24-hour shifts, staffing issues plague pediatric ICU at Janeway Hospital

There have been six 24-hour shifts at Newfoundland and Labrador's pediatric intensive care unit in the past month, the same unit which has been under diversion to Halifax since last weekend, according to Eastern Health.

The diversion protocol is the latest in a string of issues that have been going on for years in the PICU, says Yvette Coffey, president of the Registered Nurses' Union of Newfoundland and Labrador.

In an interview with CBC News, Coffey said the 24-hour shifts should never have happened.

"When you are working a 24-hour shift, your head is not in the game as it would be if you were working your regular shifts of eight hours or 12 hours," she said.

"When our members are tired, when they're mentally exhausted, that equates to risks for the patients and risks for our members." 

In a statement Thursday, an Eastern Health spokesperson said the diversion protocol was still in place. The spokesperson said the PICU has four beds occupied and a core staff of 16.6 full-time positions.

According to Eastern Health, the unit can accommodate two extra patients if required, but Coffey said it's a challenge to care for more than two patients at a time given current staffing levels. 

"Our members are being mandated to stay extra long at their workplaces and being mandated to do overtime and extra shifts here, irregardless of their own home life situation," Coffey said

Speaking with reporters Thursday, Health Minister John Haggie said the diversion protocol is reviewed at least once daily, and no patients have been diverted to Halifax yet. 

"As soon as the occupancy drops to what the clinicians decide is at an appropriate level to match the resources than the capacity they've got, then they'll lift it," he said.

Haggie said the department would like to avoid 24-hour shifts if possible, but he's grateful to those who have worked them.

He said Eastern Health is currently training new staff for the PICU, although he doesn't know when the staff will be ready.

Staffing the PICU can be more difficult because it requires staff with specialized skill sets in critical and pediatric care.

Coffey said a committee was established in 2019 to look at staffing levels in the unit and possibly establish a "float team" of specialized nursing staff, but the team didn't come to fruition.