Air pipes

Leaking pipes, toxic fumes: Crumbling infrastructure pushes Halifax pathologists to the brink

Inside the Halifax pathology ward, a doctor works in a room with a hose dripping into a bucket.

In another room, staff wear expensive safety suits to protect themselves from toxic fumes due to ventilation problems.

Located inside the Mackenzie Building on the Victoria General site, the head of pathology says their crumbling infrastructure puts patient care at risk.

The pathology laboratory is a crucial, but often overlooked, part of the health care system, says Dr. Laurette Geldenhuys.

His concerns are echoed by a Nova Scotia Health review that also warns that the state of the lab’s facilities is failing.

The team processes approximately 100,000 samples per year for patients across the Atlantic region. While the volume of work is enough for them to be overwhelmed, problems with the building push the team to the brink, says Geldenhuys.

“As the pressure keeps mounting and mounting, no collegiality is going to catch up,” she said of the stress placed on her team. “I fear that once we start losing pathologists, once people quit, it will have a negative effect on the spiral.”

Dr Laurette Geldenhuys, head of the pathology division, is worried about burnout in her department. She says staff are struggling with infrastructure issues, while coping with a heavy workload. (Submitted by Dr. Laurette Geldenhuys)

She says there have been several floods. One was “within centimeters” of the lab’s sensitive equipment that processes cancer samples.

In another office, “there is a pipe running from the ceiling into a large bucket of water that cannot be repaired. The pathologist therefore has to work under these conditions”.

Geldenhuys says his team is constantly worried about further flooding.

“It can have a very negative impact on patient care, so it really is a disaster waiting to happen.”

Geldenhuys’ concerns are reflected in a department review released in March. It says “there are significant structural concerns with the Mackenzie building” with “potential for serious disruption of service”.

Pathologist’s Assistant Janine Jackson treats a lung cancer sample while wearing an air-purifying respirator or PAPR. (Submitted by Dr. Laurette Geldenhuys)

The building’s ventilation system is also woefully inadequate, says Geldenhuys. Some staff members have to wear bulky safety gear to protect themselves from toxic fumes.

“They have to wear these suits with … a hood and a special filter which is very expensive. It’s completely non-recyclable. They just go in the trash,” she said.

Geldenhuys says they’ve been working with Nova Scotia Health engineers for years to find a solution, but any improvements will take years.

The pathology department hoped that a permanent solution would be in its future, as it planned to be part of the QEII redevelopment project.

Not included in redevelopment plans

The Halifax Infirmary expansion includes moving nine operating rooms from the Victoria General site to the new facility. Pathologists work closely with surgeons and often transport specimens as part of their job.

Geldenhuys says they were shocked to learn that pathology will remain permanently in the Mackenzie building.

“That means very highly specialized sub-specialists should drop whatever they’re doing, go all the way to HI, give their opinion and come back,” she said, adding that this makes it more likely to lose a specimen. “

“Ongoing discussions” to modernize

The Nova Scotia Department of Health declined several interview requests about the concerns. Instead, he sent statements that did not explain why the pathology was not misplaced.

“Nova Scotia Health and the Government of Nova Scotia continue to assess health care infrastructure needs and are committed to upgrading and upgrading facilities across the province,” the statement said.

“The Mackenzie Building is part of those ongoing discussions.”

The Mackenzie Building will continue to house the pathology department, although surgeons near Victoria General will be relocated as part of the QEII redevelopment. (Dave Irish/CBC)

The health authority also sent out a five-year plan for maintenance work on the Mackenzie Building. It included new windows and work on heating, ventilation and air conditioning systems, but it did not say whether those projects would directly address the concerns of the pathology department.

Computers crash

The pathology department’s review also focused on the outdated computer system, which relies on Windows 7 operating systems.

Geldenhuys says it’s so unreliable that some pathologists have resorted to manually typing their lengthy reports instead of dictating them.

“It takes forever,” she said. “Then you have to keep proofreading it to make sure you don’t have typographical errors. It’s really, really frustrating.”

Nova Scotia Health said in a statement that 84% of the health authority’s computers have been upgraded to Windows 10. It expects the entire network – including pathology – to be complete by the end of the year.

Burnout is a concern

In the face of all these challenges, Geldenhuys says staff are suffering from burnout. She says they’re staying because they have a great sense of camaraderie, but that can’t go any further.

She says both sides of the department — the pathologists and the technologists who prepare the samples — are working overtime just to stay afloat and process the samples in an acceptable timeframe.

She says they don’t have time to learn new testing methods that can help determine if patients can take newly developed drugs. Some of these samples are sent to other laboratories.

“There are other areas that are hurting, but patient care is a priority, so where possible we continue to do that,” Geldenhuys said.