Battle over language in Winnipeg's St. Boniface General Hospital

A language battle is brewing at one of Winnipeg's leading medical institutions.

Since October 14th, nursing jobs posted for the Woman and Child program at St. Boniface General Hospital list the ability to speak French as one of the qualifications.

That has some nurses worried the ability to speak French is taking priority over skill and experience, possibly putting patient care at risk.

"They've started hiring people into positions and taking French language qualifications over top of nursing experience," said nurse Tamara Burnham, a 14-year nursing veteran who works in the St. Boniface program that includes obstetrics and gynecology.

"With all the things going on in health care, to focus in on that doesn't make sense."

Manitoba Nurses Union Local 5 says it's gone to court to fight the French language requirement because it violates their collective agreement and common sense.

The nurses union went to court October 23rd after the Labour Board refused to hear the matter.
Their suit said the Labour Board erred when it refused to hear their complaint that the hospital committed an unfair labour practice by changing the conditions of employment and refusing to negotiate.

The hospital has a hard time filling all of its nursing shifts, never mind requiring that they're filled by French-speaking staff, said Burnham.

Burnham said she has never seen a francophone patient's treatment hampered because of a language barrier.
Most Franco-Manitobans can also speak English, she said.

"A very real problem, however, exists with the growing number of immigrants who speak neither official language," she said.

"If the hospital wanted to address a real language barrier, it would hire interpreters who speak languages like Urdu, Hindi and Mandarin," she said.
The hospital has volunteer interpreters who speak 60 languages but they're not always available when you need them, she said.

Burnham said she has seen women in labour unable to get pain medication because of a language barrier.

"You can't get informed consent because you don't know if they understand," said Burnham. "If it's a delivery, you can't stop a baby from coming," she said.

"Too bad they couldn't spend this much time and energy to have interpreters on call."

Union local president Debbie Mintz said the hospital hasn't done a demographic study of the patient population since the early 1990s, and doesn't know how the client population in Winnipeg has changed.

The hospital says it has to expand services in French.

"St. Boniface General Hospital has a government-conferred responsibility to actively offer and provide services in French to its patients, their families and the public," hospital spokeswoman Helene Vrignon wrote in a statement.

"To meet our legislated responsibility, a small number of staff in direct patient care positions must be bilingual French and English.
In fact, health services in the language of your choice is a basic component of quality of care."

Brampton Civic Hospital apologizes for cutting in wrong leg

The chief of staff at Brampton’s criticized Civic Hospital has now officially apologized to the 72-year-old Amar Kaur Brar, whose wrong leg got cut by a surgeon, her family says.

The doctor, who sliced open Amar Kaur Brar’s right leg when he should have cut into her left, has also expressed his regret.
The apologies came after the family filed a formal complaint with the Brampton Civic Hospital ombudsman over the incident.
Her 21-year-old granddaughter Kanwaljot Brar said it has left her formerly agile grandmother in serious pain and handicapped as she now has to recover from incisions on both legs, on top of a broken bone.

“Before the complaint they didn’t apologize. Now they have apologized,” she said. “They do the mistake and after they say sorry. That’s not good.”

A spokesperson at Brampton Civic was unable to confirm yesterday whether these verbal regrets were issued.
Despite requesting a new physician, Amar Kaur Brar was today back under the care of the surgeon who performed the procedure.

"The reduced holiday staffing levels at Brampton Civic made it impossible to have another doctor on the job," Kanwaljot Brar said.
“He’s taking care of her, but after the vacation is over another doctor will be given to her,”

The alleged mistake is the latest in a string of controversies that put Brampton Civic under fire since it opened its doors amid much fanfare last October.

Two patients have died and their families believe it was due to complications caused by long waits for proper care.
In November, Harnek Sindu, 52, perished of pancreatitis 10 days after waiting 12 hours for a bed when he presented with abdominal pain and only last month it was Amerjit Narwal, 42, who succumbed to a stroke.

Calling the two deaths “unacceptable,” Health Minister George Smitherman last week appointed a supervisor to assume control of William Osler Health Centre, the hospital network responsible for Brampton Civic.
A citizen’s group, billing itself as Bramptonians for Better Health Care, held a thousand-person protest last month and is now organizing a petition calling for more funding, better staffing levels and the opening of more beds at a hospital serving one of Canada’s fastest growing communities.

Group spokesman Rajinder Saini, who is also editor of Parvasi Weekly, called the latest incident “unbelievable.”
“It’s tragic, there is outrage in the community. They are losing confidence in the hospital.”

While the apologies were appreciated, Ms. Brar said they come as cold comfort to her grandmother, who arrived in Canada from India last summer and now remains hospitalized.

“She just started crying,” reported her granddaughter.
Mrs. Kaur Brar slipped and fell on the stairs on Christmas day, fracturing her left leg.

Related articles:

Brampton Civic Hospital operates on wrong leg

Brampton Civic hospital has cost $340 million more than planned

Brampton Civic Hospital under fire

The Ottawa Hospital starts testing overnight patients for superbugs

The Ottawa Hospital will begin testing overnight patients for two virulent strains of bacteria beginning in January to help combat infections and deaths.

Overnight patients will be screened for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), two strains of bacteria that, along with other hospital-acquired superbugs, kill thousands of Canadians annually.

The mandatory screening follows a pilot project the hospital conducted in the summer, which found that certain members of the patient population should but weren't screened for the drug-resistant bacteria, hospital spokeswoman Allison Neill said.

The Ottawa Hospital will be the second hospital to adopt universal screening for these two superbugs. Toronto's University Health Network initiated testing for these two bacteria in the fall.

If patients test positive for either bug, they will be isolated in private hospital rooms, the hospital said.

In the six months ended September 30th, there were 82 cases of hospital-acquired MRSA at the Ottawa Hospital.

In the same period, there were 18 cases of hospital-acquired VRE at the hospital.

Source: CBC

Brampton Civic Hospital operates on wrong leg

A Brampton family is frustrated after their 72-year-old grandmother had the wrong leg cut open during Christmas Day surgery at the city's new hospital.

But residents demanding better hospital care say the alleged medical mistake is one more in a long list of complaints they've heard since the Brampton Civic Hospital opened last October 28th.

Amar Kaur Brar, 72, fractured her thigh bone when she slipped from the stairs at the family's Brampton home, her granddaughter Kanwaljot Brar, 21, told The Sun yesterday.

"She just missed one stair and fell down," Brar said.
The family took her to the emergency room at Brampton Civic where doctors told them her left leg was broken and surgery was needed.

"In the operating room, doctors cut Amar's right leg open," Brar said, adding the cut ran almost the entire length of her grandmother's thigh.

When they realized that the bone in Amar's right leg was okay, they stitched her up and performed surgery on her left leg, she said.

"She's in so much pain now," Brar said. "She can't move either leg ... she can't move at all."

Doctors told the family after surgery that they opened the wrong leg, she said.
Along with the pain, Amar has been confused and disoriented since the operation.
She remains in the hospital with her son Gurcharan Singh Brar at her side.

"We don't know what to do now for her," Brar said.

The issue is further complicated because Amar arrived in Canada from India in August and wasn't issued a health card until Thursday.
Brar said the family isn't certain if they will have to pay for the hospital care up to that point.

This week's incident comes a few weeks after 1,000 residents took to the streets protesting conditions at the hospital, where they claim patients wait up to 12 hours in the emergency room only to deal with understaffed and insensitive health-care workers.

In response to inquiries about Amar's case yesterday, the hospital issued a statement.
"William Osler Health Centre's top priority is the well-being and safety of our patients and staff," the statement reads.

The centre is made up of Brampton, Peel and Etobicoke hospitals.

In order to protect patient privacy, the hospital said it could not comment on the specific case. "We cannot release any information about a patient or any information about the care provided to a patient without his or her written consent," the release states.

The hospital does have a quality of care committee, a patient incident reporting system and a patient safety committee in place to respond if an incident occurs.

"We're following all of our processes with regard to this case," hospital communications director Gillian Williams McClean said.

Rajinder Saini of Bramptonians for Better Health Care said the incident is another in a long list of complaints the group has heard about the hospital.

"Things are not good at this new facility," Saini said.
"They use excuses like shortages of funds and staff." He called operating on the wrong leg an 'unbelievable' mistake."

"She had swelling on the broken leg, they had X-rays, they had everything," Saini said.

Media attention focused on the hospital in November when Brampton resident Harnek Sidhu, 52, allegedly waited 12 hours for a bed before he died of pancreatitis 10 days later.

Following the protests in early December, the province stepped in and appointed a hospital supervisor.

Amid the problems at the new hospital the future of the old hospital, Peel Memorial, remains uncertain.
Protesters have maintained the fast-growing city needs both hospitals to serve the burgeoning population.
A plan for the old site, that has been temporarily closed when the new hospital opened, is being developed.
Two public meetings, one January 9th at the Pearson Convention Centre and January 17th at Courtyard by Marriott on Biscayne Court, have been scheduled.
Both meetings start at 7:30 p.m.

Source: Toronto Sun

Related articles:

Brampton Civic hospital has cost $340 million more than planned

Brampton Civic Hospital under fire

Country-wide Physicians' health checkup

Doctors across the country are getting a checkup.

A national study launched by the Centre for Physician Health and Well-being of the Canadian Medical Association will survey physicians' health, from nutrition and physical activity to job satisfaction and burnout.

"There's abundant data in the literature showing a relationship between mental health issues such as depression and exercise for example," said Dr. Erica Frank, the principal investigator and the Canada Research Chair in Preventative Medicine and Population Health at the University of British Columbia.

"There are a number of other areas that we'll be looking at as well. One of the key pieces that we're going to be looking at is physicians' personal health practices because there's a lot of really interesting research that shows that can really make a difference in the population."

The surveys are sent out to more than 8,000 randomly selected practising physicians.

Dr. Vino Padayachee, the chief of staff at St. Joseph's Hospital of Estevan and the past Saskatchewan Medical Association president, is keen to participate and hopes many of his counterparts do the same.

"This is not just about physician health," he said. "Indirectly it's about patient health. If you have healthy physicians, then you'll have healthy patients. We don't allow airline pilots to fly beyond a certain number of hours because of the risk to the passengers and we should look at the same thing for physicians as well."

CMA research conducted in 2003 reported that 46 per cent of physician respondents were in advanced stages of burnout.

Read the full story here

Premier Nova Scotia wants to allow more private competition in health care

Rodney MacDonald, Nova Scotia's Premier, should be applauded for his openness to a greater role for private competition in health care.
In his recent state-of-the-province address, he said specifically that the provincial government was moving towards a greater role for the private sector in the delivery of publicly funded health services.

For far too long, Canada has been out of step with the rest of the industrialized world in its steadfast opposition to tapping into the competitive market for solutions to our health care woes, to the detriment of both patients and taxpayers alike.

Consider for a moment what Canadians receive in return for this steadfast commitment to the status quo.
Among the 28 developed nations that have universal health insurance programs, Canada ranks third in age-adjusted health care spending as a percentage of GDP.

At the same time, Canadians endure relatively poor access to physicians and medical technologies, while wait times for health care in Canada are not just unacceptably long but are among the longest in the developed world.
Perhaps a closer look at why other countries are getting more for less is in order.

Among the world’s 28 most developed nations that have universal health insurance coverage like Canada, the majority allow private providers to deliver publicly funded services.

All of the nations that outperform Canada across several measures of mortality related to health system performance (Australia, Sweden and Japan) employ private competitive providers in the delivery of publicly funded health care.

Allowing private hospitals to compete for the delivery of publicly funded care is a proven policy that would improve the state of Medicare for all Canadians.

Premier MacDonald’s willingness to sit down and take an honest look at those policies that have worked so well elsewhere in the developed world, bodes well for both patients and taxpayers in Nova Scotia.

Read the full story here

Dangerous drugs still prescribed to seniors

Doctors are still prescribing dangerous drugs to seniors, despite government warnings.

Over two years ago was reported, that more than a million seniors were prescribed atypical antipsychotics. Atypical antipsychotics are specific kinds of antipsychotic drugs. They are considered by many experts to be ineffective or even dangerous for elderly patients.

Health Canada followed up with warnings pointing to the drugs' side effects according to 13 scientific studies, which included a 60 percent greater risk of death in seniors who were taking the drugs than in patients taking placebos.
It also warned that elderly patients taking atypical antipsychotics were almost twice as likely to die from side effects such as heart failure.

In its advisory, Health Canada requested that the drugs' manufacturers include a warning describing the risk in the safety information sheet provided along with the drugs, and that health care providers refrain from relying too much on the drugs to treat dementia.

Atypical antipsychotics are drugs such as Risperidone (Risperdal), Quetiapine (Seroquel), Olanzapine (Zyprexa) and Clozapine (Clozaril).
Many of these types of drugs have never been tested on seniors.
They are intended to treat severe mood disorders, symptoms of schizophrenia and bipolar disorder in adults under 65.

A new investigation has revealed that the number of prescriptions of these drugs for seniors actually increased in spite of and after the Health Canada warnings.
They shot up in six provinces, including in Ontario and Quebec.

In some cases, they increased by 40 percent, according to sales data provided by IMS Health, a business intelligence and strategic pharmaceutical and health-care consulting firm.

Read the rest of CBC's story here

Editor's opinion:

"Hmm, I wonder if the drug industry with its incentive programs has anything to do with it..................."

In Newfoundland and Labrador an initiative for drug use among seniors has just been announced last week:

New program to help seniors taking medication in a safer way

Wait time for surgery hits all time high of over 18 weeks

A typical Canadian seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high, according to new research published today by independent research organization The Fraser Institute.

“Despite government promises and the billions of dollars funneled into the Canadian health care system, the average patient waited more than 18 weeks in 2007 between seeing their family doctor and receiving the surgery or treatment they required,” said Nadeem Esmail, Director of Health System Performance Studies at The Fraser Institute and co-author of the 17th annual edition of Waiting Your Turn: Hospital Waiting Lists in Canada.

The survey measures median waiting times to document the extent to which queues for visits to specialists and for diagnostic and surgical procedures are used to control health care expenditures.

“It’s becoming clearer that Canada’s current health care system can not meet the needs of Canadians in a timely and efficient manner, unless you consider access to a waiting list timely and efficient,” Esmail added.

The 2007 survey found the total median waiting time for patients between referral from a general practitioner and treatment, averaged across all 12 specialties and 10 provinces surveyed, increased to 18.3 weeks from 17.8 weeks observed in 2006. This is primarily due to an increase in the first wait, between seeing the general practitioner and attending a consultation with a specialist.

Total wait times increased in six provinces: Alberta, Manitoba, Ontario, Quebec, Nova Scotia, and Newfoundland. This masked the decreased wait times in British Columbia, Saskatchewan, New Brunswick and Prince Edward Island.

Total Waiting Time

Ontario recorded the shortest waiting time overall (the wait between visiting a general practitioner and receiving treatment), at 15 weeks, followed by British Columbia (19 weeks) and Quebec (19.4 weeks). Saskatchewan (27.2 weeks), New Brunswick (25.2 weeks) and Nova Scotia (24.8 weeks) recorded the longest waits in Canada.

Read the rest of the numbers here

Source: The Fraser Institute

Editor's opinion:

"If this isn't a cry for more efficiency, accountability and openness of hospital managements.........

It wouldn't hurt to have more people form "real" business life management in hospitals.

Wouldn't you like to know where all our billions of dollars end up?"

Manitoba hospital put on watchlist by nurses union

The nurses union in Manitoba has listed the Dauphin Regional Health Centre on a watch-list over serious concerns about patient safety.

Maureen Hancharyk says patients are being put into utility rooms for lack of space.

She says some call-lights in the hospital don't work and elective surgery is not cancelled, even when there's a shortage of nurses.

Allan Bradley, chief executive of the Parklands Health Region, says officials are looking into the concerns.

He says any problems affecting patient safety will be resolved right away, if possible.

It's the 5th time in the last 30 years that the nurses union has put a Manitoba hospital on the unofficial watchlist.

Canadian Press

GlaxoSmithKline Inc. prescribes restricted use of diabetes drug Avandia

GlaxoSmithKline Inc., the manufacturer of a drug for treating Type 2 diabetes has placed new restrictions on use of the medication based on a Health Canada review of clinical data pointing to an increased risk of heart-related problems in some patients.

In consultation with Health Canada, Glaxo is updating prescribing information on products made from or containing the drug rosiglitazone: Avandia, Avandamet and AvandarylTM.

Once touted as the gold standard for preventing Type 2 diabetes in high-risk patients, rosiglitazone lost its glitter after a study published in the New England Journal of Medicine in May showed Avandia significantly raised the risk of heart attack and possible death.

The NEJM analysis of 42 studies revealed a 43 percent higher risk of heart attack for those taking rosiglitazone compared to people taking other diabetes drugs or no diabetes medication at all.

Glaxo said patients taking rosiglitazone and especially those with underlying heart disease or with a high risk of heart attack or heart failure should talk to their doctor about the benefits and risks of continuing the drug.

Important restrictions for patients are:

• Rosiglitazone should not be used in patients with any stage of heart failure
  
• Rosiglitazone should not be taken if insulin is also being used.
• Rosiglitazone should not be used as part of a "triple therapy" in combination with metformin and a sulfonylurea drug.

Rosiglitazone can cause the body to retain fluid, which can worsen some heart problems and lead to heart failure, swelling and weight gain.

Several lawsuits have been launched in Canada and the United States over the medication's adverse effects, and drug safety regulators in both countries have been investigating its safety.

CBC

"Little" communication problem causes death of immigrant

Yesterday, a Quebec coroner entered the controversial debate on reasonable accommodation by suggesting caregivers in the province should show more openness to the needs of immigrant patients.

Following the recent 4 deaths of newcomers to Quebec, Dr. Jacques Ramsay presented his reports on the accommodation of minorities to a government commission .

He told a news conference in Montreal yesterday, that the deaths could have been avoided, claiming linguistic and cultural barriers often prevent patients from getting the care they need.

Ramsay cited the example of one man who entered a psychotic state and later killed himself thinking his wife had been diagnosed as HIV positive.

In fact, the Albanian immigrant had misunderstood when hospital staff informed him his wife's blood type was A positive.

Ramsay says that health care workers should work from the assumption that no accommodation is unreasonable when it comes to somebody's health.

Original article by the Canadian Press

Editor:

"How's that for a little misunderstanding............?"