Old equipment, overcrowding and unrealistic deadlines for one-site hospital major concerns, says Dr. Bonin
A doctor has gone public with his concerns about the state of Sudbury Regional Hospital.
Dr. Miguel Bonin says he refuses to let his patients suffer because of these problems. He is speaking out about the hospital’s old equipment, overcrowded facilities and behind-schedule capital construction project.
He originally made his statements about hospital conditions on CBC Radio last week.
“I’m not afraid of anyone. The biggest price I’ve paid for doing what I’ve done is I’m being stopped in the halls to tell me to keep going and do these things, and I’ve so little time to start with that I don’t have time to keep going.”
Bonin is a family physician who, on top of his primary care practice, delivers 150 babies a year at the hospital, assists other doctors with surgeries, and cares for his patients when they’re admitted to the hospital. He is the son of Nickel Belt MP Ray Bonin.
The hospital’s operating rooms are equipped with out-of-date and even dangerous equipment, he says. When he was operating in a room at the Memorial site last week, the operating table wouldn’t always go up and down because the electronic components weren’t working.
There were also ceiling tiles missing in the operating room, and he was concerned dust from the ceiling would fall into the patient’s wound, causing an infection.
“If the hospital does regular maintenance checks of all the operating rooms as Ms. Kaminski says, they would have to be blind to miss those four holes in the ceiling.”
An electric current machine used to cauterize blood vessels during operations was recently deemed unsafe because it was so old.
“One of the points I’m trying to make in the media right now is not to take every little complaint to heart, because there’s tons of them. It’s a table not working today, a suction unit not working tomorrow. It goes on and on and on.”
When Bonin spoke about the equipment problems on CBC Radio’s Morning North, his concerns were corrected within an hour by hospital staff.
Bonin also says he has doubts the one-site hospital will be completed by 2009 or 2010.
“I don’t think it’s a realistic goal. They’re telling us they’re going to build 96 chronic care beds in the next five years, but they’re going to build a 400-bed hospital in the next two years. You do the math. It’s not going to happen.”
He wants the province to promise the one-site hospital will be completed in two years.
Overcrowding is also creating a lot of problems for patients and staff, says Bonin.
Patients who are waiting to be placed in long-term care facilities are tying up a lot of beds, meaning there’s nowhere to put people coming into the hospital through the emergency room, he says.
The doctor recently had a patient who was in the intensive care unit (ICU) for much longer than she should have been because she couldn’t get a bed in a regular ward.
The community needs to demand money from the province to build a new long-term care facility, he says.
“We need large investments. We’re not talking $1 million or $2 million. We’re talking hundreds of millions of dollars.”
Bonin says if members of the public are unhappy, they should attend the public portion of monthly hospital board meetings or write a letter to hospital officials or politicians.
“Patients, when they finally get through the door, are so grateful to even be seen and treated, they don’t question the fact that it’s unacceptable. We’re accepting our plight. We need to change that.”
Sudbury Regional Hospital CEO Vickie Kaminski says a lot of what Bonin is saying about equipment is accurate.
“We’ve said all along that we do have an equipment issue. We’ve talked in the neighbourhood of $50 to $70 million of medical equipment that needs to be purchased,” she says.
“We are slowly buying equipment – we spend $9 or $10 million a year on medical equipment – but we haven’t got the cash to go out and buy it all at once, nor do we have the capacity to store it if we did. Some of the equipment we’ll be using in the new site, we have to have parts of the new site built before we can even get the equipment in. So it’s not like we can go out and buy it.”
The hospital does have biomedical engineers on staff to repair broken equipment and do regular preventative maintenance. And, when equipment is still under warranty, companies come in and do maintenance, she says.
Kaminski says Bonin’s specific concerns have been dealt with – a foot pedal was replaced on the operating room table so it goes up and down and the ceiling tiles in the operating room have been replaced.
The ceiling tiles that were missing were not over top of the patient, but at the other end of the room, she says.
As for the timetable for the construction, Kaminski says the experts are telling her it’s realistic.
The CEO says the solution to the bed shortage is more money for long-term care facilities and home care. She is not surprised to hear one of Bonin’s patients was tying up an ICU bed while waiting for a regular hospital care.
“It’s happening everywhere. I don’t know if you’ve heard about the issue in Kingston, but Kingston is in the process of building more ICU beds.”
The following is part of the transcript of the interview with Dr. Miguel Bonin that ran on CBC Radio’s Morning North program Jan. 25.
MARKUS SCHWABE: As you may have heard on the Regional News earlier this morning, Dr. Miguel Bonin of Sudbury is getting specific about what he calls major problems at the Sudbury Regional Hospital. The family doctor assists in surgeries and works in the emergency room at the St. Joseph’s site and he says he sees things which concern him greatly. The CBC’s Sherry Huff spoke to him yesterday about those concerns.
MIGUEL BONIN: I have spoken to you in the past about the shortcomings of our institutions as they are now and no one is speaking out. Unfortunately, I just feel that I have to come out and talk about the realities of everyday care at the Sudbury Regional Hospital. The waiting room at the Memorial Hospital, while you are waiting to go in for your surgery, is in a public hallway. At the General Hospital, there’s one small room for private conversations to take place but basically you are sitting next to other patients and giving your medical history, basically in a public forum. This is simply not acceptable. Surgeries were cancelled again today, because there are no beds. This is a perennial problem, it was happening last week, it happened the week before, but no one comes out and says we have problems at the regional hospital, we are having to delay surgeries. I heard some surgeons saying that they are now going to limit the number of surgeries they do instead of trying to get appropriate funds...we’re just going to provide less care. I hope Ms. Kaminski and the president of the board of the hospital will get out there and start arguing the case for more funding for hospitals so we can actually take care of our needs. One, you know, operating rooms are way too small, we’re in temporary shelter basically while the construction was to be done. We’ve put up a full ....(inaudible) during that time. One operating room that I was actually working in this morning has four holes in the ceiling tiles for the last five years and I can visibly see dust in those holes. Feasibly, this dust can be falling on to patients while we are doing surgery. I have not had the privilege of seeing that happen but it’s just logic that the dust from the walking and the noise being made upstairs will derange this dust and possibly end up in a patient.
SHERRY HUFF: What kind of an affect would that have on a patient?
BONIN: Well that possibly could lead to infection. Infection is one of the highest complication risks that any surgery poses. We make all sorts of efforts to prevent infections from instilling themselves in patients, including scrubbing our hands, including prepping the patient’s belly, including giving them antibiotics prior to surgery which are all standardized procedures that are done in every hospital. But, you know if you have holes in your ceiling tile, if you have lights that don’t work, so you can’t see what you are doing, these are factors and in the long run, must affect patient care.
HUFF: Some lights don’t work?
BONIN: Yah, no, we are working with lights that are well over 30 years old, continually adjusting the lights so we can actually see what we are cutting and what we are burning, what we are doing inside the patient’s bellies. You know the institutions of St. Joseph’s Health Centre and Memorial Hospital are old hospitals. Our most modern institution is Laurentian Hospital and the operating rooms there were being closed in the transitional period of construction. So we are working in very old institutions with equipment that is failing. Operating room tables that electronically don’t go up or down or tilt the way we want them to do. We deal with this as physicians every single day. This is not acceptable.
HUFF: Is this at the St. Joseph’s site?
BONIN: Well, St. Joseph’s, Memorial, the operating room table I was working on this morning failed us a couple of times and you wiggle a wire or try to you know, kind of punch the box and see if it will make it work and eventually, some times it works and some times it doesn’t. But we are not working with modern equipment. We are not working with equipment that you know patients should be confident in on a day-in and day-out basis. Yes, there has been some purchase of new equipment, yes the budgets are tight, but we have coagulators here in this hospital as recently as two years ago and when some broke down, they called the company to get pieces and they said that those machines were obsolete and dangerous and should not be re-used anymore. We’ve replaced those machines, but we didn’t know until we made the call to try and get them fixed that this company didn’t even know we were still using them.
HUFF: And a coagulator is what?
BONIN: That’s what burns the blood vessels to stop the bleeding when we are doing surgery, that’s the electric current that goes through and burn the blood vessels and the like. We are working with dangerous machines. I am breaking my silence because it’s just frustrating to be working in this environment... I have a patient in the hospital right now, that’s sitting in an intensive care bed, and she’s been quite ill, but actually has recovered quite well, and is still sitting in an ICU bed because we don’t have a medical bed, a normal bed in the hospital, to put her in. So, she’s actually tying up an intensive care bed, which is more expensive, and probably needed by other people. But, we can’t move her out to a normal floor bed, because we don’t have enough beds in this institution. Where is our hospital administrator, where is our board? Are they telling the government, this? Are they coming out and telling the public that they’re doing the best they can, and the provincial government doesn’t want to give us money? Or doesn’t have money to give us? Or are we just going to have to accept lower quality care?
SCHWABE: That’s Dr. Miguel Bonin, speaking with the CBC’s Sherry Huff, yesterday.
