Children with Type 1 diabetes are being impacted by Manitoba’s nursing shortage as the province’s only pediatric diabetes clinic is canceling appointments.
The Manitoba Nurses Union said many nurses in the clinic, as well as nurse educators at Health Sciences Center in Winnipeg, have been reassigned to other areas because of a nursing shortage.
Health Sciences Center is where the Diabetes Education Resource for Children and Adolescents (DER-CA) is located.
“It affects people in really big ways. It’s really scary,” said Trevor Kirczenow, founder of the advocacy group Emergency Diabetes Support for Manitobans.
Insulin is a hormone, “but it’s also a pretty dangerous medication,” he said. “If you give too much of it, your child could die. If you give too little of it, your child could die.”
Manitobas only children’s diabetes clinic is canceling scheduled appointments weeks in advance, telling patients that they have no nursing staff because they’ve all been seconded to Children’s Hospital.
Nurses who work in clinics but previously worked in areas where they’re now short-staffed have been reassigned back to those areas to provide support, said MNU president Darlene Jackson.
“This is really indicative of how short we are in health care right now, and what this nursing shortage is doing.”
It has forced parents into a stressful position where they are second-guessing how to care for their children, she said.
Shared Health, which co-ordinates health care in Manitoba, said 70 appointments have been impacted since last month due to staffing issues at the clinic.
A spokesperson said a nurse from the clinic was moved in August to HSC Children’s Hospital, which has seen a rise in patients in recent months while experiencing its own staffing issues. A second staff member at the clinic later left their position, and a third is on a leave of absence.
The clinic has a new staff member scheduled to start next month, the spokesperson said, and the clinic’s medical team “has assisted with teaching to minimize the impact to patients and families as much as possible.”
Canceled appointments will be rescheduled, Shared Health says, but families can access care through their family doctors in the meantime.
Having regular meetings with nurses about changes in insulin dosages and a child’s lifestyle is extremely important, especially for families who have never dealt with diabetes before, said Kirczenow, whose 11-year-old son is the only person in his family to experience it.
People new to dealing with the disease can require information about how much insulin to give a child when they eat certain things, or scramble to understand why a kid’s blood sugar is high or low and what to do next, he said.
“It’s very serious and the amount that you need to give can change because of activity [the child becomes involved in], or it could change because of a growth spurt and growth hormones. So there’s a lot of variables.”
Type 1 diabetes is a genetic condition that often shows up early in life, so it is most common in children. Type 2 is mainly lifestyle-related and develops over time.
Shannon Naldrett, whose 14-year-old daughter was diagnosed with diabetes two years ago, said it was difficult enough during the height of the COVID-19 pandemic when most meetings were virtual. To now have them outright canceled or delayed for months is hard to take, she said.
They were supposed to have an appointment in May but that was canceled and moved to November. Appointments should be every three months, said Naldrett.
“We were quite upset…. To pull services from youth and and diabetes management didn’t really seem family-centred, and it seemed unsafe,” she said.
“In the diabetic world, [six months] a really long time to go with just your parents kind of managing things and being an endocrinologist and trying to have to figure [it] out.”
Naldrett said her family is fortunate to be able to afford continuous glucose monitors and insulin pumps without it being a financial burden, but that’s not the case for many others.
Those devices still require education and support from medical professionals but without them, and going six months without an appointment, it would be much more challenging and worrisome, she said.
“The pandemic has really given us a new lens on how terrible our health care is in a lot of situations,” Naldrett said.
“We’re in trouble if we’re pulling nurses from something like managing kids in the diabetic community. It’s frustrating for parents and people who are really feeling this.”
The scenario currently facing nurses is also causing anxiety, Jackson said, not only because they are being moved to jobs for which they might not have the most up-to-date skills, but also because they’re worried about the patients they’ve had to leave behind.
“What we’re seeing is nurses being shuffled around like pawns on a chess board,” she said. “And part of the domino effect is how are we ever going to catch up with all of these appointments that are being cancelled?”