On the Necessity of 24/7 In-Person Emergency Physician Coverage at Stanton Territorial Hospital:
Northerners deserve a high-quality, caring, culturally-safe healthcare system that is aligned with standards across Canada. Yet this summer, Stanton Territorial Hospital is operating without guaranteed in-person emergency physicians. As the Northwest Territories’ main referral site and only Level 3 trauma centre, this staffing crisis poses serious risks to patient safety.
Staffing plans now include regular 12-hour physician shifts and an untested “virtual ER” model where no physician is physically present. These approaches are unsafe, especially in a high-volume, high-acuity emergency department serving the Northwest Territories and the Kitikmeot region of Nunavut. In addition to receiving medevacs, the ER physician provides phone support to physicians, nurses, and lay people serving as health cabin workers. As a result, this failure significantly impacts people living in other communities.
We, the Northwest Territories Medical Association (NWTMA), the Union of Northern Workers (UNW), and the College and Association of Nurses of the Northwest Territories and Nunavut (CANNN), stand together in stating that 24/7 in-person emergency physician coverage is essential and non-negotiable at Stanton.
- NWTMA notes: The ER physician group considers three 8-hour shifts to be the minimum for safe coverage. Across Canada, when emergency departments face collapse, provinces step up with surge funding, competitive compensation, and dedicated locum support. In the NWT, we need equal action immediately.
- UNW notes: We are deeply concerned about the impact the lack of physicians in the emergency department is having on nurses and other frontline workers. The expectation being put on our members by the employer to go over and above not just their job description and statement of duties, but also potentially what they can legally do, is a threat to worker and public safety. The employer appears to be taking advantage of the sense of duty and care that healthcare workers feel in order to leverage unreasonable demands. This and other poor working conditions have caused morale to sink even lower than what we thought was already an all-time low.
- CANNN notes: Without in-person physician backup, emergency nurses and nurse practitioners are placed at unacceptable risk, pressured to manage situations beyond their scope… This creates legal liability, moral distress, and direct threats to patient safety. Nurses must remain within their legislated scope of practice, even under systemic pressure, to protect themselves, their licenses, and their patients.
We are united in our commitment to the people of the North. We call on the Premier, the Minister of Finance, and Minister of Health to intervene immediately: staffing gaps are already upon us and continue through the summer. We need immediate policy change to provide leadership with the tools required to guarantee 24/7 in-person emergency physician coverage this summer.
Signed,
Dr. Courtney Howard
Medical Doctor (MD), Master of Public Policy (MPP), CCFP-EM
President, Northwest Territories Medical Association
Emergency Physician, Yellowknife, NT Canada
Clinical Associate Professor, Cumming School of Medicine, University of Calgary.
Community Research Fellow, Planetary Health, Dahdaleh Institute for Global Health Research, York University.
- on behalf of the Northwest Territories Medical Association
Gayla Thunstrom
President, Union of Northern Workers
- on behalf of the Union of Northern Workers
Megan Wood
MN, RN, CPMHN(C)
Chief Executive Officer & Registrar, College and Association of Nurses of the Northwest Territories and Nunavut
– on behalf of the College and Association of Nurses of the Northwest Territories and Nunavut