The Capital District Health Authority said the strike prompted the cancellation of 91 surgeries, though emergency surgeries were still being performed at the usual rate of about 20 per day.
About 300 outpatient appointments were put off at clinics that were supposed to see 1,665 patients Thursday, and 227 out of a total of 740 beds at the QEII Health Sciences Centre were closed to patients, said Capital Health CEO Chris Power.
"This situation isn't sustainable over the long term," Power told a news conference. "It is affecting the entire provincial health-care system."
Power said the Halifax hospitals overseen by the authority were operating with 50 per cent fewer nurses than usual.
The union and the health authority have agreed to maintain full staffing levels for emergency rooms and units offering dialysis, cancer care and intensive care. However, many other services were reduced to emergency-only levels.
The strike was expected to be short as the government was prepared to pass essential services legislation as early as Friday, a move that would force the 2,400 nurses back to work.
The law would apply to as many as 40,000 workers including nurses, paramedics, ambulance dispatchers, hospital employees and people who work in homes for seniors, youth and people with disabilities.
Union president Joan Jessome said the nurses will end their strike once the legislation passes.
Dr. David Kirkpatrick, the health authority's head of surgery, said no life-threatening cases had been compromised by the labour dispute.
Still, Power said the strike's impact is significant for patients.
"For people who have waited months for surgery and procedures to only have it cancelled ... the disruption to families, the emotional stress that people are undergoing is tremendous."
The nurses' union, the Nova Scotia Government and General Employees Union, wants a collective agreement that includes mandated nurse-to-patient ratios.
The union's demand has been rejected by Capital Health, which says such rules are too inflexible and that there is no evidence they actually work.
Paolo Amati, an operating room nurse, said more nurses are needed to ensure patient safety.
"And what's important is that hopefully this government will understand that you can't go on with something you don't have," said Amati, 50. "It's a national worry."
Inside the provincial legislature, as the Liberal government tabled its annual budget, a group of noisy nurses were ejected from the public gallery by the Speaker.
Phyllis Durning, a nurse at the Victoria General Hospital in Halifax, was one of those asked to leave.
"We joined in with the opposition clapping and they threw us out," she said. "I can't even express my disappointment with the government."
During earlier hearings on the essential services legislation, Bill 37, one nurse told a legislative committee that she is sometimes forced to care for up to 25 patients on her own.
Power said that was unlikely.
"I wouldn't have ever thought that would be the case, not to my knowledge," she said.
Capital Health says its staffing levels are based on a complex process that requires flexibility to meet the needs of patients. As for safety, the authority says that the QEII Health Sciences Centre, the largest hospital in the province, has a mortality rate on par with the national average, citing statistics from the Canadian Centre for Health Information.
The strike affects services at a number of hospitals and health centres in Halifax, but its impact has already been felt across the Maritimes.
The hospitals provide treatment to people in the three Maritime provinces and some patients have already been transferred to other health districts in the region.
Capital Health said 234 surgeries have been postponed since Monday, but Jessome said operations are often cancelled because of tight staffing levels.
"The amount of surgeries that are cancelled on a weekly basis at Capital Health goes untold, but because this is such a public fight, they're (the public) seeing these numbers over the past couple of days," she said.
A few hundred of the nurses represented by the union staged a wildcat walkout Tuesday that forced the cancellation of dozens of surgeries as they protested the introduction of Bill 37.
Maureen MacDonald, the NDP health critic, said she expected the bill would pass by Friday, but she said the nurses' grievances will remain and solutions will become more difficult to achieve.
"This government has botched these rounds of negotiations and they solely are responsible for the situation we're in," she said outside the legislature.
Premier Stephen McNeil has said the law would not take away a union's right to strike because that option remains once essential staffing levels have been negotiated or determined by the Nova Scotia Labour Board.
But the nurses' union says such deals can take up to six months to reach, effectively undermining the leverage of a strike.
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