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LETTER: Former Guelph General nurse speak out against unit merger

Lack of RNs, not enough training some issues brought up by concerned nurse
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GuelphToday received the following Letter to the Editor from local Registered Nurse Nancy Wright, who expresses her concerns with Guelph General Hospital's decision to merge the Pediatrics and Special Care units: 

I am a Registered Nurse (RN) who retired early because of the decision by Guelph General Hospital (GGH) management to merge the Pediatrics and Special Care Nursery.

I worked at GGH for 19 years in the Special Care Nursery. I know that infants are in this unit because they suffer from serious complications with their health at the time of birth, frequently requiring resuscitation and stabilization of critical illnesses.

Many of these vulnerable infants experience severe breathing problems, heart issues, serious abdominal and feeding issues. In your news report, GGH Chief Nursing Executive Melissa Skinner says that RNs “volunteered to learn about the duties provided in specialized care.”

This is not accurate.

Cross-training for nurses was never offered on a voluntary basis. To continue to remain employed at GGH, RNs were required to obtain the knowledge and skills to provide care on the other unit. On the Special Care Nursery, nurses were offered six weeks of training; on the Pediatrics Unit, nurses were offered four weeks’ of orientation, in-class, and bedside training. RNs were not offered a customized training plan to meet our individual needs. We were told after our training, we would be assigned to work in the other area. There was no phased-in integration approach spanning two to three years.

Having spent most of my career specializing in the care of critically ill infants with highly complex needs, I know it takes years of training, continuing education, and hands-on practice to become competent in specialty skills, such as: resuscitation, intubation assistance, appropriate medication dosing, high-risk infusions, seizures, and high-risk deliveries. I had worked in Pediatrics, but that was 19 years ago. I knew that the training provided by the hospital would not make me competent to meet the care needs of children and adults on Pediatrics. The range of patients and differences between babies in the Special Care Nursery and children and adults in Pediatrics is too broad and could affect my ability to practice safely.

Being forced to work in another discipline would make it difficult to assimilate a new nursing specialty. Potential skill and competency issues could lead to negative patient outcomes, creating a risk to children or adults. I was not prepared to risk losing my nursing license and livelihood because management decided to merge the units rather than increasing the number of RNs on each shift in Special Care Nursery, from two to three, which is the root cause of the staffing problem.

There are not enough RNs to meet the complex care needs of the babies admitted to the unit. Care needs fluctuate and their medical condition can change quickly. RNs are called to attend to emergency deliveries, leaving the unit with one RN. Management’s “just-in-time staffing model” will require nurses to move between two geographically separate areas to provide supports when needed. This means that nurses will be forced to leave their area with only one nurse, if required, to support the other area. Again, this puts babies, children, and adults at risk.

I am particularly concerned about the cross-contamination of critically ill babies with children infected with Respiratory Syncytial Virus. The risk of infection is high when nurses are required to work across both units to meet emerging staffing needs.

This end result is that this merger negatively impacts care for highly acute babies, patients, children, adults, and their families in the Guelph community.

Nancy Wright RN