When Vancouver-based emergency physician Dr. Anthony Fong answered an urgent call for emergency doctors at a north Vancouver Island hospital, he expected two busy nights of work.

Instead, he found that Port Hardy Hospital would be closed overnight during the shifts he was assigned on Tuesday and Wednesday night. 

“I was pretty surprised and shocked when I saw on the door there [were] posted some notices saying that the hospital will be closing for the night,” Dr. Fong told Capital Daily. “I basically was talking to the staff there, and receiving my orientation, and the message I got was that, ‘Well, it sounds like you won't have much to do tonight because we're closing at 7pm.’”

According to Dr. Fong—and later confirmed by Island Health in a statement—the emergency department could not stay open because there weren’t enough nurses to cover the overnight shifts. Instead, the locum physician spent his nights as an on-call physician for inpatients, with not much to do.

“There were no care issues that needed tending to overnight on the already admitted patients,” he said about his Tuesday night shift.

These overnight closures are not new for the North Island hospital. The Port Hardy Hospital emergency room has shut down 16 times since July, according to notices posted on the Island Health website, including for almost the entire month of October.

Patients who need emergency care between 7pm and 7am in Port Hardy on a day that the ER is closed are transported to Port McNeill by ambulance, a half hour away. But the emergency department in Port McNeill has also been beleaguered by staff shortages, and had to shut down overnight at least eight times this year.

The current crisis is a result of a shortage of nurses, not just in northern Vancouver Island, but also across BC and Canada. This year, Dr. Fong has worked as a locum physician in emergency departments across rural BC, Newfoundland, Nunavut, and the Northwest Territories, and reports similar disturbances across the board.

“The general theme that I'm seeing with nurses in situations all across the province and all across Canada is that in general they're being asked to do more with less,” he said.

With many nurses out sick, their colleagues are tasked with a larger workload, leading to more burnout and sickness among staff, and a vicious cycle of staff absences. Earlier this year, Capital Daily reported on situations in Victoria hospitals which were so short staffed, there were only two or three nurses looking after 25 to 30 patients in a ward.

For Dr. Fong, showing up for a locum placement and finding that the department he was supposed to work in is closed was a new and surprising discovery, but he has seen similar incidents unfold on the other side of the country.

At the end of a 10-day locum at a hospital in Fogo Island, Newfoundland, Dr. Fong said there were no physicians to take over for him, and the hospital had to close after he left.

“This is a new thing that’s happening in Canada,” Dr. Fong said. “It’s unprecedented. I’ve never seen this before in the 15 years I’ve worked in healthcare in Canada.”

Island Health said in a statement that they are working on “local, national, and international recruitment campaigns” to attract healthcare workers to the region, but expect nursing shortages to continue.

“Despite the success in securing physician coverage and many other professional and support staff, it is expected the ongoing shortage of emergency trained nurses will persist, impacting service interruptions,” the statement reads.

Dr. Fong sees a situation that is increasingly dire across Canada, causing bad patient outcomes and anxieties among healthcare workers and residents of rural and remote emergency rooms that have been hit the hardest.

“[With] the fact that there's no help available nearby, what can you do in case of emergency?” he said. “You have to drive an hour away and hope that you don't get worse on the way.”