The president of Newfoundland and Labrador's union of registered nurses says low staffing, rather than a lack of beds, is the primary reason why the Janeway pediatric intensive care unit in St. John's was placed on diversion to a Halifax hospital at least three times this fall.
Yvette Coffey says a recent meeting between the Registered Nurses' Union of Newfoundland and Labrador and Eastern Health senior leadership set wheels in motion, but was light on long-term solutions to staffing problems for the unit, which serves the province's critically ill children.
"The whole crux of the matter is staffing," she told CBC News. "We can have a physical bed space, but if you don't have the registered nurses to staff those beds and to care for the patients, it's no good having a bed."
Coffey said the union decided to request a meeting with Eastern Health senior leadership to work together to come up with solutions to staffing problems in the unit.
"The well-being of our members is one thing, but who wants a registered nurse working 20, 16, 24 hours looking after a very sick pediatric patient?" she said.
In a statement to CBC News, a spokesperson for Eastern Health said four staff members with previous PICU experience have been redeployed to the unit this fall, but Coffey said those nurses still have to deal with a workload in their other unit.
She said the unit has resorted to using Janeway recovery room nurses to care for stable PICU patients.
Coffey said staff in the unit were on mandatory standby for eight- and 12-hour shifts until this week. During her meeting with Eastern Health, she said, senior leadership promised there would be no mandatory standby or overtime over the holidays, though both will start up again in January.
The spokesperson said a floater team of specialized nursing staff was created in 2019 to alleviate pressure on the PICU. Coffey said the team was established with at least four positions, but it isn't currently active.
"The people who successfully, you know, were awarded those positions are still not released to work in the pediatric ICU," she said.
During the meeting last Tuesday with Eastern Health leadership, she said, the union pushed for those staff members to be released to go to the PICU. According to Coffey, Eastern Health is discussing the release of those staff members but has not provided a timeline.
CBC News has requested an interview with Eastern Health about the PICU.
Staffing is the issue, not bed capacity: Coffey
Coffey said the union is also pushing for a set protocol for when patients are diverted to Halifax. She said diversion is based on the acuity of the patient, nursing resources, and the number of current patients.
"It isn't just about the number of beds," she said.
Eastern Health says the unit has capacity for four beds with a surge capacity of six beds. Coffey said, with current staffing, it can be challenging to maintain capacity for just two patients.
According to Coffey, caring for pediatric patients requires more checks and balances than caring for adult patients. She said each patient requires two nurses and each procedure requires at least four.
A patient from Newfoundland and Labrador was diverted to the IWK hospital at some point this fall. Eastern Health will not say when the patient was diverted or if they have since returned, citing privacy concerns.
Coffey said the union has committed to another meeting with the health authority in January to come up with more long-term solutions.
"We are open to meeting with the employer on a regular basis and continuing to put pressure on them that we have to have protocols in place," Coffey said.