Calgary doctors pushing back on provincial government's response to NICU crisis

What are your specific concerns with Calgary’s NICU’s right now? So right now the ongoing concern is a lack of staffed beds in our NICU’s. We have 5 NICU’s, but some of them are Level 3 and four NICU’s which are the highest level intensity. And we only have 55 beds for a very large population which serves not just Calgary, but all of southern Alberta. So all the smaller centers and the rural centers, we don’t have enough beds and we haven’t had enough beds for quite a while. The last time we got a large increase in beds was in 2012. But however, we also don’t have enough people to staff the beds. To be able to run these beds, you need nurses and you need bedside physicians to be able to care for the patients. And we are really deficient in staffing. And so sometimes we have empty beds and we can’t fill them with patients because we don’t have any staff to take care of them. So we have been trying to get more staffing for several years now and the premier says if more staffing is needed, that will happen. OK. So Doctor Howlett, how often are babies being moved around to different hospitals because of these capacity issues? We move babies. On average, there’s two babies every day that are moved to capacity issues because that’s how we keep our Level 3 beds open. Level 3 beds are for the sickest kids, and if a baby is born and is very sick, then they need to bed immediately. So we are constantly moving kids out of the Level 3 NICU to make sure that there are beds immediately available. And so it’s two kids a day on average. It can be more obviously. So what is your reaction to what the premier say it saying that there are beds available, saying that they will add staffing and that these are the issues, why they’re restructuring Alberta Health Services? What are your thoughts on her response? I guess my, my first thought is in terms of there are beds available. Well, I’m not sure if it’s clear if these beds are staffed and also if we need Level 3 beds and we have Level 2 beds available, that’s not going to work. Level 3 beds are very different from Level 2 beds. So you can’t assume that all beds are equivalent. So I would really be interested in a bit of a conversation around that in terms of providing us with more staffing. We had two temporary bedside position positions that were taken away from us just at the end of March. So we need many more positions than that to be able to adequately staff her unit. So I would certainly welcome more positions for sure. And you have mentioned there are different levels of care for different NICU’s. Can you explain how that is also impacting the situation? Yeah, so Level 3 and level 4 and ICU’s are units where the sickest and the tiniest babies go. This is where babies can be put on a ventilator which we commonly call being put on life support. Lot of IV infusions, medications often one to one nursing level 2 beds are for babies that are convalescing or are the larger Prems. We don’t do invasive ventilation, but we do do respiratory support. So they provide very different levels of care and what we really don’t want is we don’t want a Level 3 micro premia being born at a level 2 and then being transferred because when you transfer babies they don’t do as well. There’s a lot of research around that, that babies that have been moved to have worse outcomes, that babies that stay in the center where they’re born. So we want babies to be born in the center where they’re going to be cared for, especially the really tiny ones. All right, So Alberta’s Minister of Health, Adriana LaGrange, also says she’s willing to consider airlifting babies to other provinces if necessary. What do you make of that prospect of transporting these infants? Well, apart from the fact that it would not be safe for the babies and it would be very upsetting for the families to be separated from their babies, that is a tremendous cost because you need an entire specially trained transport team, specially equipped incubator to move these kids. And I know that there are crunches in staffing and bed numbers across Canada, so I’m not totally sure where we would send these kids. I think it would make more sense to bring the resources to the babies rather than shipping out critically I’ll patients to the resources.