Eastern Health CEO defends monitors

While Eastern Health CE0 Vickie Kaminski defended a new system of patient monitors Tuesday by attributing much of the problem to nurses’ resistance to change, their union head said nurses feel their worries have fallen on deaf ears for a long time.

“At the end of the day, nurses want safe patient care. … They have been documenting issues related to the monitors for almost a year now and have been very, very frustrated at times at the lack of response on behalf of the employer,” Newfoundland and Labrador Nurses’ Union president Debbie Forward told The Telegram.

She said as recent as a meeting between Health Sciences critical care nurses and Eastern Health two weeks ago, the nurses were not satisfied.

“To me that speaks volumes.”

Kaminski said the Health Sciences Centre nurses didn’t want to change the brand of monitors, which track vital signs.

“Change is always hard. I don’t know how else to describe it,” she told reporters at a news conference, insisting she’s not trying to minimize the nurses’ concerns.

“Whenever you have a new installation, you work out the bugs. These were not big bugs.”

Tuesday, The Telegram reported on a document presented in November by critical care nurses at the Health Sciences Centre who are concerned about the new monitors in the intensive care, cardiovascular intensive care and critical care units.

The report listed a litany of worries about patient safety and nurses said their standards of care are being breached, placing them in a moral and ethical dilemma.

About 100 critical care nurses have signed a petition.

The monitors, which have been rolled out at several sites around the province, were installed at the Health Sciences in April 2011. That site has also been the first to get wireless devices, introduced in September.

Contrary to earlier reports from Eastern Health, the nurses said in the November report problems with the monitors aren’t all to do with wireless capability at the complex.

In the House of Assembly Tuesday, Health Minister Susan Sullivan defended the monitors once again when questioned by the Liberals and NDP.

But according to an email to The Telegram, a spokeswoman said while Sullivan is satisfied the monitors are safe, the equipment has passed the review process and is registered with Health Canada and similar bodies in the U.S. and Europe, she wants to be fully briefed on Eastern Health’s implementation plan.

 Sullivan plans to meet with Kaminski this week.

“The minister wants to clearly understand the staff engagement on this issue, the change management plan, Eastern Health’s timelines and the unique challenges being experienced at the Health Sciences Centre and not at other facilities,” the spokeswoman said.

Kaminski noted the Health Sciences Centre is the only area experiencing difficulties.

“I think it’s time for us to try and put this one to rest,” she said.

“We have a very safe, very effective patient monitoring system. It’s in place across Eastern Health and is working very well. We have one site — Health Sciences site — where the nurses have had more adaptability problems than we’ve seen elsewhere and we are trying to work with them to resolve it. But I would reiterate and say clearly, patients are not at risk.”

Kaminski noted the ICU has a one-to-one ratio of nurses to patients.

“And in fact we insist (the nurses) use their eyes and their ears and their brains and their hands to look after people. We nurse patients. We don’t nurse monitors. … Monitors are a tool. They are not diagnostic. They are not treatment. Nurses need to remember that and they need to remember that they need to use all the tools at their disposal,” she said.

Kaminski said 95 per cent of the issues with the devices have now been resolved, the cardiologists are happy with the equipment and even the wireless capability problems at the Health Sciences are fixed.

Among the unresolved issues, there is concern among critical care physicians about the noise in the units caused by the equipment and Kaminski said the health authority is working on that.

Kaminski said the Health Sciences nurses have received twice as much training on the monitors, the vendor is working with individual nurses and Eastern Health will send some staff out to hospitals similar in size to the Health Sciences to observe how the monitors are being used.

She said a group of 20 from across the province went on a nationwide search — based on tender submissions — to select the equipment and the Draeger monitors were deemed the best.

“They came back with this a particular system in mind. They did an evaluation and over 92 per cent of the people involved agreed this was a very good, in fact the best system for us. The people who didn’t agree were the nurses from the Health Sciences Centre and they are now the ones having a problem,” Kaminski said.

Forward said nurses just want to ensure safe patient care.

“For Eastern Health to dismiss those concerns is doing very skilled, educated, responsible professionals a disservice here,” Forward said.

She said it’s not about a backlash over what brand of monitors were chosen and Sullivan appears to be now taking their desire to be heard seriously.

Nurses are waiting for a response to their documentation, and also a detailed action plan expected in the coming weeks.

Although there have been 300 occurrences filed, Kaminski attributed many of them to nurses wondering “what if?”

The November report noted incidents with patients, including two who bled in their bed and a patient that had to be revived with CPR. Kaminski said the monitors didn’t malfunction and there was no harm done to the patients.

One bleed was attributed to a bedside rail being lowered — the lead disconnected and the issue has been resolved by reconfiguring where the monitors and leads are placed, Kaminski said.

The other one occurred when an arterial line leaked, she said.

As for the patient who had to be revived, Kaminski said the nurse in the room handled the situation and the incident occurred for less than the time the monitor was set to alarm at.

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