Cardiac surgeries put on hold at St. Boniface Hospital

Elective cardiac surgeries are being cancelled at St. Boniface Hospital as the wait list for operations toppled over the 100-person mark this week, the Free Press has learned.

Réal Cloutier, president and chief executive officer of the Winnipeg Regional Health Authority, confirmed Friday there were 102 people waiting for elective cardiac surgeries, which is up at least 70 per cent from October.

The WRHA couldn’t provide the average number of people usually on its elective cardiac surgery wait list Friday, though the Manitoba Nurses Union said it believed 40 to 50 people was close to the norm.

The median wait times for cardiac procedures currently vary from six days for emergent and urgent surgeries, to 19 days for semi-urgent operations and 68 days for elective procedures.

St. Boniface is the only Winnipeg hospital where the cardiac surgeries occur, Cloutier said. He blamed a shortage of critical care nurses as the main reason for the backlog, although he couldn’t say exactly how many surgery cancellations have occurred recently.

"The beds are there. It’s having the nursing staff to look after the patients," Cloutier said, noting cardiac patients require longer after-care from nurses post-surgery.

"So part of the issue in the health-care system (is) there’s always a bit of ebb and flow in terms of vacancies in critical care. I’ve seen it over the years," he said. "It’s really about making sure that we’re getting nurses interested in... the critical care education program, and making sure we’re anticipating vacancies in the area."

The nurse vacancy rate in the WRHA’s two cardiac critical care units (St. Boniface and Health Sciences Centre) is currently 22 per cent, which works out to 17 empty positions among the baseline cohort of 79 nurses.

The most recent class of the Winnipeg Critical Care Nursing Education Program graduated 33 nurses last week. According to the WRHA, all 33 accepted positions in the field, 12 of them at the St. Boniface cardiac program. Class sizes vary for the six-month course, which is offered twice a year to nurses who have at least one year of acute nursing experience.

Cloutier acknowledged there is difficulty trying to fill the nurse vacancies in critical care, since "you just don’t necessarily recruit a nurse in this area overnight."

In an emailed statement, Manitoba Health Minister Cameron Friesen noted the new critical care grads will join six nurses hired in the same area this year.

While the elective cardiac surgery wait list numbers are "higher than we’d like to see," Friesen said, he pointed out the average number of people waiting has been lower over the past 12 months than it was during the NDP’s final year in government. (The Tories were elected in 2016.)

He also attempted to highlight the virtues of reorganizing the health-care system to quell staff shortages.

"While the current vacancy rate within the WRHA’s two critical care units are within normal ranges, the situation validates the need to reorganize and simplify what experts have called an overly complex health system," he said.

"Consolidating services and developing a provincewide clinical and preventive services plan will allow the system to better manage normal fluctuations in demand and capacity, improving the care patients receive."

Cloutier said the WRHA’s clinical executive team is working with staff at St. Boniface to identify "the root causes" of the cardiac program’s problems, beyond a nursing shortage.

MNU president Darlene Jackson said members have been pointing to a lack of ICU beds in the health-care system as a contributing factor causing elective surgery cancellations, something Cloutier disagreed with.

'The beds are there. It’s having the nursing staff to look after the patients.' — Réal Cloutier

"That’s certainly not what we’re hearing from nurses. That’s who I get my information from," Jackson countered.

She also pointed to issues with acuity, where cardiac patients are staying sick and requiring longer stays in ICUs, as a problem.

The union leader said nurses are working increasing amounts of overtime — both elective and mandated by their bosses — to cope with increased patient volumes and a "chronic shortage" of staff.

The WRHA is planning to close the emergency departments at Concordia Hospital in June, and at Seven Oaks General Hospital in September, converting the latter facility into an urgent care centre.

Manitoba NDP Leader Wab Kinew has echoed a common sentiment about wanting to see the emergency rooms stay open. He said the cardiac program’s surgery backlog is a symptom of a system-wide problem.

"This is not happening by accident. This is a direct result of (Premier Brian) Pallister’s rushed changes to the health-care system," Kinew said.

jessica.botelho@freepress.mb.ca

Twitter: @_jessbu