Dr. Jeff Eppler, an emergency room physician at Kelowna General Hospital, is getting ready for a hectic summer. He’s not only thinking about the typical seasonal spike – but the ripple effects of the closing of the hospital’s dedicated pediatric ward from May 26 to July 4 due to what Interior Health called “limited physician availability.”

“It’s very difficult, but then you throw this pediatric service disruption in … [it’s] just going make our life a lot more difficult, especially as we go into the summer, as things become much busier,” he said. Eppler said ER staff would have to treat some children who would typically be directed onward to pediatrics.

“We can provide safe and effective acute care, but rely on our pediatric colleagues for their support and far deeper knowledge, as well as for providing ongoing care. We cannot be de facto pediatricians as a long-term solution to this current crisis,” he said.

And Eppler predicted the resource drain would extend outside the hospital, to ambulance services, as Kelowna General is forced to send other children to other hospitals, in Vernon, Penticton, or potentially even the Kootenays more than 300 kilometres away. Typically, it’s the other way around.

“So it’s kind of reverse of what we normally do,” Eppler said. “That certainly ties up ambulances, resources, and it’s not great for families or kids, who have a one-to-four hour drive to the other centre.”

The closing of Kelowna’s pediatric ward is part of continuing hospital staffing shortages that have caused rolling closings of emergency rooms across the province. Service disruptions at the pediatric ward and concerns about the state of care at Kelowna General are also not new.

But the abrupt nature of the pediatric closing last week, and a recent warning from doctors about maternity care is putting one of the province’s biggest regional hospitals in the spotlight. Nine doctors working in the department of obstetrics and gynecology released a statement last month warning about a “growing crisis” in maternity care putting the “safety of patients and newborns” at “serious risk” unless officials take immediate actions.

They said primary maternity care at the hospital was “facing a collapse” as early as June 1 because of a “critical shortage” of family physicians willing or able to provide such care. “This means that many pregnant patients may arrive at the hospital in labour with no doctor available to provide safe, continuous care during delivery.”

Then came the closing of the pediatric ward last week. It should have 12 full-time pediatricians, Interior Health said, but when it closed, staffing was put at five and a half doctors. Susan Brown, president and chief executive officer of Interior Health, said the ward was closed to “preserve the higher level of care” offered by the pediatricians, who will be redeployed.

“So that would be on our neonatal intensive-care unit and some other work at the site,” she said. “So we’ve done that to ensure safe patient care, but also thinking about the wellness and retention of the medical staff who continue to go above and beyond.”

The hospital with 497 beds received 95,022 emergency room visits in 2023-24, according to Interior Health. It not only serves Greater Kelowna with an estimated population of 235,000, but is also one of two “tertiary referral hospitals” providing specialized and complex care to a larger region that is home to almost 900,000 people.

Adriane Gear, president of the BC Nurses’ Union, said nurses at Kelowna General are now responsible for managing acutely ill pediatric patients in an “already strained emergency department setting” not designed for ongoing pediatric in-patient care.

“This compromises safety, delays treatment, and can increase the risk of poor outcomes,” she said in a letter shared by the union. “Nurses entered this profession to deliver safe, high quality care – not to be forced into situations that put their patients at risk.”

Eppler meanwhile predicted the pediatric ward closing would worsen ER wait times. “We definitely provide good quality care, but it’s becoming increasingly challenging, even before this disruption in pediatric services,” he said.

“We have been coping really for years, and we have been sounding the alarm for a long time, like a broken record.”

Eppler said overcrowding “is really contributing to moral injury and burnout” among physicians and nursing staff. A report from the Montreal Economic Institute released this month said that the median length of a stay in Kelowna General’s emergency room was three hours and 24 minutes, lower than the provincial figure of four hours, 13 minutes.

Eppler said about 10 per cent of ER admissions involve children. “On some days, none of those pediatric patients, once they’re seen, will need to go in the hospital,” he says. “But some days, we might admit three or four of them.”

Eppler said Wednesday that seven transfers of pediatric patients from Kelowna General to other hospitals had taken place since the ward closure, a figure confirmed by Interior Health. “But I know those numbers are gonna go up there,” he said. “So you are gonna see sick children that are going to need admission, and we are going have to transport these patients, if there are beds available at other centres.”

Source: The Globe and Mail.