Friday, June 30, 2006

Northern Health spins a tale of frustration (for them and for us!)

It’s not the most reassuring of scenarios being painted by the folks at Northern Health, as the latest crisis in the health care industry in the Northwest begins to become more commonly told. On Wedensday, Northern Health responded to the story in Tuesday’s paper of the mother shipped to Terrace to deliver her baby, due to local staffing shortages at PRRH .

In a front page story in the Daily News, Northern Health outlined the frustrations they have in filling many positions at the Prince Rupert Hospital, how the hospital is hostage to RCMP, transfers, spousal layoffs and relocations.

The Daily News story paints a hospital in dire need of staff and finding it very hard to attract people to our corner of the Northwest. It will act as a companion piece to a story out of Terrace about the overworked status of the radiology department there due to the departure of Prince Rupert’s radiologist Dr. Hudson. Resulting in a staffing situation, that has made for a heavier load for the Terrace department and left Prince Rupert without its own radiologist. That situation is explained in full detail on the Terrace Standard's website.

It also presented Northern Health’s side of the baby story, where the hospital simply couldn’t get anyone on staff to come in to work over the Seafest weekend, which one can only assume is going to get worse as long weekends and summer vacations begin to play through the summer. Reading of the nightmare scenario of trying to bring in staff over Seafest, you have to wonder if it’s possible that one weekend we may find the entire hospital closed due to a lack of staff unavailable or unwilling to come into work!

Health Care is always a controversial subject in BC, but the situation in Northwest BC seems even more dire than most communities around the province, it makes you wonder what’s going to happen here should the boom in population comes that is anticipated with the Container Port and other projects on the books.

A quick scan of the Northern Health website shows that the staffing situation is not just a Prince Rupert problem, but seems to affect most hospitals across the region.

Seemingly overtaxed at the moment, you have to wonder how they’ll cope should the population double or triple in a very short period of time. If we can’t cope now with our shrunken population, Lord help us if the place expands as we keep getting told it will. It’s something that should be get people thinking about our health care in the Northwest and what we’re going to have to do to make sure we have a proper level of service in the community.

Both articles are provided below for your information gathering purposes.


NH SCOURING WORLD FOR NURSES
By James Vassallo
The Daily News
Wednesday, June 28, 2006.
Pages One and Three

Prince Rupert Regional Hospital is facing a serious staffing crunch after the sudden departure of three maternity nurses, but Northern Health is already going to great lengths to find replacements, says the head of the hospital.

“The biggest concern seems to be that (people think) we’re looking at regionalizing services and that’s absolutely not true,” said Sue Beckermann, Health Services Administrator for Prince Rupert and Queen Charlotte Islands.

“We want to maintain our services here, but with the nursing shortages in Canada, recruitment is really, really tough and the people we’re looking for have special training which makes it even tougher.”

Presently, there is a significant shortage of nurses in Canada and all the provinces are struggling both to retain the nurses they have and train new ones.

“I don’t think it’s a surprise that recruitment of health professionals is really tough, there’s a world wide demand for them,” said Beckermann.

The U. S. has done amazing things for years – they may offer double wages, they may offer completely free tuition to post graduate degrees, they’ll offer free housing.

“In terms of competition, it really is a fierce effort to try and keep our nurses at home.”

Most recently the nurses that have left town have done so as a result of their spouses transferring elsewhere to work. In recognition of the need to attract nurses to the community, NH goes so far as to help spouses try and find jobs locally.

“The challenge for us is that if a spouse finds a career opportunity in another community it does affect the hospital,” she said. “If we have a husband who is in the RCMP and it’s time to transfer , if we have someone who has lost a job or found one in another community, the nurses go with them and that’s really been the case with us in regards to maternity in particular over the last couple of months.”

In the hopes of dealing with that hurdle NH has looked to nurses that do want to stay locally, offering to support them financially if they wish to obtain specialized certifications.

Unfortunately, the skills require those nurses to leave the community – sometimes for as long as a year and a half – to gain the skills.

“That poses a real challenge for us in trying to support our nurses. If they’re young mom’s, or they have a family here or a husband working shifts, going down south for at least three months or longer to gain that experience isn’t practical,” said Beckermann.

“Last year we spoke to all of our nursing staff and offered to support month’s worth of education and acquiring these certifications.

“We have a very small number of people able to take advantage of that whether it’s because of personal circumstances or a desire not to leave the community.”

There are any number of nurses in town who are certified to provide maternity service as well, but most have moved on to other phases of their careers, she said.

“The doctors will talk about all these people in town and point of fact – we’ve talked to every single one of them,” said Beckermann.

“They simply don’t have any interest, they’ve move on in their career … it’s not something that they want to come back too.

“We’ve exhausted that resource in terms of bringing people back.”

With these opportunities seemingly not present, NH has posted jobs on their web site, on Workopolis and in newspapers across the country.

“There’s also a Northwest nurse recruiters looking overseas, particularly in the UK and Ireland where many health professionals are currently being laid off.

“We’re in daily contact with our staffing agencies,” she said.

“To date they haven’t been able to find us anyone beginning in September but they have been providing two (operating room nurses) until July.

“(And) we have used the nurse in Terrace, when she’s not scheduled there she’s scheduled here.”

With respect to Leslie Olsen’s experience – a Port Edward woman who was taken to Terrace to deliver her baby over Seafest weekend – there was simply no available to fill the shift with the three nurses gone.

“We’ve been trying since the previous Monday to try and fill that night shift; it was 12 hours from 7:30 p. m. to 7:30 a. m.,” said Beckermann.

“Normally we always have two RNs on the floor plus a maternity nurse plus two LPN’s. That night we could not get a maternity nurse at all, in fact we couldn’t even get the second nurse.”

“We tried our staffing agency, we tried calling everyone, it was Seafest weekend, there were going away parties for those staff members leaving and people simply didn’t want to come in.”

She explained that the two maternity qualified nurses working the next morning were both asked if they were able to come in that night, but neither were.

The unionized employees can only be asked, not ordered to come in.

My concern then was much more for the safety of the moms and babies,” said Beckermann.

“If someone had come in with an emergency and they were delivering right then we would cope with it, not an ideal situation but we would do it.

“In the afternoon well in advance of Leslie’s expected delivery her GP decided it would be wise to send her along well in advance of her delivery time.”

If people in the community have additional ideas on what NH could be doing to recruit more nurses locally, Beckermann is encouraging them to come forward.

“I’d really like to work with the community to find a solution rather than rubbing up against each other over this,” she said.


NORTHWEST SHORT TWO RADIOLOGISTS
The Terrace Standard
Wednesday, June 28, 2006
(on line website)


THE NORTHWEST is short two radiologists, placing medical diagnostic services in the region under pressure, says a Northern Health Authority official.

Dr. Mark Hudson left Prince Rupert just recently as attempts were already being made to find a second radiologist for Terrace because Dr. Ernie Behm, who practises here, is swamped as it is, says Rowena Holoien.

"All this has really put us in a critical situation," she said.

Recruiting is made even more difficult because radiologists are in demand everywhere, Holoien added.

For now, physicians in the region are dealing by sending images to other places for analysis with new imaging and computerized storage technology, but it's not considered a permanent solution.
"The support plan that's been put in place is working. It's like covering a holiday schedule, but there really is nothing like having a radiologist on site," Holoien said.

That's particularly true for urgent cases where a hands-on radiologist is needed.
As well, Dr. Behm does not do nuclear medicine, which is a feature of imaging services at Mills, said Holoien.

The search for radiologists comes just as the Northern Health Authority has ordered a top-of-the-line $1.65 million CT scan machine for Mills Memorial Hospital.

And the shortage follows a new medical manpower plan which also lists recruiting of a second internal medicine specialist for Terrace as a "high priority" while the need for three psychiatrists is listed as "urgent."

Local general practitioners are doing good work initially with visiting psychiatrists treating patients afterward, but permanent ones would be good to have here, says Dr. Geoff Appleton, a Terrace doctor and president-elect of the B.C. Medical Association.

At the moment, one psychiatrist is in Terrace and none is in Prince Rupert or Kitimat. At one time, the northwest had five psychiatrists.

Numbers reached their current level around 2002 after a complete renovation and gutting of the regional psychiatric ward at Mills Memorial was completed.

In addition to radiologists, internal medicine specialists and psychiatrists, the medical manpower report suggests Terrace and area can use more general practitioners, one more opthalmologist, a second ear, nose and throat specialist and an orthopedic surgeon, all by 2010.

Appleton isn't surprised by some of those recommendations, saying that more general practitioners, for instance, would help in spreading out the on-call work at night and on weekends.

He noted that having an orthopedic surgeon is a long standing desire of the local medical community.

There are orthopedic surgeons in Kitimat and in Prince Rupert, but none in Terrace.

"The encouraging thing is that it is now on the list. But when you talk about surgeons you also need to talk about more operating room time and the costs that go along with it," said Appleton.

The Northern Health Authority report states there are 367 physicians of all kinds practising in the north but another 62 are needed to fill current vacancies.

Of those 62 openings, 12 are in psychiatry, making it the specialty with the largest number of vacancies.

By 2010, the authority estimates it will need 454 physicians, an increase of 87 over those practising today.