Royal Vic closes two more ORs
Wait times expected to increase as hospital deals with nurse shortage
Wait times for surgery at the Royal Victoria Hospital — already among the longest in Montreal — are expected to grow even longer as the hospital closes two more operating rooms because of an acute shortage of nurses, the Montreal Gazette has learned.
In an internal memo sent Wednesday evening, the interim executive director of the McGill University Health Centre warned of the logistical hardships now facing the Royal Vic, and expressed concern about the impact of potential delays on the health of surgical patients.
“A challenge upon us currently is related to the adult operating room (OR) team at the Glen site,” Martine Alfonso said.
“At the moment, we are experiencing a shortage of operating room nurses, which is due primarily to a high number of absences, for reasons such as new pregnancies. In the case of pregnancies, a nurse is required to stop working immediately because the OR environment is considered potentially hazardous to fetal health.”
In addition to preventive maternity leaves, the MUHC is grappling with a high number of sick leaves among nurses, many of whom are suffering from burnout.
The rising absenteeism is occurring as the MUHC — which oversees the Royal Vic — continues to cut tens of millions of dollars from its operating budget under orders from the Quebec Health Department.
When the Royal Vic moved to the Glen site in April 2015, the new facilities boasted 13 state-of-the-art operating rooms.
Because of budget cuts, that number was reduced to 10 and will now be decreased to eight until the end of the year as a direct result of the nursing shortage.
Alfonso explained “the OR schedule had to be reorganized to offer optimal access and maximal safety to our surgical patients. To best achieve this goal, it was decided to temporarily reduce activity in two operating rooms at the Glen site while the other eight will remain fully open.”
The MUHC has launched a recruitment drive for OR nurses to fill at least 10 positions. However, it will take months to recruit and train them.
In the meantime, the MUHC has decided to use up its reserve of unassigned OR time — known as “flex time” and intended only for urgent situations — to “minimize the effect of the situation on patients who have already been scheduled for surgery.”
“This comprehensive plan,” Alfonso added, “will ensure that patients continue to be seen in a timely manner while we work at the reopening of the two operating rooms again by the end of the year.”
The Gazette reported last week that more cancer patients are waiting considerably longer for surgery at the MUHC than at other hospitals in Montreal, according to the latest provincial government statistics.
The Health Department’s own access targets stipulate that 90 per cent of cancer patients who are medically ready for an operation should undergo the surgery within 28 days and 100 per cent should have it done within 56 days.
Yet 13 per cent of Montreal cancer patients on wait lists were on standby for at least 57 days at the end of May, the most recent period available.
Worse, the rates for all five MUHC hospitals were higher than the Montreal rate: 17 per cent at the Royal Vic, 22 per cent at the Montreal General, 33 per cent at Lachine, 60 per cent at the Montreal Children’s and 67 per cent at the Montreal Neurological.
In November, Health Minister Gaétan Barrette announced the government was investing an extra $20 million to reduce surgical backlogs. Under his plan, the government funded the reopening of three ORs at the Jewish General, three at the CHUM and 2.5 at the MUHC.
In February 2016, the MUHC’s surgeon-in-chief alerted OR staff in a letter that because of budget cuts he was left with no choice but to postpone and cancel elective surgeries.
“From the perspective of the surgical mission we have calculated that … we will have a reduction of approximately 1,000 to 1,500 scheduled cases per year,” Gerald Fried wrote in the letter.