President of the Ontario Nurses’ Association says shortage is ‘a crisis.’
Nancy Halupa was seated with her co-workers at 3 a.m., nearly eight hours into her 12-hour shift, when a colleague looked at them and said what many were feeling: that they had never seen such a “defeated group of nurses.”
“I was like, ‘Yeah, we’re done,’” Halupa says.
A registered nurse who works in an emergency department in Toronto, Halupa said she’s never felt so demoralized in her 23-year career.
“I can’t even explain to you how hard it is to get up and go to work these days.”
The latest blow came in the form of a directive from her hospital network, which Halupa asked the Star not to name, that said nurses should still go to work if they are asymptomatic but have had “significant COVID-19 exposure,” including to high-risk contacts or family members who are experiencing symptoms, under what is called “work self-isolation.”
It’s among similar measures being enacted at different hospitals as nurse-strapped health-care systems across Canada try to contend with the Omicron variant.
Dr. Donald Vinh, an infectious disease specialist at the McGill University Health Centre, says all Canadian provinces will likely face similar choices in the coming days as the number of sick people rises and the pool of workers available to treat them shrinks.
“We are in a fixed, limited number of health-care workers in every province, because there’s no reservoir or pool of health-care workers that we can sort of depend on to bail us out here,” he told The Canadian Press this week.
Halupa sent a copy of the directive she received, up to date as of Wednesday, to the Star. It lays out a list of scenarios and return-to-work procedures.
One scenario says staff who have a member of their family experiencing symptoms but are asymptomatic themselves can continue working following work self-isolation guidelines, which entail wearing appropriate personal protective equipment and actively self-monitoring.
Another scenario makes clear that if staff are experiencing symptoms, they must notify their supervisor, get tested, report their absence and symptoms to the COVID-19 call centre, and self-isolate at home while they wait for their PCR test results. They can only return to work when cleared by the call centre.
Halupa said it feels like the network is encouraging nurses to work until it’s effectively impossible to do so, rather than erring on the side of caution.
“‘We’re prioritizing the staffing issue that we caused, at your risk.’ That’s what they’re saying,” she added. “We need to have our staffing fixed, so we’re going to punish you for something we caused.”
Halupa said patient-to-nurse ratios have increased from four patients to one nurse to five patients per nurse where she works.
“The floors are short-staffed and the ICU is full … We’re full because we don’t have nurses, that’s what people don’t understand. So you’ll walk into a hospital and see empty beds, but that’s because there’s no one to work (on patients),” she said.
Vicki McKenna, provincial president of the Ontario Nurses’ Association, calls the nursing shortage “a crisis.”
“It was happening and predicted to happen before COVID,” she said. “We knew the numbers were a problem.”
McKenna said a month or six weeks ago she would have said there was a 15 to 18 per cent nurse vacancy rate in Ontario hospitals. Now, she said, it’s closer to 20 to 24 per cent.
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, agreed that Ontario’s nursing shortage is a long-standing problem, but said the pandemic has brought it to a breaking point. The surge in cases due to Omicron in the past month has increased the pressure.
Furthermore, she said nurses have been leaving Ontario due to unfavourable work conditions and the dispute with the Ontario government over Bill 124, which limits wage increases to a maximum of one per cent total compensation for three years.
“It’s not only because of Omicron … one is the length of the pandemic, 22 months now, so people are more and more exhausted. Number two, employers and many organizations, if you get sick they don’t pay you. Third, nurses are fed up with Bill 124 … and they don’t feel respected,” Grinspun said.
In a statement, an Ontario Health Ministry spokesperson said the province is working to safeguard the province’s hospitals, primarily through getting people vaccinated.
“In the face of the rapidly spreading Omicron variant, the Ontario government is rapidly accelerating its booster dose rollout by expanding eligibility to all individuals aged 18 and over, as well as shortening the interval to three months following an individual’s second dose,” said spokesperson Denis Murphy.
The Ontario ministry said there are approximately 740 ICU beds immediately available with nearly 500 more available for surge capacity.
Raywat Deonandan, an epidemiologist and associate professor at the University of Ottawa, said asking nurses to continue working even after being infected with COVID-19 may be “unavoidable” in the near future.
“As we come under an enormous health-care worker crunch — and I don’t see any way around it — you may have to mobilize medical students, nursing students as well,” he said.
Deonandan said if a person is asymptomatic they are likely not shedding a lot of virus. If they’re wearing a properly fitted N95 mask, in an environment where there’s good HEPA (high-efficiency particulate absorbing) filtration, and are being careful not to be near people, he said he thinks the risk is low.
But the key is those nurses shouldn’t be in contact with patients who aren’t infected.
“We have to keep you away from vulnerable people. And you’re really well served to work in the COVID ward, because those nurses aren’t going to be newly infecting people. So there is a role to be played by these people, but what you have to be careful about is the asymptomatic nature. That’s critical. Once you’re symptomatic, I think all bets are off. The risk is far too great.”
Birgit Umaigba, a registered nurse who works for an agency in the Toronto area that provides nursing services, told the Star she was working on Wednesday in an ICU where there were nine nurses for 22 patients, adding that typically an ICU should have a one-to-one patient-to-nurse ratio.
“And then they had five agency nurses come in. So almost half the staff a lot of the time are agency nurses, which is crazy,” she said.
Before the pandemic, she said work wasn’t always available for agency nurses. But now there is a huge demand.
“Sometimes I never even got a shift. Now I could have a prepared schedule if I wanted to. That’s how much they rely on us,” Umaigba said.
Halupa, meanwhile, called in sick Wednesday after she woke up with a bad headache and chills. She believes she may have contracted COVID-19, as she was working with several babies on Monday night who were infected.
“It could just be a simple cold. But the anxiety whenever I get sick is just horrible. And this past fifth wave has been the worst for me. I feel like I’m doing everything I’m supposed to do and it’s like you can’t protect anybody … honestly, I’m broken,” Halupa said, her voice cracking over the phone from her home, where she was isolating.
Halupa doesn’t get paid for sick days because she is considered casual staff, despite working full-time hours and having more than 20 years’ experience. It’s a scenario that is common in Ontario.
The shortage is not only affecting nurses’ morale, but is having a ripple effect on the whole hospital system, Halupa said.
The emergency department is seeing more acute-care patients, because there’s nowhere else to put them. In some cases, doctors are helping nurses with certain tasks, such as removing IVs and completing required blood work and paperwork, Halupa said.
Halupa said the most important message for her to get across to the public is that nurses “aren’t the bad guys.”
“Nursing is the most trusted profession in the world. People literally give you their children and let you walk away. And yet, I get called vile names because of a pandemic I didn’t cause,” Halupa said.
“Yelling at me and threatening me that you’re going to call your lawyer because we don’t allow unvaccinated visitors doesn’t help. It’s just beating us down.”
Article From: The Star
Author: Omar Mosleh
