Two decades into a career she once loved, Toronto emergency room nurse Nancy Halupa says she is almost ready to throw in the towel.
“I don’t think I can do a fourth wave with this kind of staffing,” she told Global News.
“It’s not good for my mental health. It’s not good for my family. It’s not a workable situation anymore.”
Across the country, hospital staff are leaving their jobs at an alarming rate. And that’s prompting experts and health-care workers to call for more action from the federal government.
Nearly one in five job vacancies in Canada is in health care and social assistance, according to Statistics Canada. In early 2021, those sectors experienced the largest losses year-over-year compared to all other sectors.
Weekly overtime increased, too, 78 per cent on average from May 2019 to May 2020, the Canadian Federation of Nurses Unions (CFNU) said, using data from StatCan.
According to the CFNU, that number jumps to 137 per cent in Quebec and Ontario.
In Canada’s largest province of Ontario alone, the president of the CFNU told Global News it estimates there are more than 16,000 vacancies.
For those, like Halupa, who haven’t quit, the workload, she said, is crushing.
“Things need to change. It is getting dangerous out there,” said Halupa.
“I’ve never gone to work with this much anxiety or fear on what I’m going to see or what we’re going to have to deal with or how short-staffed we are.”
Halupa said not all the blame can be put on COVID-19. Recruitment, retirements and pay, she said, have also played a role in pushing people out of the profession.
At a recent rally in Toronto, medical professionals condemned the Doug Ford government for Bill 124.
The legislation was introduced pre-pandemic in 2019 and caps certain public sector wages, such as nurses’, at a one per cent annual increase.
For registered nurse Leah Waxman, that meant 47 cents more per hour for her last raise, a number that doesn’t make her want to stay in her role.
“Something acute needs to happen to make a drastic change and prevent our health-care (system) from collapsing … because it is,” she said.
Richard Mullin, a spokesperson for Ontario’s Treasury Board, told Global News in a statement that “it is inaccurate to suggest that Bill 124 caps wages at one per cent annually.”
“Ontario’s public sector employees will still be able to receive salary increases for seniority, performance, or increased qualifications as they do currently,” Mullin explained.
Labour expert Rafael Gomez called the legislation “suppressive.”
“Health-care spending now is the largest ticket item of any government. So I understand the macro priorities,” said Gomez, the director of the Centre for Industrial Relations and Human Resources. “But health-care is a micro event. When you’re in a hospital and you need help and you want a nurse to be there, that’s affecting you personally. And if there are policies that are hampering that, I think the government is sort of short-sighted.”
A Canadian problem
In July, Alberta Health Services confirmed it had only about 18 treatment beds available at one of its busiest hospitals, the Royal Alexandra, “due to short-term staffing coverage issues.”
Alberta Opposition NDP Leader Rachel Notley said bed closures due to staffing pressures aren’t isolated.
“This has led to bed closures and cancelled surgeries and repeated emergency room closures in the communities of Edson, St. Paul, Boyle, Elk Point, Galahad, Westlock, Fairview, Rocky Mountain House, Cold Lake, Lac La Biche, High Prairie, Slave Lake, Wainwright, Rimbey and Lacombe.”
Since then, the United Nurses of Alberta has said the province has been hiring contract nurses to address severe staffing shortages in hospitals there.
Meantime, in Kamloops, B.C., the shortages have become deadly. There, a 70-year-old woman died in an emergency department waiting room while seeking treatment last week.
“The government has let the situation at the hospital’s emergency department become dire — we’ve heard reports that some shifts have only three nurses trying to keep up with a workload usually handled by 13 people,” Kamloops-South Thompson MLA Todd Stone said Monday.
Cheryl Cusack of the Association of Regulated Nurses of Manitoba said there, nurses are struggling with depression and other mental health issues, including trauma, as a result of their efforts to save coronavirus patients.
And in Nova Scotia, what was once a seven per cent vacancy rate has climbed to 20 per cent, according to the Nova Scotia Health Authority.
“We’ve had 34 people leave the Halifax Infirmary emergency department in the past two-and-a-half to three months,” said the province’s General Employees’ Union president Jason MacLean. “Six of them didn’t even have other jobs. So what we need to do is find out why they are leaving, which I believe we are getting to, but also people need to be incentivized to stay there.”
Experts call for federal leadership
The president of CFNU, Linda Silas, told Global News Ottawa needs to “show leadership.”
“We need commitment from the federal government to create a health-care workforce agency,” Silas said. “The federal government will have an agency to look at how many nurses we need in five years. What do we need to do today to keep what we have and plan better with the provinces and territories?”
When asked if it would consider any of these measures, in an email to Global News, Health Canada spokesperson Mark Johnson wrote: “the responsibility for matters related to the administration and delivery of health services, including health workforce planning and management, falls within provinces and territories jurisdiction.”
It’s not the first time health-care experts have asked for the Canadian government to create national standards or regulations for nurses.
Over the last year, seniors’ advocates have been pleading for national standards in nursing homes. And while Liberal Leader Justin Trudeau made the promise last fall, his government still hasn’t put anything into action.
Colleen MacPherson, a critical care nurse in Toronto, is upset the provinces and the federal government haven’t made significant steps to fix the growing problem.
“Look what happened in long-term care. The nurses were working without protection. They were understaffed,” she told Global News.
And, she said, hospitals aren’t immune.
“People are at risk. We have no staff. Nurses didn’t get any vacation this year. Wages are stuck.”
Now, MacPherson and others worry an election has created more uncertainty and set back any plans for a solution.
During the 2021 federal election campaign, Trudeau has promised that a re-elected Liberal government will give $10 billion to help provinces clear their backlogs and pandemic wait-lists. It plans to help provinces hire 7,500 nurses, nurse practitioners and family doctors.
The Conservatives, meanwhile, have vowed to meet with premiers to make a new health-care agreement and boost the annual growth rate of the Canada Health Transfer by six per cent if elected. That plan would add nearly $60 billion to the system over a decade.
Erin O’Toole did fall short of promising to hire more front-line workers.
Jagmeet Singh and the NDP announced $250 million to address the health-care worker shortage, a fund to help hire 2,000 nurses across the country.
The Green Party, meanwhile, promised to develop national health-care guidelines.
Toronto emergency room doctor Chris Keefer said in the meantime, patients are the ones really suffering.
“If nurses aren’t available to get orders done, to get procedures done and treatments done, patients wait and wait and wait. And people are already quite frustrated with that. But it’s getting worse and worse and it’s getting critical,” Keefer said.
“It’s impossible to run a department shorthanded,” she said, worried the time to save the health-care system is running out.
“There’s not a lot of veteran nurses left,” she said. “if you want to keep health care somewhat safe, then you need to retain the people you have. You need the veterans. You need to retain who you have now.”