and Leah have done here with this model,” She said. “It’s a matter of being creative, being flexible. Not letting funding barriers, or job descriptions, or things like that, hem us in. If we can do something that meets the goals and needs of patients in our community safely.” She said her hospital is hiring for two nurse practitioners to start right away.

“They’re still short physicians [this] hasn’t changed it. But it has helped alleviate the stress.” said Leah Galusha. It’s an important story to share “because [when] all the health care providers collaborate together we can do great things.”