NICU nurse writes health minister, says OT levels out of control

A Winnipeg nurse responsible for looking after sick babies has directly written to Manitoba's health minister, saying nursing overtime levels are out of control.

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This article was published 07/11/2018 (2241 days ago), so information in it may no longer be current.

A Winnipeg nurse responsible for looking after sick babies has directly written to Manitoba’s health minister, saying nursing overtime levels are out of control.

The nurse, who asked to remain anonymous in media reports, took issue with statements Cameron Friesen made to the Free Press last month.

In an Oct. 5 article, the minister said: “We’re standing up against misinformation that the opposition parties are peddling by suggesting that nurse overtime is at some record level. They’re just wrong. It’s false and the public deserves to be in possession of correct information… I would say at this point in time (it’s) so far, so good.”

Letter from NICU nurse to health minister

The nurse wrote to Friesen on Oct. 31, saying she was a “trifle confused” by his comments, and the situation is “so far from good.”

“I have worked in the NICU (neonatal intensive care unit) for more than 30 years. In those decades, I have never seen the amount of voluntary and mandatory overtime that is occurring,” she said.

“In the space of nine days, I personally worked three sixteen-hour shifts, then 20 hours, then 12 hours, and one more 16-hour. I would like to say this is anomalous, but it has become the ‘new normal’ in the NICU.”

David Lipnowski / THE CANADIAN PRESS FILES
On Oct. 31, an anonymous nurse wrote a letter to Manitoba health minister Cameron Friesen:
David Lipnowski / THE CANADIAN PRESS FILES On Oct. 31, an anonymous nurse wrote a letter to Manitoba health minister Cameron Friesen: "I have worked in the NICU (neonatal intensive care unit) for more than 30 years. In those decades, I have never seen the amount of voluntary and mandatory overtime that is occurring."

In August, 70 NICU nurses co-signed a letter to St. Boniface Hospital president Martine Bouchard and Friesen detailing frustrations about their working conditions.

“We are feeling stressed, burnt-out, and exhausted,” they wrote. “It has reached the point where parents are staying overnight in the NICU because they are fearful about the quality of care their baby will receive from exhausted nurses staying for prolonged shifts.”

When talking to reporters Thursday, the health minister said he takes front-line workers’ concerns seriously.

“No one is denying that more nurses were working overtime. No one was denying that somehow in the long term that would not create challenges on sustainability,” Friesen said.

Friesen said the Winnipeg Regional Health Authority took a number of interim steps this year to try and dial back reliance on overtime. It resorted to a more permanent solution Wednesday — a $3.2-million funding boost for NICU units at St. Boniface and the Health Sciences Centre.

The minister said the additional funds will be put toward increased staff and beds on both wards.

WRHA probes infant deaths

In a report sent to the Winnipeg Regional Health Authority in September, St. Boniface Hospital president Martine Bouchard said there were seven fatalities reviewed by the hospital’s perinatal morbidity and mortality committee that were deemed preventable.

“We cannot confirm without a doubt that (four) neonatal deaths… were directly related to understaffing issues,” Bouchard wrote.

In a report sent to the Winnipeg Regional Health Authority in September, St. Boniface Hospital president Martine Bouchard said there were seven fatalities reviewed by the hospital’s perinatal morbidity and mortality committee that were deemed preventable.

“We cannot confirm without a doubt that (four) neonatal deaths… were directly related to understaffing issues,” Bouchard wrote.

In an Oct. 31 letter to Manitoba Health Minister Cameron Friesen, a St. Boniface neonatal intensive care unit nurse raised the deaths as a serious concern — especially in light of increased nurse overtime.

“Staff exhaustion and moral distress are not a sustainable way to deliver health care,” she wrote. “We need safe working conditions. Lives depend on it.”

Friesen said the WRHA’s chief medical officer investigated the information, and initially found the babies’ deaths occurred between 2009 and 2012.

“So it’s very troubling to me that someone would use that data to try to suggest that a transformation in the health-care (system) that is taking place now, that there’s some kind of connection (to the infant deaths),” he said Thursday.

“Out of an abundance of caution, we are having the WRHA continue to investigate the situation to see if there’s something else to be learned.”

Bruce Roe, vice-president and chief medical officer of the WRHA, weighed in after saying he’s confident based on his review “there have been no critical incidents related to resource or staffing issues.”

Bouchard clarified in a statement to media Thursday evening information contained in her business case — which was tabled in the legislature Thursday — wasn’t accurate.

“In fact, we have since confirmed that the cases reviewed by the St. Boniface Hospital perinatal morbidity and mortality committee in 2015 were cases dating back to the 2009-12 period. We apologize for the confusion created by the inclusion of this information,” she said.

Bouchard also thanked the St. Boniface NICU team for its work.

“They have shown great perseverance, a high level of commitment to their colleagues, and above all, they have provided excellent and compassionate care to infants and families during an admittedly challenging time.”

“The investment we announced is significant. I think it does demonstrate that government is responding to these real needs,” Friesen said, not ruling out the possibility of more future funding announcements.

Last year, St. Boniface Hospital’s NICU experienced a 42 per cent increase in babies born with symptoms of drug addiction and withdrawal. It also reported a 10  per cent to 15 per cent increase in deliveries requiring admission to the NICU.

The statistics were laid out in a business case sent Sept. 26 to Réal Cloutier, WRHA president and CEO, from Bouchard.

In her report, Bouchard said the St. Boniface NICU has been consistently understaffed over the years, and relying on nurses to work overtime was “unsustainable.”

“Additionally, mandatory overtime, exhaustion, and moral distress currently being experienced are a result of chronically functioning over capacity. The impact of other staff being seconded to NICU leaves other units at risk and creates a domino effect,” she wrote.

Both Bouchard’s report and the NICU nurse’s letter were tabled by the NDP during question period at the Manitoba legislature Thursday.

Darlene Jackson, president of the Manitoba Nurses Union, said the situation at St. Boniface’s NICU worsened after the province began Phase 1 of its Winnipeg health-care overhaul last fall.

JOHN WOODS / WINNIPEG FREE PRESS FILES
Last year, St. Boniface Hospital's NICU experienced a 42 per cent increase in babies born with symptoms of drug addiction and withdrawal.
JOHN WOODS / WINNIPEG FREE PRESS FILES Last year, St. Boniface Hospital's NICU experienced a 42 per cent increase in babies born with symptoms of drug addiction and withdrawal.

She said there were 1,792 incidents of nurses working mandatory overtime shifts at St. Boniface from Jan. 1 to Oct. 31, many of those in the NICU and women and children’s programs — compared with 328 incidents of mandatory overtime during all of 2017.

Jackson emphasized nurses have been sounding the alarm on their increased overtime hours since March, and claimed the province and the WRHA didn’t respond accordingly.

“I think it’s shameful that they were not listening to the front-line health-care workers out there who have been begging for help,” she said.

“It just makes you think that had this government taken those nurses seriously in March, and put the funding out then and hired the nurses then, (now) we’re into November. We’d have some pretty experienced nurses out there right now, but here we are… now funding a program that’s in crisis.”

NDP Leader Wab Kinew agreed with the nurses’ assertion.

“The government has been slow to respond,” he said. “But even their response to date doesn’t address the impact of this ripple effect.”

– with files from Larry Kusch

jessica.botelho@freepress.mb.ca

Twitter: @_jessbu

NICU Business Case

History

Updated on Thursday, November 8, 2018 7:16 PM CST: Adds pdf of letter

Updated on Thursday, November 8, 2018 7:19 PM CST: Fixes broken pdf link

Updated on Friday, November 9, 2018 8:22 AM CST: Corrects figure to $3.2 million

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