Staff needed to open up N.B. nursing home capacity for people in hospital: advocate

Click to play video: 'Shortage of New Brunswick nursing home staff prolonging wait for beds'
Shortage of New Brunswick nursing home staff prolonging wait for beds
WATCH: The New Brunswick government can now bump those waiting in hospital for a spot in a nursing home to the top of the waiting list. But some say a chronic lack of staff in homes means there aren't beds free to move patients into. Silas Brown has more. – Jan 24, 2023

A seniors advocate says additional staff are needed to increase spaces in nursing homes for those taking up hospital beds while waiting for a placement.

Cecile Cassista, the executive director of the Coalition for Seniors and Nursing Home Residents’ Rights, says there are about 250 closed beds in nursing homes across the province, which could be used to open up acute care beds in hospitals. Closed beds are empty due to a lack of staff in a given facility.

The waiting list for a nursing home bed remains near record levels, with more than 800 waiting for a placement. Over half of those are considered alternate level of care (ALC) patients, who have been medically discharged but remain in hospital while waiting for a spot in a nursing home.

“If you’ve got 400 and some in the hospital and another 400 at home, obviously they can’t place them because there’s no beds, no workers,” she said.

In December 2022, provincial cabinet approved a regulation allowing ALC patients to be bumped to the top of the waiting list should a hospital fall into a “critical state,” which is when acute care beds are over capacity, the emergency room is full and causing lengthy ambulance offload delays, or critical surgeries are cancelled from a lack of beds.

But Cassista wonders where the province would be able to find spots in nursing homes in those critical situations.

“Just in Riverview alone, one nursing home had eight vacancies,” she said.

Read more: N.B. may move some patients up nursing home waiting list if hospital is in ‘critical state’

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Green Leader David Coon says the idea makes sense on paper, if it’s well implemented, considering that the number of ALC patients in hospital can have knock-on effects through the facility.

“When there’s no beds available it backs everything up, right down through the ER, out to the ambulances waiting to offload their patients,” he said.

“There’s quite a domino effect when there’s no beds. It leaves people in ambulance for quite some time, it leaves people in hallways for days and it creates really poor situations that have got to be addressed.”

In 2021-2022, 25 per cent of acute care beds in Horizon hospitals were taken up by ALC patients.

Click to play video: 'Health network discussing 24/7 emergency services in Sackville, N.B.'
Health network discussing 24/7 emergency services in Sackville, N.B.

Ensuring those people have spaces to go means ensuring that there is adequate staffing in nursing homes to take them on, opening up some of those 250 closed beds, Coon says.

“We have nursing homes who have closed beds around the province for lack of staff. So we need to be able to open up more beds that are currently unavailable in existing nursing homes,” he said. “I don’t feel that there’s enough emphasis on that.

“On the nursing home side there needs to be more effort on hiring and retention, the nursing homes themselves are doing a lot in that area, but support from the province would be important, when you think about wages, you think about benefits, you think about working conditions.”

Liberal social development critic Robert Gauvin said the chronic lack of staff in nursing homes is not a new issue and worries about the number of young people leaving the care and medical sectors due to poor working conditions.

“The problem always remains the same, it’s a staffing problem,” he said.

“And as long as we aren’t taking care of that, you can only move the problem so far because we’re not fixing it.”

The province is moving to create more beds, with five 60-bed facilities under construction and expected to be open by next year, and tenders for four new 60-bed homes were issued this month.

But each of those beds depends on the staff to run them.

“They’re building more nursing homes,” Cassista said.

“But where are the staff?”

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