The Independent will not announce a “First Baby of the Year” in 2013 since babies are no longer delivered at Providence St. Joseph’s Hospital due to an insufficient nursing staff and low local provider availability.
PSJH temporarily closed obstetric services in November when two labor and delivery nurses resigned within days of each other. As a result, the hospital cannot currently continue the service at the level necessary for quality care, said Michelle Wasco, vice president of clinical services.
Although only about two to three babies were born weekly at PSJH, ranging from about 55-80 each year, Wasco said the specialized staffing needs are extensive because of the unpredictability of delivery dates and times. To support a maternity unit, PSJH needs doctors and surgical technicians on-call 24 hours a day with the ability to handle emergency cesarean sections, in addition to qualified labor and delivery registered nurses who are available at all times as well.
Wasco said it is a low census year and less patients have been admitted to the hospital, which means less hours for nurses to work. This is especially hard on any traveling nurses, Wasco said, as specialized nurses do not always live in the area.
Furthermore, Dr. Gary Baldwin retired in 2012 and moved out of the community. He was the only provider other than Dr. Kim Johnstone qualified to perform C-Sections. Also, Dr. Jillian Foglesong will be leaving at the end of they year to take a position closer to Spokane as she has privileges to deliver at Holy Family hospital in North Spokane.
Johnstone said they really need about three doctors in town to offer obstetric services so they can share on-call duties.
Johnstone has privileges at Providence Mt. Carmel Hospital in Colville and has already delivered babies there since OB services are no longer offered in Chewelah. She said they have a newly remodeled maternity unit and a good staff to work with, but is much more of an inconvenience to her as well as her patients.
Johnstone said if she must go in to deliver babies at Mt. Carmel, she has to cancel her appointments for the day and if a C-section is necessary, she has to visit her patients at least once a day for three days after major surgery and that adds up to a lot of driving and time out of the office. It also takes a lot of coordinating between other doctors in Chewelah because they share call in the St. Joseph’s emergency room.
Johnstone said it is riskier to transport patients already in active labor and there may not be enough time to make it to Colville for those that live locally. Although OB service are closed, Johnstone said she has still delivered a few babies in Chewelah because they came in too late to be transported and a labor and delivery nurse happened to be in the area.
PSJH will continue to offer non-stress tests and diagnostic ultrasounds for maternal services. Patients are also encouraged to go to the emergency room if necessary for evaluation.
Wasco said they want to be able to offer OB services and are trying different things to make it possible such as opening training opportunities for current registered nurses, however that takes time and may not be the interest of the staff. They also have opened positions for nurses to double as acute care and labor and delivery so they can still work when no babies are scheduled for delivery.
However, Wasco said it is hard to draw specialized nurses to do acute care. The best way to attract nurses to those positions is when they come to the community for a different reason but have the skills the hospital seeks. Additionally, there is a national shortage of RNs and surgical technicians, which makes it harder to recruit to the area, she said.
Johnstone said many patients will choose Spokane over Colville or she believes that home delivery rate will increase in the area now that St. Joseph’s now longer offers that service. She believes it will return as it is a need for Chewelah as a rural community.
Wasco said that they want to do whatever they can to serve the community, but will not provide a service if they cannot deliver the best health care and ensure top patient safety.
By Kellie Trudeau
The Independent Staff