PULLING BACK THE CURTAIN: A peek at the growing pains in Newmarket hospital's Maternal Child Program
'There's no space anymore': Southlake staff share challenges in overcrowded birthing unit
Aug. 5, 2021
In the midst of clutter and cacophony, little Avery sleeps soundly.
Born premature, the wee baby is swaddled and peaceful with her mother cribside, unaware of the bustle around her.
But new mom, Michelle Sist, is aware.
It was a shock to leave the spacious, private room she and her baby shared at Sunnybrook for the crowded fourth floor at Southlake.
Here, new parents and infants in Neonatal Intensive Care Unit (NICU) are side by side within arm’s reach of the busy nursing station.
“I was surprised to see it was just one big room,” Sist says. “It’s definitely not what I envisioned for my first experience as a mom.”
Key parts of the Maternal Child Program, in Southlake's East Wing, are in part of the hospital that is 47 years old and was last renovated in 2004.
Like most of Southlake’s programs, it has outgrown its space, says Sheena Shannon, manager of Maternal Child and Postpartum.
All the neighbouring hospitals -- Royal Victoria in Barrie, Markham Stouffville and Mackenzie Health -- have had recent renovations to their birthing units.
Southlake averages seven to eight births daily, but the unit only has six beds and is caring for higher acuity mothers and babies than ever before.
Shannon, Chief of Obstetrics Dr. Genevieve Chang, and Pediatrics and NICU manager Stephanie Simson, lead the tour and pull no punches when discussing the building’s inadequacies.
First stop, before the NICU, is the “Teddy Bear Room,” a tiny space that has clearly seen better days.
A family's donation made this carpeted, quiet room possible. Once cosy with stuffed animals and fireplace, it’s now used for offices with a computer, desk, mini fridge, formula storage and the occasional new mom who finds her way here to breastfeed in private.
It’s a running theme during the tour: storage rooms converted into clinics, closets into offices, hallways for waiting rooms and patient beds.
Down the hall, David’s Room is another donor-created space, originally a playroom for older kids with TV and games, now a multi-functional clinic for assessing, triaging and treating patients.
Behind the equipment and stretchers, a hopscotch floor and mural with scenes of unicorns and castles reflect what once brought peace to former patient David English.
The donors agreed to this repurposing to help Southlake address space challenges, but the loss of this special place is missed.
“We have an eating disorder program so some of these kids stay here for a long time,” Chang says. “You have to give them facilities for them to be able to do other things ... but there’s no space anymore.”
Even before the pandemic, the hospital struggled to find room for patient beds, she says.
“We have to do a lot of juggling to determine which patient gets what spot,” Stimson adds.
If you were to go to Toronto’s Hospital for Sick Children, or another newer hospital, private pediatric rooms allow both parents to stay, Chang says. At Southlake, those who want a private room often make do with a ward room where curtains suffice as walls and there’s no space for parents to sleep.
In the birthing unit's triage room, Chang shows how she must squeeze up against the curtain to examine a patient, sometimes moving the bed for access; the light is inadequate, there’s often luggage taking up space.
Everywhere on this floor, rooms have been rejigged to meet demand, but it’s never simple and never ideal -- rooms without showers can’t work for postpartum moms, rooms without oxygen or wall hookups for equipment have limited use for patient beds.
In one prenatal room, pregnant moms with health concerns share space with moms who’ve miscarried and need counselling and support.
The steady thrum of heartbeat monitors makes it a heartbreaking juxtaposition.
They try to be sensitive when scheduling appointments to minimize exposure for the grieving moms, Chang says, but it’s not easy. Behind the scenes, there are meetings upon meetings, working out patient flow like a jigsaw puzzle.
In another room, Michelle Miles and Adam Calcaterra are preparing to bring newborn Charlotte home.
Expansive windows make it one of the better rooms, but it gets hot with the sun and nothing about the dated decor feels homey, Miles says.
Their friends gave birth in other hospitals with comfortable space for fathers to sleep and bathtubs for labour.
Newer hospitals offer tubs to ease pain. Here, the only tub is in a storage room, surrounded by boxes, equipment and ice machine.
While the space may have been subpar, Miles and Calcaterra say the care was “exemplary.”
Shannon says she hears that often.
“Despite the fact that our space is really limited and cramped, the care people get here is excellent. But it’s not the nicest place to be.”
That can be a factor for those “shopping” for a hospital to give birth.
“If it looks lovely, they think they’re getting better care, but that’s not always the case.”
It can be a factor in recruiting staff, too, Chang says.
Working in a dated, cramped hospital impacts morale, she says.
More than a dozen nurses, physicians, clerks and residents share a tiny, pie-shaped alcove on breaks. Administrators’ offices are in closets or stuck behind the elevator.
Nursing stations are jam-packed; created before electronic records, five nurses, an on-call physician and two medical students share three computers.
“We’re really lucky to have physicians here who are at Southlake and SickKids so they have high-specialty training .... but it’s important to have the space to remain attractive to those specialists.”
The tour wraps up in the NICU.
To access this unit, a repurposed postpartum ward, families must walk through the general medicine unit, past disturbing shouts and noises from patients with dementia, through doors kept locked to prevent wanderers from entering.
Most newer NICUs have pods with private rooms but here, it’s an open space, no lounge for parents who need a break from the bedside after a traumatic birth experience.
Sist has called this unit home for the past month after 12 weeks at the comparatively luxurious Sunnybrook.
She’s here from 9:30 a.m. to 6 p.m. and has become used to the constant beeping and bustling.
It’s worth it, she says, to have health care close to her Bradford home.“They’ve all been wonderful here,” she says. “At first it was hard, but it’s routine for me now.”