HHS obstetrical nurse training program a labour of love

In-house partnership “builds the teams we want and need” amid WLMH service pause, global staffing crisis

Nursing positions within the West Lincoln Memorial Hospital (WLMH) obstetrics program have historically been hard to come by. The program’s reputation and culture make it a place where many staff often start out of school, and then stay for their entire career.

When a spot opened up in August 2021, Courtney Davis didn’t miss the opportunity to throw her hat in the ring.

“It was hard to get in because nobody ever left,” said Davis, a registered practical nurse who spent the previous four years working at the site on a general medicine unit. “When I was hired in medicine at WLMH, the obstetrics program had a great reputation. I’d always considered working here.”

The birthing service has been temporarily redirected to Niagara Health a few times since 2019 as a result of necessary safety upgrades needed at the site, staffing shortages and response to the COVID-19 pandemic. The current redirect has been in place since December 2021, when the fast-moving Omicron variant spread across the site closing all but a few beds to new patient admissions. Last week, the hospital announced that the obstetrics program would reopen to deliveries at the site on October 3 in a 24/7 care model. The reopening follows months of necessary work to rebuild the program.

Recent hires into the program need to add or enhance their existing obstetrical skills in preparation for the fall return. But with limited volumes at WLMH due to the redirect, a unique in-house training program has been developed in partnership with the labour and delivery team at Hamilton Health Sciences’ McMaster University Medical Centre (MUMC), which is attached to McMaster Children’s Hospital.

The team at MUMC deliver approximately 4,000 births a year, many of which are high-risk.

Specific skill set needed

“When hiring a nurse to work in the obstetrical service, I’m really looking for a few things,” said Angela Leslie, clinical manager in WLMH’s obstetrics department. “First, do they have general nursing experience? Then, there are specific skills needed to be successful in the role like fetal heart monitoring, perinatal certificate and neonatal ressucitation.”

The in-house training is beneficial to the WLMH nursing team, and is also welcomed by the McMaster team as well.

“The advantage of having McMaster in our system with its volumes and nurses with such expertise is a fantastic learning opportunity. But it also benefits the McMaster team as well, bringing skilled nurses and a few extra sets of hands into the delivery rooms to help with those volumes has also been well received,” Leslie pointed out.

Caring for adults and babies

Even for experienced nurses like Davis, making the transition to caring for newborns has a learning curve as the role requires a 50/50 split in assessing and treating moms and babies.

“All of the assessments are different and all of the vital signs are different. Over eight years of nursing I’ve developed a ‘nursing intuition’ about things. Now we’re adding some specific skills needed to safely care for these little patients,” Davis noted.

Shyma Prince agrees. Originally trained as an obstetrical nurse in India, Prince brings significant operating room nursing skills to the WLMH obstetrics team, which she honed while most recently working at a hospital in Alberta.

“Since being hired we have mostly done c-section deliveries at West Lincoln. We have had the opportunity to work with the team at McMaster to assist with high-risk deliveries as well as upgrading post-partum care skills, caring for mothers as they heal from the delivery,” said Prince, a registered nurse who was hired in February 2022.

Team critical to success

According to Shasta Cividino, clinical manager in labour and delivery at MUMC, there are many experiential learnings beyond skills development which can also be gained through training opportunities like this partnership.

“Being a regional centre, staff get exposure to wide variety of normal low-risk and high-risk care. But they also have the opportunity to experience emergencies which will happen in every birthing centre. In those situations, developing the wherewithal to understand how the team can come together and work through a situation is very important,” she said, adding that there are many unique situations and cases a nurse will see only once in a 30-year career.

Another benefit of spending time in different clinical settings is the chance to build a community of practice with other nurses. A result Cividino calls the “phone-a-friend” mentality.

“Mentorship in health care can be sometimes hard to achieve, especially given the current generational shift going on. We have a wealth of people in that intermediate to expert range to talk and vent to and deconstruct scenarios with. This is great for workplace wellness. You can’t bring these conversations home because of confidentiality and privacy, which is where like-minded colleagues can really help you through those situations,” she said.

Hiring in a global staffing crisis

Finding experienced obstetrical nurses – or any specialty nursing position – is increasingly challenging in the current climate. Health care professionals are in short supply after what many sources attribute to two years of pandemic chaos across the sector. According to Leslie, training programs like this will be increasingly important.

“It’s extremely competitive out there trying to find staff,” she said. “For the obstetrics roles, we are looking at all angles to reach candidates where they are and where they are looking for work. We get candidates for every posting but most don’t have the complete skill set we need. We are fortunate to have in-house training opportunities to help build the teams we want and need.”

The intensity of hiring has also increased. Candidates have many options so they don’t wait too long for a hiring manager to respond to their inquiries. Fortunately, the promise of the new hospital continues to attract great candidates.

“The biggest selling point is the new hospital. Everyone wants to work in a state-of-the-art, smart hospital in a beautiful and growing community. It will allow us to further incorporate research and education into practice. We have a very bright future,” Leslie noted.

Over at MUMC, Cividino – who has held roles during her career at WLMH – believes the new hospital and the program’s reputation will be a perfect storm bringing many expectant mothers to the site to deliver.

“When the new hospital opens its doors, the team can anticipate a much busier obstetrical program with the attraction of a new site, exceptional care delivery standard and a growing community in West Niagara.”

Photos: Tearing down, building up

If you’ve been by the West Lincoln Memorial Hospital site lately, you will probably notice that it doesn’t look quite the same anymore. Work continues to roll along at West Lincoln Memorial Hospital to prepare for construction on the new hospital. If you haven’t been by recently, don’t worry, we’ve got you covered.

Workers are renovating the emergency department (ED) platform. The awning has been removed and a giant retaining wall is being built to increase the space outside of the ED.
View from the ED. The purpose of this work is to allow enough space for ambulances to turn around and then return to the street down the ED driveway, as opposed to exiting out the east parking lot exit.
Speaking of the east parking lot exit, a construction access pathway has been created. The access on the west side of the building will also be used as an access point.
Construction trailers – three to be exact – have moved onto the front lawn. These will provide space to the construction teams to conduct meetings without taking over space inside the hospital.
Roughly 35 trees across the site were taken down in preparation for new hospital construction. Efforts are being made to protect all trees which are at high risk of exposure to construction activity. More than 120 trees will be planted throughout the redevelopment project.
A walkway connecting WLMH with Deer Park Villa is being taken down. The walkway is directly in the path of construction. It’s location is very close to where the new hospital’s front entrance will be.
Soon, the area in the forefront will be excavated and formed for the hospital’s basement and footings.
With the loss of parking due to construction, off-site parking has been arranged for staff. So has a shuttle to the lot.
General rules of engagement for the project: safety always first!

Obstetrics services resuming October 3

Program rebuilding includes return of WLMH Midwives

The below is an abbreviated version of a staff and physician message shared on August 17, 2022

Starting October 3, the labour and delivery program will return to West Lincoln Memorial Hospital (WLMH) site, operating in a 24/7 model of care. This is the result of many months of work and significant recruitment efforts by multiple departments at the site and across Hamilton Health Sciences (HHS), to bring the service back in a sustainable manner. This was also made possible by significant partner contributions, including the WLMH Foundation and Niagara Health.

Specifics include:

• Physician coverage will be enhanced by a new obstetrician and gynecologist who will join the program on a six-month contract, with the possibility of extension for an additional four months.
• Following months of aggressive recruitment efforts, program staffing is currently sufficient to return based on expected near-term patient volumes. Recruitment will continue to ensure further coverage as volumes grow over the coming months.
• WLMH’s operating room team is also growing with the addition of new procedures and surgeries being delivered at the site, which will allow for a 24/7 call schedule to support urgent after hours obstetrical cases.
• As part of a return to 24/7 coverage, we are excited to welcome the WLMH Midwifery team back to the site. WLMH Midwives have been practicing at Niagara Health, and will provide care to expectant mothers, families and babies at WLMH starting October 3. Their presence will be an essential piece of the program’s transition back to the site by adding ongoing low-risk obstetrics mentoring to the nursing team, as well as for the long-term success of the program.

In addition, recruitment has progressed toward hiring two additional full-time OBGYNs to the program. Interviews will take place this fall. A team of four FT OBGYNs – the largest physician complement the program has ever operated – will add stability and predictability to the program, enabling long-term growth.

This period of temporary redirect has been longer than anyone expected or wanted. We are optimistic that the foundational rebuilding mentioned above represents the start of the program’s next chapter.

Thank you to our staff and physicians who remain committed to serving patients at the site and in this program, despite the many changes over the past few years. We would also like to acknowledge the WLMH Foundation which graciously provided the hospital with a grant to assist with OBGYN recruitment, in addition to its ongoing financial support of the program. Finally, we thank our partners at Niagara Health in caring for WLMH mothers and babies during this time.

Creating Capacity for Construction

In the coming weeks, you may see WLMH staff and physicians making their way to the hospital on foot or via shuttle service. Some of the hospital’s parking lot space is needed to support the next phase of construction and arrangements have been made for staff and physicians to park off-site.

Patients and visitors may continue to access parking as usual via the lot on Main Street.

If you see a WLMH team member walking down Main Street, please give them a friendly wave and thank them!

New West Lincoln Memorial Hospital is a done deal!

Now its time to build!

Shovels are about to hit the ground on the new West Lincoln Memorial Hospital (WLMH)!

The Government of Ontario approved the start of construction to begin on the new Hamilton Health Sciences (HHS) site following the closing of the project contract between EllisDon Infrastructure Healthcare (EDIH) and HHS on April 29, 2022.

Related: read the full news release

The next day, local elected, hospital and community leaders gathered to celebrate.

Here are a few pics from the day.

More diagnostic imaging upgrades on the way

Summer is in full swing, and so is construction on the WLMH mammography and x-ray rooms.

The current machines have been well used and have now reached the end of their useable lifespan. Upgrades are needed to the rooms before the updated, top-of-the-line equipment can be installed.

Construction is well underway on the mammography room. The room is on-track to receive the machine the first week of September, with it being ready for patients by the end of September.

Demolition is also taking place on the first of the two x-ray rooms, to allow for continuity of service. X-ray machines use and produce more radiation than mammography, so the construction will follow a similar path as the computed tomography (CT) suite preparation. The first room will be open early October and work will start on the second at that time, reopening later this year.

These machines are being purchased through Hamilton Health Sciences’ Managed Equipment Services (MES) agreement with Siemens Healthineers. The same one which supported the purchase of the CT.

We’ll have more to share on these developments in the coming weeks and months.

Photo essay: Building the CT suite

Pictures are worth a thousand words. We’ve taken many opportunities over the past 9 months to capture different stages of the development – from office space to CT suite. Check out this stunning transformation.

Original floor plan when it was used as office space
Office space
And just in case you didn’t believe us that this was formerly an office space, here’s another blurry pic to prove it
CT suite floor plan
Demo day! Out with the old…
…preparing for the new
After demolition, construction crews rebuild the suite and line walls with lead panels to contain the radiation
Welding overhead mounts for equipment
Structure is built outside of the suite to house the CT “chiller”
At long last, the CT is delivered into….
…the brand new CT suite!
Patient waiting area with nature-print dividers
IV insertion and patient monitoring area
Details matter. This overhead panel provides a calming view for patients while receiving a scan
Finally, here’s the CT in its natural habitat!

Ontario Invests $15 Million to Support the Redevelopment of West Lincoln Memorial Hospital

New State-of-the-Art Replacement Hospital in Grimsby will Improve Access to Quality Health Care

February 2, 2021

GRIMSBY – As part of its comprehensive plan to end hallway health care, the Ontario government is making an additional investment of over $15 million to support the planning and design of the new Hamilton Health Sciences – West Lincoln Memorial Hospital in Grimsby. Once complete, this new state-of-the-art hospital will replace the existing aged facility, expand capacity, improve access to quality care and help end hallway health care for patients and families in West Niagara.

“This is another great step toward the new hospital West Niagara needs. A new West Lincoln Memorial Hospital is right around the corner,” said Sam Oosterhoff, MPP for Niagara West.

“I will keep advocating to make sure this project continues to move forward. Since the announcement of a new hospital in 2018, everyone has moved quickly to make this a reality. Getting to Stage 3 is an immense accomplishment for the many staff and planners who have helped get it to this point.”

The Ministry of Health has reviewed and accepted the Functional Program Submission. The new West Lincoln Memorial Hospital will provide patients and families in the region with the following:
• A modern, up to date facility with capacity for a total of 61 beds;
• A larger, 24/7 emergency department that will provide more space for staff and patients;
• Maternal and newborn services to support high-quality care during labour and birth;
• Modern surgical suites to deliver care with the best technology available; and
• Outpatient care services including minor surgical procedures such as endoscopies.
Following design of the new hospital, project procurement is expected to begin in 2021. The procurement process will ensure a fair, open and transparent selection of a proponent to begin construction on the new hospital.

“Investing in major hospital infrastructure projects like the redevelopment of West Lincoln Memorial Hospital is a key part of our government’s plan to end hallway health care and build a modern and connected health care system,” said Christine Elliott, Minister of Health.

“This investment will help to ensure that patients and families across West Niagara have access to high-quality care they need, when they need it, and that frontline health workers have the modern facilities and resources they need to deliver that care.”

“Hamilton Health Sciences is grateful for the outpouring of support for this project, particularly from Minister Elliott and her team, MPP Oosterhoff, Infrastructure Ontario, regional and local elected representatives and partners, and the West Niagara community,” said Rob MacIsaac, President & CEO of Hamilton Health Sciences.

“This project is a great example of what can be achieved through collaboration and shared vision. Each milestone we reach is a shared accomplishment for everyone involved.”

The new hospital in Grimsby is part of Ontario’s investment of $20 billion over 10 years to build new and expanded hospital infrastructure. The funding announced today is in addition to the over $2.2 million in provincial funding provided to support the planning of the redevelopment of the hospital.

Quick Facts
• On average, there are approximately 20,000 visits to the emergency department at West Lincoln Memorial Hospital each year, and around 2,900 patients are admitted to the hospital. Approximately 750 babies are born every year at the hospital.
• While early planning work for the redevelopment project was undertaken, Ontario invested $10.5 million to support immediate infrastructure improvements to West Lincoln Memorial Hospital.

Fundraising for new WLMH gets big boost

When building new health care infrastructure in Ontario, hospitals are required to raise 30 per cent of the total project cost, which includes 10 per cent of construction cost and 100 per cent of furniture, fixtures and equipment. This fundraising effort is referred to as the “local share.”

Infrastructure Ontario is pegging the WLMH rebuild around $200 million, which means the WLMH Foundation’s campaign will need to raise about $60 million.

Last week, Niagara Regional Council approved a $12.6 million commitment for the rebuild. The Region’s pledged investment follows the $26 million support already committed by the Town of Grimsby, Town of Lincoln and Township of West Lincoln.

“We’re grateful for these commitments from our municipal and regional partners. The campaign team is excited to build on this momentum and continue on the fast lane to a new WLMH. We are thrilled to continue our work with the community to take it to the finish to build a healthy community,“ stated Andrew Smith, Campaign Chair.

Stay up-to-date on the Foundation’s campaign on its website.

WLMH OR renos to start mid-June

While infrastructure projects have continued outside West Lincoln Memorial Hospital, there has been a pause on infrastructure activity inside the building due to COVID-19.

Teams at the hospital have continued to work with the contractor to review and adapt renovation plans for the Operating Rooms (OR) and Endoscopy reprocessing area. Here’s a reminder about the renos and what will be involved.

Construction is scheduled to begin mid-June and be completed by early September. All work will be completed in accordance with provincial and hospital guidelines regarding contractor screening and safety.

As plans proceed, we are making sure that everything possible is done to ensure a smooth and seamless process for all of our patients and staff.

Gradual reintegration of services

Planning for the gradual reintegration of clinical services that were paused during our initial pandemic response is underway. The reintroduction of clinical services will follow direction from Ontario Health.

Hospital-based work groups will be meeting to review the perioperative and obstetrical models and services for when the OR reopens in the fall. Work will continue to maintain a safe hospital environment and ensure appropriate allocation of hospital resources as we move through the next phase of pandemic planning.

Completing these projects will help us provide safe care until the new hospital is built. Updates will be shared as work progresses.

(Pictured: the custom air handling unit for the OR was delivered during the first week of May.)

Hospital entrance: November 22 – 25, 2019

The corridor on the main floor at WLMH will be closed as of November 22 at 1:00 pm to support infrastructure work in the main hallway. The main entrance will be open, however access to all areas of the hospital except obstetrics will be via the first floor or the basement.

If you are unable to safely manage stairs, we recommend that you enter the hospital through the Emergency Department entrance or the entrance ramp on the west side of the hospital.

The main hallway will reopen by 7:00 am on Monday, November 25, 2019.

Thank you for your patience.