Short-staffed Ste. Rose du Lac hospital overwhelmed by Dauphin ER reopening

A rural Manitoba physician is warning that Ste. Rose du Lac could face significant emergency department closures after its doctors were stretched thin helping absorb the fallout from the flooding and prolonged shutdown of Dauphin Regional Health Centre.

When Dauphin was evacuated July 1, Ste. Rose expanded its emergency department to 24-7 service and nearly doubled its in-patient load. But with Dauphin’s ER reopening last week and staff that had been temporarily working in Ste. Rose returning to their regular posts, Dr. Ashley Blais says her hospital, located about 50 kilometres southeast of Dauphin, has been left without enough physicians to maintain reliable emergency coverage.

“We answered the call when Manitoba’s health-care system needed us,” Blais said Monday. “Now we are asking the Manitoba health-care system to answer ours.”

Blais, who penned an open letter to Manitoba Health Minister Uzoma Asagwara, is calling on the province, Shared Health and Prairie Mountain Health to urgently develop a sustainable staffing plan for Ste. Rose, with direct input from physicians working there.

The Métis physician, who sits on the board of directors of the Indigenous Physicians Association of Canada, said Ste. Rose already had a plan to manage with its limited complement of doctors before the Dauphin flooding upended health-care delivery across the region.

There have been only four doctors working at the hospital during Blais’ 13 years in the community, she said, and one entered partial retirement this year after providing the required six months’ notice in February, while the other two have young families.

When Dauphin’s hospital closed, its emergency department staff moved to Ste. Rose, allowing the ER to operate around the clock for the first time in about a decade. The hospital’s in-patient load also jumped from between 15 and 18 patients to just under 30.

Blais, who operates her own clinic in Ebb and Flow First Nation, said Ste. Rose physicians also lost income under their fee-for-service model while taking on the extra hospital workload. There have been discussions about those lost wages, she said, but money is not the primary concern.

“I am worried about the fallout that is going to happen with our emergency department,” she said.

That began when Dauphin reopened sooner than expected, she said. Staff from Dauphin who had been helping operate the Ste. Rose ER returned to their regular positions, leaving the remaining physicians scrambling to cover the department.

“We had a plan before all this happened. Now we don’t have a plan,” she said. “How are we going to keep our emergency department open?…. Now there’s only two of us to rotate through the emergency department.

“The last time that that happened was 10 years ago, when we switched from 24-hour to 12-hour (operations), and I put two of my colleagues through the ringer to keep an emergency department going. It’s not possible to sustain that.”

The Ste. Rose ER was closed from Sept. 11 to 14 and is scheduled to open only twice this week, Blais said.

“It’s not humane (having two doctors working alternate shifts), so the only thing that we can do to fix this is to get more doctors,” she said.

She spoke with Asagwara’s office late Monday afternoon and said she is hopeful the province will help find a solution.

“They’re going to discuss and maybe pressure PMH and Shared Health and make some movement on this now,” she said. “They didn’t realize the position that reopening the emergency department in Dauphin was going to put us in.”

Asagwara said the the concerns are being taken seriously.”

“Prairie Mountain Health and Shared Health leadership have been engaging directly with physicians in Ste. Rose, including discussions about emergency department scheduling, and my office has reached out to Dr. Blais to better understand the concerns being raised,” Asagwara said in a statement.

“We will continue working with Prairie Mountain Health, Shared Health and local physicians on physician coverage and longer-term recruitment to support access to emergency care in Ste. Rose and ensure the people providing care have a voice in that work.”

Shared Health said it and Prairie Mountain Health are “actively working to address physician coverage gaps and maintain access to emergency care in Ste. Rose.”

“Prairie Mountain Health is pursuing additional physician coverage for Ste. Rose and plans to have another physician in the community by early 2027,” a spokesperson said on behalf of Shared Health and PMH.

Blais said rural hospitals cannot simply be relied upon as overflow capacity during emergencies without ensuring they have the resources to recover afterward.

ER closures in communities such as Ste. Rose mean longer travel and ambulance times for patients while putting additional pressure on neighbouring hospitals, she said.

Still, Blais said she is not trying to assign blame. She said Shared Health, Prairie Mountain Health and Asagwara’s office have been “great” and have done what they can in a difficult situation.

“But they just can’t squeeze this group any further,” she said.

scott.billeck@freepress.mb.ca