Two hospitals will perpetuate inferior level of patient care

Dear editor,

I can no longer remain quiet about the subject of the new hospital(s).

Dear editor,

I can no longer remain quiet about the subject of the new hospital(s).

I fully agree with everything that Barbara Mellin, RN, and Jerry Simice, MD, have written in their many eloquent letters to the local papers over the years. Both people are highly respected in the medical community.

I believe that the decision by VIHA to cave in to the demands from the vocal minority for political reasons is fundamentally wrong, and results in short-term gain for long-term pain.

Most of the people in favor of a regional hospital are health care workers, with many years of experience within the hospital system.

Not only is the proposed site next to the college too small, it will be difficult to access once this whole area is fully developed. We also need a new regional hospital that is easily accessible to the residents from up Island, and is located north of the river.

The duplication of services that exists at present, and will continue to exist with two local hospitals for the North Island, is an issue that people need to be aware of.

Every evening, night and weekend we have health care workers in-house or on-call to provide emergency services: OR, recovery room, lab and X-ray to name a few. None of these services are consistently busy enough in each local hospital to have these workers in-house during nights and weekends.

In the areas mentioned, the nurses that work on evenings are on-call for the night that follows, as well as the entire weekend. This results in sleep deprivation and exhaustion on nights and weekends that are busy.

Not only does this system affect the quality of life for these workers, and is detrimental to patient care, but is also very costly for the health care system. When on-call but not called in, workers get paid far less than minimum wage for being available, but when called in, even for a short case, they get paid a minimum of two hours in overtime pay.

In a regional hospital, we would have three in-house shifts of eight hours, which would be justified by the much larger number of patients we would now be looking after than St. Joseph’s and CR are each seeing now.

Another situation that continues to worry me is that some patients wait far too long for their emergency surgery.

Currently, neither St. Joseph’s nor Campbell River has enough general or orthopedic surgeons to cover call for their local hospital every day. Instead, the call is shared between the two hospitals.
I will explain my concerns by giving you two not-uncommon scenarios:
1. A healthy young man presents to ER at St. Joseph’s with vague abdominal pains. He does not look unwell, and ER is busy with several patients that are much sicker than he is. His assessment is finally completed four hours later, and the diagnosis is made of acute appendicitis. It is now evening, and the surgeon on call is from Campbell River.

The ambulance is out on another call, and takes three hours to pick up the patient for transfer to CR. When he arrives at ER in CR, the man is assessed again.

By now, he is definitely unwell, and by the time he gets to the OR the appendix has perforated. He now faces a long stormy recovery, perhaps in ICU, and a lifelong risk of bowel obstruction due to adhesions.

2. A frail 80-year-old woman living in Campbell River trips and breaks a hip on a Saturday afternoon. She can’t get up, so an ambulance is called and takes her to ER in CR.

She has many medical issues so she needs to be seen by the internist and the anesthesiologist on call. It takes until Sunday that she is deemed as fit as possible for surgery to fix her broken hip.

However, the Comox surgeon is on call for orthopedics, so the patient is transferred by ambulance to St. Joe’s. The OR staff is very busy with other surgeries, including a few Caesarean sections.

By the time that the OR is ready for this elderly woman’s surgery, the staff is exhausted. It is now 2 a.m. early Monday, and since the patient’s hip fracture is neither “life or limb” threatening at this time, it is decided to postpone the surgery until the day staff arrives. The patient’s broken hip is operated on at 3 p.m., after the elective slate is finished.

It is now 48 hours since she broke her hip. The delay of surgery increases her risk of post-operative complications, including blood clots to her legs and lungs. 
The examples above are based on true situations, and serve as examples how duplication of services over two hospitals is unsafe for patient care, and very costly to the taxpayer.

Please let us reconsider the option to have one regional hospital, serving the whole North Island, and somewhere close to the Inland Highway.

CR and Comox are connected by two good highways, two airports, and by water. The vast majority of people live fewer than 45 minutes by car to anywhere in the region, which is far less time than most people in the big cities live from their hospital.

I urge my health-care colleagues to stand up with me and demand to be heard. Let us be the vocal minority.

Louise Jackson, MD FRCPC

Editor’s note: Louise Jackson is a semi-retired anesthesiologist working in the Comox Valley.

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