VGH technician shortage threatens to derail urgent heart surgeries

Vancouver Sun

By ManoriRavindran, Vancouver Sun  August 14, 2012

Since July 24,three non-elective heart surgeries at Vancouver General Hospital have had to bepostponed due to a shortage of heart-lung machine technicians, orperfusionists. The in-patients, all with potentially life-threateningconditions, required urgent surgeries, but their operations had to berescheduled because the only perfusionist available was called in for a doublelung transplant that required 24-hour monitoring.

The operations,which were completed late last week, are the second group of surgeriespostponed in the last month. Four operations were cancelled in late July afterone of the specialized technicians was injured.

Rob Chalus, aperfusionist at VGH, said the hospital is so understaffed with technicians thathis colleagues worry about the fate of their patients if more arent hired.

-People aroundhere are like, Whats it going to take? People are going to die becausetheres no perfusionist, and because of delays," he said. -Right now, theweakest links in the chain are perfusionists."

The techniciansare specialized health care professionals who use heart-lung machines to managethe physiological and metabolic needs of patients while surgeons operate onhearts that are not beating. Heart surgeries require the efforts of aperfusionist, anesthetist and cardiac surgeon without all three, theoperation cant be completed.

Chalus, 40, whohas more than 11 years experience and has worked in Newfoundland, Alberta,Ontario and Saskatchewan said B.C. hospitals are the most understaffed.

-Were at acritical low," said Chalus, who has worked at VGH for two years. -[Lastweekend] I had one colleague who worked 35 hours, and another who worked 37hours ... Were working away and it seems like theres no end in sight."

Miriam Sobrino,union spokeswoman for the Health Sciences Association of B.C. pointed out thatat -optimal staffing levels" there would be 50 perfusionists across B.C. Only39 are currently available.

Sobrino, whoseunion represents 16,000 health professionals across the province, said heartpatients can expect more delays in surgeries unless the government activelyrecruits more of the specialized technicians.

VGH has eightfull-time perfusionists on staff, in addition to one part-time, and anothercasual technician. Trudi Beutel, a spokeswoman for the Vancouver Coastal HealthAuthority, said the hospital has enough employees to regularly schedule a fullslate of surgeries, but it recognizes more are needed.

-All I can sayis that wed like more, we dont have them, were hoping to get more in thefuture," she said.

Beutel addedthat if an urgent operation is cancelled, VGH will go -on diversion," meaningit will send a patient to another hospital for surgery a tactic that can haveserious repercussions, said Chalus.

The VGHperfusionist said during the August long weekend, Lower Mainland hospitals wereso understaffed that cardiac centres could not perform any emergency heartsurgeries due to lack of heart-lung machine technicians.

-If you neededemergency heart surgery, you needed to go to Victoria," he said. Chalus addedthat the government needs to do more to recruit and retain specialized healthcare professionals.

Ryan Jabs, aspokesman for the Ministry of Health, said that in the mid- to late-2000s, theprovince identified perfusionists as an -area of need." In 2011, it opened atwo-year perfusion training program at the B.C. Institute of Technology, butthe program, which takes seven candidates at a time, will only contribute a fractionof the perfusionists needed.

The HealthSciences Associations Sobrino said two of the candidates set to graduate fromthe program this November are already interviewing for positions in Alberta.

-When they comeout of training, they can potentially earn $11 more per hour [in Alberta], andpay less for rent," said Sobrino. -They have a lot more options because theyreyounger and much more mobile."

For now, Chalussaid the status quo cannot continue at hospitals like VGH, for the sake ofperfusionists and their patients.

-Im not hereto blame anyone," he said. -Im just disappointed that sometimes things aremade to look like theyre not as bad. Because the problem is only getting worseby the week."