The Nova Scotia Health Authority says a rising number of nursing vacancies at the East Coast Forensic Hospital has led to “intensive recruitment” of nurses from other units who don’t necessarily have experience in forensics.
“It is normal practice within NSHA for nurses to work or help out in another area when there are high levels of vacancies, but we would always orient our nurses before putting them into independent frontline care roles,” said Rachel Boehm, the NSHA central zone director of mental health and addictions.
In recent years, the patient load at the East Coast Forensic Hospital has increased, leading to challenges with managing the rising number of offenders with mental illnesses in need of care.
Boehm says that for nurses seeking overtime shifts at the facility, preference has been given to those who have casual experience picking up shifts there before.
“We did put a call out to the program within mental health and addictions to see if we could bolster our casual roster,” she said.
The patients in the East Coast Forensic Hospital are ordered there by the courts. Many of them have committed crimes but were found not criminally responsible on account of mental disorders.
Boehm says providing healthcare for offenders with mental illnesses can come with unique challenges and safety risks that may increase in the face of a nursing shortage.
“If you had to operate without appropriate staffing levels, there is a risk, and that was our concern. We were managing to fill all of our vacancies but we’re doing it with overtime and we know that sustained overtime over a long period of time isn’t good for our nursing workforce,” she said.
“It often leads to other recruitment issues because people do tire of that and it wears on their physical and mental health.”
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While NSHA says they’ve been successful in recruiting nurses from other areas to help manage the shortage, the union that represents those nurses says they’re hearing otherwise.
“The specific concerns that they [nurses] have is that they’re understaffed, severely understaffed. Also, people aren’t taking other shifts because they’re overwhelmed and tired and they’re not getting compensated at the overtime rate,” said Jason MacLean, the president of the Nova Scotia Government and General Employees Union.
The way NSHA nurses are paid overtime has recently changed. According to the union, nurses used to be paid overtime for any extra shift they worked during a pay period. Now, NSHA won’t pay overtime if a nurse is ill or on vacation for part of a two-week period. They only get paid straight time for an extra shift under those circumstances.
“What people are saying is they’re not giving up the extra time in their lives to work for straight time,” MacLean said.
NSHA spokesperson Carla Adams wrote in an email that “the collective agreements have always had language that stated that overtime was paid for extra hours ‘worked.’ That has not changed. NSHA, as the employer, gave notice that we intended to implement the language in the agreements.”
Regardless of the interpretation, the change in overtime is being felt by managers and employees.
“It’s a different approach, different guidelines to how we call in overtime. So, there has been a learning curve for the staff and the managers,” Boehm said.
NSHA says a significant amount of recruiting work has gone into avoiding future staffing challenges at the East Coast Forensic Hospital, including the hiring of upwards of 15 nurses since June 2018.