Canada’s nurses pushed to work too long, too often

RN Karen Noseworthy: “We’ve got to take the time to say ‘Good job.’”

NOBODY WANTS NURSES TO GET TOO EXHAUSTED TO CARE. Yet our provincial governments keep making that a real possibility. Nowhere more so than in Newfoundland and Labrador.

The government there refuses to spend money to hire the nurses the province needs. It makes the nurses they do have work overtime, instead. More and more for 24-hour shifts. This is bad economics and a health risk for patients and nurses alike.

Debbie Forward, President of Newfoundland and Labrador’s 5,500-member Registered Nurses’ Union, says: “Twenty-four hour shifts are becoming—I wouldn’t say routine, but certainly becoming—the solution for not having an RN to provide relief.

“It’s not acceptable for a pilot to fly for 16 consecutive hours. How is it ok to force a registered nurse to work 14, 15, 16 consecutive hours caring for patients—sometimes even an unthinkable 24 hours straight!

“This is unsafe for RNs and their patients.”

Safe staffing, safe workload key issues

Nurses there are in contract negotiations. Forward says safe staffing and safe workload are the number one issues for her members.

There are roughly 6,000 RNs in the province. In 2016-17 they were paid $14 million in overtime—enough to hire 191 full-time nurses.

In addition, the long hours and short staffing take a real toll on the health and well-being of the nurses. Sick leave increases. It cost the province about $33 million in 2017—enough for another 452 full-time nurses.

Forward says the nursing shortage caused 350 surgeries to be cancelled in the two years 2016 and 2017.

She said 24-hour shifts are still occurring, and the shortage is making it difficult for nurses to take leave days.

The response from the provincial government has been less than encouraging.

In 2016, John Abbott, then Newfoundland and Labrador’s deputy minister of Health and Community Services, claimed there were actually too many nurses in Newfoundland, and accused them of being unproductive. They were taking too much sick leave, he said.

Abbott was forced to walk his comments back. But current Newfoundland government policy continues to take a hard line with their nurses—in keeping with the rest of Canada.

Toughing it out everywhere

“It’s a crisis,” says one retired Ottawa nurse. “Not enough nurses. People don’t want to work those ridiculous hours. New nursing graduates are unprepared for the increase in seriously ill patients who used to be in ICU (intensive care units) but are now on regular wards. They burn out.”

The bitter irony is that front-line medical workers are themselves falling ill on the job. But stress and exhaustion make people sick. Nurses work in a high-risk profession these days. Job stressors, including extended shifts, lead to high blood pressure and obesity. There is also considerable risk of physical assault by patients.

“Nurses have been hit, slapped, punched, kicked, stabbed with a variety of objects. They’ve been spit on, not to mention the psychological trauma of being verbally abused,” says Henrietta Van hulle, the executive director of the Public Services Health and Safety Association, which trains Ontario nurses in occupational health and safety.

Too risky for everyone

Too few nurses with far too much work, in an increasingly hazardous environment puts patients at risk as well. Long hours can result in lack of concentration, reduced ability to ensure patient safety, clinical mistakes, and poor interaction with co-workers and patients. A report in 2004 found nurses who work more than 12.5 hours on one shift are three times as likely to make errors.

An American study indicated that 40% of nurses routinely worked shifts exceeding 12 hours, with one in seven regularly exceeding 16 hours. “This research seems to confirm what we hear on the floor,” says Linda Silas, president of the Canadian Federation of Nurses Unions.

Forward is blunt: “We need more RNs in the system. Patient demands are up and they just don’t have the staff to meet them.”

But increasing the number of nurses is a a chicken-and-egg problem. Recruiting and retaining nurses depends on better working conditions; but better working conditions depend on hiring more nurses. Right now, providing money to hire more nurses continues to be the last thing provincial governments are ready to do.

The overall number of nurses in Canada is barely rising: in 2015, it actually dropped. Meanwhile the population continues to grow.

Nurses are popular with the public. Their unions are strong. This should give them a strong hand at the bargaining table—strong enough to force governments to take good care of them and all our health care workers, so they can care for us the way they want to.

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