Exclusive: Operating room nursing shortage undermining surgeries
Published Thursday, September 13, 2012 6:39PM EDT
MONTREAL - A shortage of operating room nurses at the Royal Victoria Hospital has led to the delay of many operations.
The most recent nursing crisis has been sparked by a rash of sudden pregnancies and ongoing defections into better-paying jobs.
One senior hospital administrator acknowledged that there is a major problem hampering scheduled operations.
“We're having a serious nursing crisis, particularly at the Royal Victoria site of the MUHC,” said MUHC Chief Surgeon Dr. Gerald Fried.
“The reason is that there's a remarkable number of women that are off on maternity leave or pregnancy leave at this time,” he said.
A dozen OR nurses are currently out on pregnancy leave and for health reasons they are ordered out of the operating room the minute they are confirmed to be with child.
The shortage of OR nurses is rife throughout the province but the current situation at the MUHC is considered particularly severe, disrupting almost one-of-three operations.
“We have had a reduction of nurses from our ideal capacity of 36 percent. This is a huge limiting factor in our capacity,” said Fried. “So this has resulted in us having to change our operating room schedule for the Royal Vic operating site to decrease the amount of scheduled surgery by 30 percent.”
Three operating rooms will be closed and between six and nine surgeries postponed each day.
The MUHC is writing 100 cancer patients to apprise them of the situation and reassure them they will receive their cancer surgery within ministry guidelines.
“From an individual patient's perspective, no delay is reasonable but we do know there is a timeframe within which we can work without compromising the patient's wellbeing,” said Fried.
Cardiac and transplant operations will be prioritized, along with the cancer surgeries and a hotline will be set up to answer questions from patients.
The Montreal General has picked up some of the slack, raising its capacity by 15 percent and some surgeries have been sent to Lachine and Lasalle hospitals.
A representative from the French-language CHUM hospital network told CTV Montreal that it has dealt with its own nursing shortage by having several non-OR nurses sub at operations.
The MUHC has done that as well as a stopgap measure, but points out that assistant nurses do not have the same training and cannot do what an OR nurse does.
The MUHC said that nurses are often inadequately trained in their studies to practice in the operating room, a craft that requires eight months of special training.
“The educational system for nursing really does not have them do a complete stage in the operating room,” said Donna Stanbridge, Associate Director of Nursing at the MUHC. “We're lucky if they come for half a day so they don't get exposed to the operating room. They don’t really see it as a viable career choice.”
Some OR nurses like Abigail Ramos thrive on the action.
“There’s never a dull moment,” said Ramos. “One day you'd be coming in with traumas and for those that like the adrenaline rush, it's quite exciting.”
But many others choose less stressful working conditions or get lured into other better-paying positions in the private sector.
“Our problem is that once they have a year, or a year-and-a-half experience, they have a lot of options open to them,” said Stanbridge.
OR nurses have skills that are highly valued in private clinics or with agencies.
“The harsh reality of the private sector coming to literally take our people away for better salary and better conditions,” said Luc Binet, Assistant Nursing Manager, at the Montreal General Hospital.
He notes that the OR nurses were not thrilled when they were snubbed when other nurses were given a 10 percent raise in 2008.
“Some of my friends are working ICU because they're getting the premium,” said Binet.
Fried, meanwhile, is pleading for patients to be well, patient.
“Patients may feel anxious now and I'm very empathetic. And believe me our goal is to treat our patients as timely as we can,” said Fried.
Fried says he can't make any promises, but he hopes the Royal Vic will have some relief by the end of October.