Community weighs in on future of OB at PDH; more meetings this week
By Debra Moore
Plumas District Hospital employs four OB doctors and four OB nurses, but the future of obstetrics at the Quincy facility could be in jeopardy.
That’s because the nurses, who stay with the patient throughout their labor and delivery, and care for the mother and baby after the birth, are stretched too thin, even with the assistance of traveling OB nurses. This is not a new situation, but in the past the hospital relied on other nurses to assist in labor and delivery. As the field has become more specialized, it has become more difficult to recruit OB nurses who don’t want to be the only one responsible for mom and baby.
The first of four community meetings to discuss the issue was held July 14 with attendees sharing personal stories of giving birth at PDH and others brainstorming ways to maintain the service.
There were about a dozen individuals in the Plumas District Hospital meeting room and a number of others participating online. Three additional forums will be held this week: Monday, July 19, at noon, and Tuesday, July 20, at 6 p.m., both in the PDH conference room, and one in Greenville on Wednesday, July 21, at 1 p.m. That forum will be held at the Greenville Wellness Center at 414 Main St.
Access the meetings here: http://www.pdh.org/about-us/events
Plumas District Hospital CEO JoDee Read opened the July 14 meeting by discussing the state of OB services in rural America in general and acknowledging that they are dwindling. “My hope and priority is to not be one of those statistics,” she said … “So to be really clear, we have staffing to keep OB open for at least 90 days, if not through the end of the year.” She reiterated that point again during an interview following the meeting and said there is time to come up with a solution.
The four doctors who deliver babies at Plumas District hospital are Erin Barnes, Alexandra Hunt, Paige Lewis and April Leonardo, and three doctors who perform Caesarean sections: Doctors Paige Lewis, Ben Hunt, and Steen Jensen. Barnes and Hunt were at the meeting, as was Dr. Ross Morgan, who used to perform obstetrics at the hospital.
“We are so lucky to have four physicians who do OB, and Dr. Hunt, Dr. Jensen, and Dr. Lewis all do C-sections. That is so rare,” Read said, and added that she doesn’t want to run the risk of losing them if they can’t do OB.
After giving a brief history of births at PDH from the first baby born in 1957, to the program as it is now, Read outlined what it would take to have a successful program — 106 deliveries annually and six full-time OB nurses. As of May 31 of this fiscal year, 64 babies have been born at PDH, and though there are four OB nurses, they aren’t all fulltime.
Dr. Ross Morgan spoke about the importance of the OB program and said, “Where there’s a will there’s a way. I just want to make the point that we have a very strong will. If the community understands how important it is, we will find a way.”
He noted that there would be people in the community who wouldn’t be able to drive out of the area and would “end up at our hospital needing our care.”
A lot of discussion centered on recruiting OB nurses, as well as other options. James Shipp, whose son was born at PDH earlier this year, asked about the potential of working with FRC’s internship program. Read said that FRC only has an LVN program, but she has reached out to Butte College, where they would be interested in offering a paramedic to RN program, but the bottleneck has been the state board of nursing.
Shipp also wanted to know which authority mandates two OB nurses be on site. Read said that it’s a recommendation. “We have a waiver; we have to have one, but the recommendation is two,” she said. “It’s the way of the world.”
Sue Brown, the registered nurse who leads the OB program, said the need for a second nurse arises for example, when newborns need medications. “We love all hands on deck,” she said, “but neonatal meds are very specific.”
Dr. Alexander Hunt, during an interview after the meeting, said of Brown, “She’s as good as it gets. She is superb.” She said all of the OB nurses “are really, really good.” Hunt said maybe it would be possible to cross train other nurses to help in obstetrics. “I think the nurses are burnt out, but I don’t want to close our program because we need two more nurses.” She added that it’s a unique situation for PDH to have so many providers, but not enough nurses.
Dr. Erin Barnes said, “It’s really a recruiting issue for getting nurses here and making sure our current nurses feel like they have the necessary support.”
Barnes said the public could help by sharing their positive experiences. “I delivered both my babies here; I loved it,” she said. “We do have a fair number of low-risk patients who drive to Reno and Enloe. We have all the same certifications that the doctors there have.”
She said that more deliveries would help retain current staff, as well as attract more staff, and would also provide funding to help pay for the staff.
Eddy Mutch, a paramedic with Care Flight, said paramedics would be happy to assist, and noted that “if this program goes away we will have a lot more people delivering in the ER.”
Dr. Barnes agreed and said, “The deliveries will still come” and some will “need emergency C sections, ”but we won’t be doing them on a regular basis.”
An audience member said that she had her second child at PDH, and the ability to deliver locally influenced her decision to move to the area, as it might others.
Mutch asked how many babies were being born out of the area.
A local midwife said that she does about 50 to 60 deliveries a year (that’s in both Plumas and Lassen counties combined) and she relies on PDH for emergencies. “It’s (the PDH OB program) pretty essential for my practice to thrive.” She suggested that the hospital could add a birthing center, which would attract mothers who want a home birth experience, but with more support. “You will get nurses who want to work in a birthing center,” she said.
Some of the participants weighed in with their personal experiences. A local childcare provider said her two kids were born at PDH and the “nurses and docs treat you like family. If my water breaks the last thing I want to do is drive to Reno or Chico without cell phone service.” She also discussed what happens when the roads are closed due to weather or fire.
One participant suggested that the hospital make a video that included people talking about their birth experience at PDH to draw other people to the hospital.
During her post-meeting interview, Read said that the hospital would continue to investigate ways to save the program. Ultimately, the hospital’s board of directors will make the final decision. In the meantime, there are three more opportunities this week for the public to share their opinions.
