Jade Arignon was overwhelmed by emotions Wednesday night as her eight-week-old daughter was hooked up to a breathing tube and loaded into an ambulance by a small army of emergency care workers and, she says, it didn't have to be that way.
“There were a lot of resources deployed for something that shouldn’t have been happening, is what it felt like,” the Kelowna mother said Thursday, reflecting on the hospital visit that brought her to tears.
“I’m usually pretty calm in these situations but at that point, I started to feel distress.”
Earlier that night Arignon had gone to Kelowna General Hospital. It was the second time in as many weeks her baby had to be checked for a viral infection that was causing respiratory distress.
When she needed the extra medical care two weeks earlier, the 10-bed pediatrics unit at Kelowna General Hospital was still open.
That unit closed this week due to an ongoing pediatrician shortage and Wednesday night’s admission for observation meant a transfer was in order, though where remained an unknown.
Arignon was given a choice between two other Okanagan hospitals and once she decided, that transfer from Kelowna General Hospital to Penticton Regional Hospital was put into motion, adding more strain to an already difficult situation.
"The entire ordeal has caused immense and unnecessary stress not only for me, but more importantly, for my infant daughter," she said.
"A middle-of-the-night ambulance transfer that could have been avoided was deeply traumatic and introduced additional risk neither of us wanted."
The mother of two said that every medical professional she’s dealt with has offered exemplary care but the strain she felt and witnessed around her in those fraught hours while the transfer was arranged and executed is something she wants more people to understand.
“I could tell from the look on the people's faces in the hospital around me as it happened, there was a mix of deep, deep empathy and anger,” she said about the experience of being transferred from the Kelowna hospital.
“Everybody I spoke to was feeling bad for us that we were in this situation and they were totally helpless.”
It was 1 a.m. when she finally checked into Penticton Regional Hospital and a whole crew of people were waiting to take her into a pediatric unit that looked very similar to its counterpart in Kelowna. The difference, she’s been told, is the level of stress on the men and women who work there.
“The physician I spoke to (Thursday) morning, who's a pediatrician based out of Penticton, said that she used to work in Kelowna and she left nine years ago because she was (concerned about) the volume of patients and what was being asked of pediatricians,” Arignon said.
“She said it was unsustainable 10 years ago.”
Now it’s gone too far with Kelowna General Hospital only having six of 12 pediatrician positions filled. The health authority has said it's part of an ongoing national shortage.
Doctor calls for support
A Kelowna emergency room doctor offered a different perspective recently.
Dr. Hannah Duyvewaardt, an emergency room physician at Kelowna General Hospital, said Monday pediatrician services have been stretched thin for an extended period of time. She said one pediatrician is responsible for covering pediatric psychiatric patients under the age of 11, every sick child that comes into the emergency department that needs consultation or admission and the entire neonatal intensive care unit.
Duyvewaardt said they're also responsible for being at every C-section and every delivery that could require support for babies.
“So for years, (pediatricians) have advocated, saying this is a unsafe work environment for patients —we need one doctor on for our neonatal unit and one for deliveries and the other one for the emergency department and pediatric care," Duyvewaardt said. "And their voices have been silenced.”
Duyvewaardt said the ensuing doctor shortage is because these specialists are worried about putting patients, as well as their own moral and professional integrity, at risk.
This view is something that Arignon said she can see as someone who recently gave birth, and has utilized pediatric services twice since.
The doctors and nurses she’s witnessed are stretching themselves thin, she said.
“It is absolutely unacceptable that a growing city the size of Kelowna is without a functioning pediatric unit for up to six weeks,” Arignon said.
From a patient perspective, there are also logistical issues that go beyond the stress of the move. She said she's lucky to have family support, so her other child is able to maintain a routine while her baby sister gets the help she needs.
If she didn't, she said she's not sure how she'd even get home once she's released from care. Her car is at Kelowna General Hospital, parked where she left it when she went to the emergency room.
"Now I'm an hour away from all of the people I love, all of the people who support me, my husband, my other child, anyone who could bring me a coffee or a sandwich," she said.
"So I'm frustrated for myself and I'm just frustrated for this incredible staff who's been trying to advocate for themselves for a long time ... it sucks that it came to this."
Interior Health responds
Since the KGH Pediatric Unit service disruption began on May 26, one patient has required transfer to Penticton Regional Hospital, Interior Health confirmed.
"These are always difficult decisions, with patient safety being the utmost priority," the health authority said in a statement.
"While we cannot speak to specific cases due to patient and family privacy, we can tell you staff have reached out to this family to discuss their experience and support any outstanding needs they may have."
Health authority social work teams are available to support families with the logistics of transferring with a child. To further support families in these situations, it's also offering a hardship policy that helps any related costs including transportation.
"Interior Health appreciates the concerns raised by the Kelowna General Hospital physicians," the statement continued.
"We are actively meeting with the medical leadership to identify further ways to support them in providing care to pediatric patients who come to the hospital. It is important to stress that pediatricians remain available to support all patients who present to the emergency department, including ongoing care and consultation for patients who may require transportation to an alternate facility."
New doctor signed on
Interior Health said it continues to work with community partners and local physicians to recruit additional pediatricians to Kelowna – this includes recruiting through national and international channels.
"There is one new pediatrician starting this summer," officials said.
"Two new pediatricians have accepted offers to work, with the first starting in July. Also, one from the US who is interested will be visiting the site this weekend."
When Interior Health announced the closure last week, they said that the pediatric group at Kelowna General Hospital was more than 60 per cent short staffed.
Dr. Hussam Azzam, executive medical director in community and maternity care, explained in an interview last week that closing the 10-unit pediatric unit was a necessity to “maintain safe, appropriate care for the population, but also to protect the remaining pediatric physicians.”
Burnout, he said, is an ongoing risk for doctors who have been “over-committed” and working longer hours for months to fill gaps.
Currently the hospital has funding for 12 pediatric physicians, though it only has six. They run the 10-unit general pediatric unit and the 14-bed neonatal intensive care unit.
“We were relying on locums coming from within Interior Health, within the province, and even from outside, from Alberta, Saskatchewan, to help us,” he said.
“We do have, with the support of the Ministry of Health, a very reasonable, generous remuneration package for locums. However, it's just become unsustainable to do that for the long term, particularly in May, June and early July.”
There are more than 100 pediatrics shifts in that time period that are uncovered, which prompted the decision to close the unit.
With its temporary shutdown, the limited pool of pediatricians was reassigned to support the neonatal intensive care unit and high-risk deliveries.
Azzam said critical care services for children, including the emergency department and NICU, will remain open.
Despite the closure, Azzam said care levels will be upheld.
“For the general public, nothing should change,” Azzam said.
“They should go directly to KGH emergency, as they do currently, and they will be assessed by the emergency physician appropriately.”
If more longer-duration care is needed, a transfer to another hospital within Interior Health or outside its boundaries will be made. Supports, he said, should be available for families of these children. What that looks like was not specified.
