Nova Scotia

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

Pathology staff in Halifax are working extra hours to diagnose patients, all while dealing with a long list of hurdles that range from basic computer functions to floods that are "a disaster waiting to happen," according to the head of the department.

Pathology department is not included in QEII redevelopment despite aging building

Technical specialist Charlene Sencabaugh and medical laboratory technologist Shane Weatherby work inside a pathology labs in the Mackenzie Building on the Victoria General Site in Halifax. Staff say the building needs significant upgrades in order to protect their work. (Submitted by Dr. Laurette Geldenhuys)

Inside Halifax's pathology department, one physician works in a room with a pipe that drips into a bucket. 

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

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

The pathology lab is a crucial, yet often overlooked, part of the health-care system, says Dr. Laurette Geldenhuys.

Her concerns are echoed by a Nova Scotia Health review that also warns the state of the laboratory's facilities are failing. 

The team processes about 100,000 samples a year for patients across the Atlantic region. While the volume of work is enough for them to be swamped, problems with the building are pushing the team to the brink, says Geldenhuys. 

"As the pressure keep mounting and mounting, no amount of collegiality is going to make up," she said of the stress put upon her team. "I'm concerned once we start losing pathologists, once people resign, it will have a negative spiraling effect."

Pathologist Dr. Laurette Geldenhuys is pictured with a microscope.
Dr. Laurette Geldenhuys, division head of pathology, is worried about burnout within her department. She says staff are struggling with infrastructure issues, all while dealing with a heavy workload. (Dr. Laurette Geldenhuys)

She says there have been several floods. One was "within inches" of sensitive equipment in the lab that processes cancer samples.

In another office, "there is a pipe coming from the ceiling into a big bucket of water and that is not fixable. So the pathologist has to work under those conditions."

Geldenhuys says her team is constantly worried about more flooding.

"That can have a very significantly negative impact on patient care. So it is just really a disaster waiting to happen."

Geldenhuys's concerns are mirrored in an review of the department that was released in March. It says "there are significant structural concerns about the Mackenzie building" with "potential for serious disruption of the service."

Janine Jackson, a pathologists’ assistant, processes a lung cancer specimen while wearing a powered air purifying respirator or PAPR. (Submitted by Dr. Laurette Geldenhuys)

The ventilation system in the building is also woefully inadequate, Geldenhuys says. Some staff must wear bulky safety gear in order to protect themselves from toxic fumes.

"They have to wear these suits with ... a hood and a special filter that costs a large amount of money. That's completely unrecyclable. They just go in the garbage," she said.

Geldenhuys says they've been working with Nova Scotia Health engineers for years to come up with a solution, but any improvements will be years away.

The pathology department hoped a permanent solution was in their future as they anticipated being 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. The pathologists work closely with the surgeons, and often transport samples back and forth as part of their work.

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

"This means the very highly specialized subspecialists would need to drop everything they are doing, go all the way over to the HI, provide their opinion and come back," she said, adding that makes it more likely for a specimen to be lost."

'Ongoing discussions' to modernize 

Nova Scotia Health declined several requests for an interview about the concerns. Instead, it sent statements that did not explain why pathology is not being relocated.

"Nova Scotia Health and the government of Nova Scotia continue to evaluate health-care infrastructure needs and are committed to modernizing and upgrading facilities across the province," the statement read.

"The Mackenzie building is part of these ongoing discussions."

The Mackenzie building will continue to house the pathology department, even though nearby surgeons at the Victoria General will be moved in the QEII Redevelopment. (Dave Irish/CBC)

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

Computers crashing

The review of the pathology department also addressed the antiquated computer system, which relies on Windows 7 operating systems.

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

"That takes forever," she said. "Then you have to keep rereading it to make sure that you don't have typographical errors. It really is very frustrating."

Nova Scotia Health said in a statement that 84 per cent of the health authority's computers have been upgraded to Windows 10. It expects the entire network — including pathology — to be done by the end of the year.

Burnout a concern

Faced with all these challenges, Geldenhuys says staff are suffering from burnout. She says they stay because they have a terrific sense of camaraderie, but that can only go so far.

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

She says they have no time to learn new testing methods that can help determine whether patients can take newly developed medications. Some of those samples are being sent away to other labs.

"There are other areas that suffer, but patient care is a priority so that for the most part, as far as we are able, we just keep doing that," Geldenhuys said. 

ABOUT THE AUTHOR

Carolyn Ray

Videojournalist

Carolyn Ray is a videojournalist who has reported out of three provinces and two territories, and is now based in Halifax. You can reach her at Carolyn.Ray@cbc.ca

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