If you're an expectant mother close to your due date, you might want to check what day of the week it is before heading to the Squamish General Hospital (SGH) to have your baby delivered.
Due to an ongoing nursing shortage at SGH, the hospital is still unable to provide a continuous labour and delivery service on weekends, a situation that has many nurses concerned about the level of safety being provided to patients.
"Because of these staffing problems, the nurses can't provide safe services in a consistent manner," said B.C. Nurses Union Steward Sandy Bauer. "The nurses are exhausted and they've all worked a large amount of overtime."
The diversion has been going since August 2003, when the Vancouver Coastal Health Authority (VCHA) announced a nurse cutback and elimination of the 'Team Leader' position as means to recover a $92,000 budget shortfall. The diversion was originally scheduled to last until this month, but has since been extended to the middle of March.
At SGH, from Friday mornings at 7:30 a.m. until Mondays at 7:30 a.m., any patients requiring obstetrics care will be diverted to Lion's Gate Hospital in Vancouver.
A memo provided to The Chief indicated that following an in-depth discussion between the Manager, Local Medical Director and Obstetrics Liaison Physician, the hospital "must regrettably extend the weekend OB diversion until mid-March 2004 as per the existing policy."
The nursing shortage at SGH can be attributed to three different factors. First, there is a recognized nationwide shortage of Registered Nurses in Canada; second, a re-organization by the VCHA to cut back front-line nurses saw many former SGH nurses take jobs elsewhere in the province; and lastly, there are currently four SGH nurses enrolled in an obstetrics specialty training courses at BCIT until the end of March, which is when the diversion is expected to stop.
At the moment, the hospital employs 14 full-time and 9 part-time nurses, as well as 10-12 casual nurses.
"The VCHA is paying for these nurses to get a proper education so they'll be ready to handle any situations that arise," said Vivianne Zanocco of the VCHA. "We want to make sure our nurses stay where they are and that they're prepared to deal with any obstetrics-related decisions that will need to be made. We've just got to deal with some short-term pain for long-term gain."
If an obstetrics patient does arrive at SGH during the weekend hours, they will be properly assessed by on-duty nurses, and if they can be transferred safely will be diverted to Lion's Gate Hospital, a 45-minute drive south.
"The weekends are very hard to staff with experienced nurses," said Bauer. "We're four nurses short and we need an experienced nurse that can be left alone to deal with emergency room situations. We have undergraduate nurses who do an excellent job but they just don't have the necessary experience to work alone in the ER or in obstetrics."
It is estimated that the diversion will impact about 25-30 per cent of the hospital's regular deliveries.