Alberta's neonatal intensive care units in 'crisis' and babies at risk, doctors warn

Some Alberta doctors say neonatal intensive care units are in "crisis," putting vulnerable babies at risk, and they're calling on the provincial government to take immediate action.

The Edmonton Zone Medical Staff Association sent a letter to Health Minister Adriana LaGrange and Alberta Health Services president and CEO Athana Mentzelopoulos on Tuesday, outlining concerns — including key staffing shortages and a lack of beds — and calling for help.

"These babies have nowhere else to be cared for, and we believe the situation has become so critical that deaths of infants may soon follow," the letter stated.

In Edmonton, for example, the physicians said NICUs frequently run at between 95 and 102 per cent capacity, well above the 80 to 85 per cent range they say is considered safe. Their data shows that happened 30 per cent of the time in the first three months of 2024.

"If every bed is being occupied and an emergency comes in, there may not be a place to put that baby," Dr. Manpreet Gill, president of the Edmonton staff association, said in an interview with CBC News.

"Babies, when they're in crisis, require swift action, and if there's not enough staff, equipment or physical beds to care for them, it puts the babies at risk."

According to Gill, the pressure is being felt across the province and doctors have been pleading for help for several years.

"We've been struggling all the time with where to put babies," said Amber Reichert, an Edmonton-based neonatologist and co-author of the letter.

Reichert said nurses are often caring for three to four high-risk babies at a time instead of one or two babies.

"I'm extremely worried," she said, adding the number of infants needing care is rising as staffing shortages worsen.

"It makes me worry that at some point something's going to get missed and a baby is going to be harmed.

The letter states that briefing notes were sent to Alberta Health raising concerns about the urgent need for beds, staffing, transport teams and neonatology teams in both 2022 and 2023, with no results.

According to Reichert, another letter was sent by a group of neonatologists from Calgary and Edmonton to LaGrange and Mentzelopoulos in early February detailing their concerns.

Nurses, while not involved in the letter, say they share similar concerns.

"It definitely borders on a safety issue," said Michelle Gurin, an Edmonton-based NICU nurse and a spokesperson with the Alberta Neonatal Nurses Association.

"It weighs on you when you can't help everyone you want to help."

The pressures outlined in the letter, she said, have become routine, and front-line staff are providing the best care they can but there can be delays as staff scramble to find a free bed.

"Those delays can definitely be detrimental for babies who need the higher acuity care immediately, " she said.

Airlifting babies

The health minister called the letter "upsetting" and said she's asked for a full briefing from the health department and AHS.

LaGrange said earlier this week that she's willing to consider airlifting babies out of the province if necessary.

"[They're] looking to see what our options are and how we can rectify it as quickly as possible. If we need to transport those babies or their families to other cities or other provinces, I'm willing to do whatever it takes to make sure our babies are well looked after," she said Tuesday.

In a news conference on Wednesday, LaGrange was less adamant about transferring babies, noting she had received new information from AHS and Covenant Health and was relieved to hear there is capacity in the system. 

"I am very encouraged by what I've heard from Alberta Health Services, that we do have capacity within Edmonton and across the province," she said, adding a baby has not had to be airlifted out of the province in the last seven years.

"My greatest concern is for babies, to make sure that they're safe. And so if we need to at some point do that, we will do that. But what I've heard from Alberta Health Services is we do have capacity."

When asked about the letter Reichert said was sent to her in February, and why the government didn't act sooner, LaGrange didn't answer directly.

"There are many issues that come before us each and every day within my department. Oftentimes things go to the department and then they come to me in a briefing," she said.

Opposition NDP health critic David Shepherd called the lack of clarity "deeply disturbing."

"If the Minister was not aware, that suggests either the minister's not paying attention to her briefing or her staff did not brief her."

According to AHS, there are 309 neonatal intensive care unit beds across the province, including 133 in the Edmonton zone and 126 in the Calgary zone. Occupancy, the health authority said, fluctuates between 90 and slightly above 100 per cent capacity.

"Every child that needs intensive care will continue to receive it," spokesperson Kerry Williamson said in an email.

"AHS has NICU capacity across the province, and our front-line teams continue to provide patients with the very best care possible."

As of noon Tuesday, Williamson said there were nine NICU beds available in the Edmonton zone, 14 in the Calgary zone and 17 in Red Deer, the south zone and Grande Prairie combined.

AHS said NICU teams work together with their colleagues in other zones, and when volumes are high, babies are already transferred to different hospitals.

Doctors call the responses from the health minister "disheartening" and "disappointing," adding airlifting babies to another province is extremely expensive and the province should have addressed their concerns earlier.

For her part, Reichert said beds need to remain open in NICUs so staff can treat severely ill babies quickly when they are admitted. She noted capacity is already above what is considered the safe zone.

"The buffer has to be there because otherwise what do we do? Where do we put these kids?"