Code Critical: N.S. nurses say ‘crisis in staffing’ continues to take emotional and physical toll

This is the latest instalment in a Global News series called Code Critical, which examines the issues impacting the health-care system in Nova Scotia. The full series can be found here. 

As a registered nurse working in infection control, Natalie Nymark knows what it means to be busy, overworked and burned out.

It’s becoming evident among her colleagues now more than ever, she said.

“They’re burning out at the bedside and in patient care,” she said.

Nymark primarily works with the women, mental health and addictions programs at the IWK Health Centre in Halifax.

During the height of the COVID-19 pandemic, she worked with infection control at the Northwood long-term care centre that became the epicentre of the province’s outbreak in 2020.

She said that in recent years, the health-care system has been growing increasingly strained amid a shortage of workers.

Even seasoned nurses are leaving the profession or retiring early.

“When you lose even mid-career nurses — like five, 10, 15 years out in their career — you’re losing the ability to have a nurse who can walk into a room and just know what to do next,” she said.

She points out that these experienced nurses are also those who mentor new employees, or international workers as they learn the Canadian health-care system.

“Some of the units I help support as an infection control practitioner, they have huge numbers of nurses who are less than five years … and they’re working on these highly acute, specialized units,” she said.

For the nurses who do stay, Nymark said they’re facing burn out.

“Their priority is their patient,” she said.

“If you’re stuck between having a difficult conversation with a family and supporting them through something hard and life-changing, nurses are going to take that conversation over their lunch.”

The president of the Nova Scotia Nurses Union, Janet Hazelton, confirms there is “still a significant number” of vacancies in the province — including 1,000 in the Nova Scotia Health Authority — which is the union’s largest employer.

The problem, she said, is that nurses are not only overworked, they’re getting injured at alarmingly high rates.

“They’re not staying because they don’t want to get hurt. They don’t want all that overtime, and they want vacation, which is often denied for a lot of nurses because you can’t give a vacation day to someone if you have no one to replace them,” she sad.

“Our injury rates are high. We have not just vacancies, but we have a lot of people not at work because they’re sick or hurt. So, that exacerbates the problem.”

Hazelton said the union has noticed the same trend Nymark has seen: mid-career nurses leaving the system.

“That has never been a thing before now because normally, mid-career, you’re in your pension plan, you’ve got your sick time, your (vacation) banks, so you’re settled,” she explained.

“It really is a crisis in staffing at the at this point in time.”

Hazelton said she does feel a sense of hope that things will improve, especially since the union made gains in its new contract. That collective agreement includes a framework to set up nurse-patient ratios to guard against hospital units working short-staffed.

“I am optimistic there is going to be some relief for our nurses. Not tomorrow, not next week, but certainly on the horizon of the next two to three years,” Hazelton said.

In a sit-down interview with Global News last month, Nova Scotia Health Minister Michelle Thompson said government has put in “a significant investment” when it comes to recruiting both physicians and nurses.

“There’s never been this amount of investment in my career as a registered nurse in health care. There’s never been this change,” she said.

There have been moves over the past year to recruit more nurses and speed up their education so they can work sooner.

In March 2023, the Nova Scotia College of Nursing announced it would speed up application processing for nurses trained in Canada and seven countries where the scope of practice is similar to Nova Scotia: the Philippines, Nigeria, India, the United States, the United Kingdom, Australia and New Zealand.

A month later, the regulator said it had received an influx of applications. 

As well, Acadia University began hosting a satellite Bachelor of Science in Nursing program along with Cape Breton University last fall. The new nursing program had a goal of graduating 42 nurses by 2026, and then 63 nurses annually after that.

During the same announcement in May 2023, Nova Scotia Community College received $2.1 million from the province to expand its LPN program.

In December 2023, the province moved to restrict the amount of time so-called travel nurses can work in Nova Scotia. The change meant nurses who travel from other areas or provinces to work at hospitals where there are nursing shortages can only be hired for a maximum of 180 days.

In addition, nurses who complete travel nurse contracts will have to wait one year before they can be hired again as such.

Premier Tim Houston said the change was aimed at encouraging travel nurses to accept permanent positions.

While Nymark said she’s concerned about her profession and her colleagues, she’s also optimistic about the future.

“I think we’re hopefully on the right path, but we’re not there yet and we still need more,” she said.