Dr. Fernando Ponce said he's comfortable with the emergency room taking in children.
NORTH ADAMS, Mass. — The Massachusetts Nursing Association doesn't want North Adams Regional Hospital to close its pediatric unit.
That message was made clear by the statewide union Friday morning during the state Department of Public Health's public hearing on the changes.
But hospital officials say the unit isn't busy enough to keep open.
According to a hospital document, NARH has proposed to close two inpatient pediatric beds as part of an overhaul of hospital operations.
That unit is currently staffed to handle just two patients a day but see generally about one a week.
The average daily census is 0.21 patients per day or 52 per year. The new plan will provide care through the Emergency Department and those who require further inpatient care will be sent to Baystate Medical Center.
Childsy Art, a pediatrician with Northern Berkshire Pediatrics, which operates independently at the hospital, said the need for the pediatric unit has been reduced during previous decades because of the advancement of vaccines and better, safer medicines.
Now, the average child who needs admittance is sicker than before and the pediatricians on hand have less experience providing the needed level of care regularly to feel comfortable, Art said.
Leesa-Lee Keith, vice president of nursing at NARH, said all nurses in the Emergency Room are certified pediatricians and can handle the needs. Art noted that the top two reasons for children to be admitted in asthma attacks and dehydration.
During the past 11 years Art has worked for NBP and she said that the sickest children already go to Baystate Medical Center.
"Over the time that I've been here the percentage of kids we have been sending has gone up as the comfort level of our nurses at the hospital has gone down," Art said.
Colleen Hunkler, a critical care nurse at NARH, opposes the closure of the units.
Colleen Hunkler, a critical care nurse at NARH, spoke in opposition to the closure — as well as other closures to be discussed at a later hearing.
Hunkler worried about overloading the Emergency Department with patients and sending patients outside of North Adams.
"What about the families of our patients, including the parents of the young children who will be shipped to hospitals far from home for the care they once received right here," Hunkler said. "Now we are placing more stress and an extra burden on entire families who must find a way to be with their loved ones in their time of need."
Charlene Richardson, an associate director at MNA, worked at Beverly Hospital
where the pediatric unit was closed and didn't like the results.
"And what I see as the common denominator in the conversation that everyone says they have a plan," Richardson said. "I don't think this is a plan, I think it's a recipe for disaster."
Richardson said the Emergency Room is already a "landing zone for everything bad that goes on in a community" and busy Emergency Room nurses shouldn't deal with pediatric issues, especially in a hectic environment.
She also said transferring out isn't a seamless procedure and expressed concerns with safe transportation and the availability of physicians and nurses at other locations.
Dr. Fernando Ponce, who heads the Emergency Room, said he's been comfortable with his staff serving children. If the child is too sick for NARH, he said he has no problem sending the patient elsewhere.
"That is more or less how I see it," Ponce said. "The hospital needs to adapt to the changing environment, we have adapted in the Emergency Room to a changing environment and I hope we continue to do so."
Dr. Arthur Turton, a retired neurologist and member of the Northern Berkshire Health Board of Trustees, said the plan was developed by the board with "considerable input" from the community.
"It was developed to advance the quality of care at our hospital and the access of care for our community while providing long-term financial stability for Northern Berkshire Healthcare," Turton said.
Turton further explained that regionalization allows more access to specialized services and technology not available at the community hospital in a more fiscally responsible way.
The state Department of Public Health will review the comments following the hearings and reply to the hospital in 15 days. Then, the hospital will need to submit a plan of how to assure access to the service within 15 days.