Mothers and their newborns are in danger because of a persistent staff shortage at the obstetrics department of the Pontaic Hospital in Shawville, Que., according to a nurse who works there.
"The life of the mother and her child are in our hands. If a baby died on my shift because we don't have enough staff? I could never stop thinking about it," the nurse said. "We've become depressed, anxious — we cry when we get to work. It's not good at all. It's too much pressure."
CBC/Radio-Canada has agreed to call the woman Martine because she's one of only five nurses in the department, and fears losing her job for speaking out.
Martine said she's sounding the alarm to protect both her colleagues, and the pregnant women and newborns they care for.
For the seventh time this fall, the Centre integré de santé et services sociaux de l'Outaouais (CISSSO) has announced it's closing the Pontiac Hospital's birthing unit, this time from 12:01 a.m. Monday until 8 p.m. Tuesday. Patients are being advised to go to the Gatineau Hospital during that time.
Health authority says unit is safe
Marie-Ève Cloutier, director of nursing services for the CISSSO, said she understands the concerns of nurses, but reassured mothers they should feel safe giving birth in Shawville — when the unit is open.
"I'd like to underline that it is safe for future mothers in Pontaic," Cloutier said. "Their safety is important for the CISSS de l'Outaouais,"
Cloutier said when when health officials believe the current staff shortage has made the situation too precarious, they close the unit temporarily and redirect people to the Gatineau Hospital, or to Pembroke, Ont.
There are currently only five specialized nurses working at the birthing unit. CISSSO has said there should be 12 for the unit to provide full and safe service. Meanwhile, two of hospital's five doctors who perform deliveries chose to leave at the end of December.
The five nurses trained in obstetrics at the Pontiac Hospital worked a total of 582 overtime hours in August and September, on top of their regular shifts.
'Sometimes I'm alone'
Martine said it's hardest during overnight shifts.
"The on-call obstetrician could be far, in l'Île-du-Grand-Calumet or Aylmer," she said. "If something isn't going well with the mother, like a post-partum hemorrhage or a respiratory problem with the baby, sometimes I'm alone."
The Pontiac representative for the Syndicat des professionelles en soins de l'Outaouais (SPSO), the union representing health-care professionals in western Quebec, said on-call staff should be no farther than 30 minutes away, and even that may be too far in certain situations.
Suzanne Mousseau said emergency room staff may not have obstetrics training.
"The other nurses have not necessarily been trained to help a baby in distress. If the emergency doctor can't step in, there could be a problem," she said.
CISSSO said emergency doctors are qualified to deliver babies if a mother needs help.
"A birth can happen in any emergency room. If a woman is having a complications in labour, an emergency doctor will attend the birth," Cloutier said.
Martine is urging CISSSO to consider a six-month closure at the Shawville birthing unit to address the staffing problem.
"We told management, 'Do you want to keep the unit open, to the point of putting your patients' lives at risk?' But they aren't listening to us," she said. "Get us out of this or help us. Do something."
The CISSSO said managers are working with the nurses toward a solution.
"The management is in Shawville every day, they work alongside their teams, they collaborate," Cloutier said. "We're doing everything we can to support right now and maintain services for the population."
The union doesn't believe a shutdown is the answer, and could give the province an excuse to close the unit permanently, reducing service to patients in the region.