Another service faces shortage

WINNIPEG — A shortage of specialized staff who operate life-sustaining equipment for cardiac and trauma patients means Manitoba’s largest hospital will soon be without dedicated perfusion services.

By next month, only eight perfusionists will remain on the job in Winnipeg, all working out of St. Boniface Hospital.

Because there are so few of them, perfusionists have been asked to stop working rotations at the downtown Health Sciences Centre. Instead, anesthesiologists are training to take over some of the work necessary to treat trauma patients, including handling the equipment used for blood cell salvage.

The cell-saver machines are necessary for patients who are losing a lot of blood to cut down on the need for donated-blood transfusions.

“The groups that will be covering it have their own responsibilities as well,” said Bill Gibb, a St. Boniface perfusionist with more than 30 years’ experience and past-president of the Canadian Society of Clinical Perfusion.

“In an emergency situation, there’s never enough hands. We were an extra set of hands, and now there’s going to be less people to help in emergency situations.”

A spokesperson for Shared Health confirmed plans are underway to make sure patient care isn’t affected by “challenges” in perfusion services, but didn’t answer specific questions about staffing levels.

“These plans will ensure patient care levels are upheld, with the main treatment typically performed at HSC by a perfusionist being provided by other qualified care team members,” the Thursday statement reads. “Further efforts to train, recruit and retain staff in this area are ongoing.”

Manitoba pays less than perfusionists can earn in other provinces, and there’s no local education program to train them, the local union representing the specialists said.

Perfusionists are part of heart surgery teams and operate crucial heart-lung bypass machines, also responding to ICU and trauma cases when necessary. They work in shifts during scheduled cardiac surgeries, and rotate being on-call 24 hours a day in case of emergency surgeries.

They typically have a background in respiratory therapy, nursing or science before they complete a two-year course to become a perfusionist, Gibb said.

The only two such courses in Canada are offered in Ontario and B.C.

Manitoba needs to do more to recruit, sponsor training and entice the specialized professionals to stay in the province, Gibb said.

Of 11 positions in Manitoba, nine are currently filled, with another perfusionist set to move out of province by April, Gibb said. When the complement is down to eight, Gibb said he expects to be on call every other day.

Gibb said he was the only perfusionist working a 7 a.m. starting shift earlier this year when three cardiac surgeries were scheduled. He couldn’t be in three places at once, so the surgeries had to be delayed for a few hours.

“Had an emergency come along, it would’ve been a bad situation,” he added.

National standards dictate one perfusionist per heart surgery, plus an additional perfusionist working simultaneously, in case they’re needed elsewhere in the hospital, Gibb said.

The current staff is spread too thin to make up for sick calls or late starts due to emergency on-call procedures, he said.

Dr. Renate Singh, an anesthesiologist at HSC and Women’s Hospital site lead for anesthesiology, said perfusionists are “relied on very, very heavily.”

She hoped leaders can negotiate better salaries and relocation bonuses for those professionals to come here.

“This is a completely unexpected change in our practice, but the anesthesiologists who currently work at Health Sciences Centre will rise to the challenge and make sure that the public continues to receive the best possible care,” Singh said.

Perfusionists and other allied health professionals in Manitoba have been working without a contract for five years. The Manitoba Association of Health Care Professionals is negotiating with employers.

On Thursday, president Jason Linklater said the union is “going to have to exercise all of our options,” including a strike vote, if the situation for staff doesn’t improve.

He said perfusionists in Manitoba earn wages up to 40 per cent less than their counterparts in other provinces. The union has known about staff shortages in this field for years, Linklater added.

“Employers failed over the past five years to implement adequate staffing and compensation, and it’s left Manitobans at risk.”

» Winnipeg Free Press