The following is an Op-ed by Darlene Jackson and Linda Silas, published in the Winnipeg Free Press on July 5, 2022
"We did the best we could with what we had at the time" is an expression nurses with our decades of experience know well. We use those words to describe to new nurses how we responded to crises at our hospitals when we were in their shoes.
What has us raising alarm bells, however, is that the "what we had at the time" part was supposed to keep getting better. Yet things are worse now than ever.
We have both experienced the devastation of caring for victims of horrific vehicle collisions. But in Darlene’s case, the experience of working in a very small hospital in northern Manitoba with minimal nurses on duty when 18 crash victims arrived needing urgent care, has echoes to the COVID-19 crisis today’s nurses have been enduring.
The pressure those three nurses felt to stay on top of patient needs was immense, but that was a crisis moment. It had an end point, and that helped them get through. Today, nurses feel that level of pressure and intensity every single day and night on the job, with no end in sight.
Nurses are telling us staff shortages have become so severe at several Winnipeg hospitals, including our flagship hospital Health Sciences Centre, they are going to work with a constant sense of impending doom and are feeling more distressed now than at any other point in their careers.
They have patients waiting up to 24 hours in the ER, and the usual per-shift complement of 24 ER nurses has recently dropped as low as 12, so triage nurses don’t have time to regularly re-assess patients in the waiting room as they’re supposed to.
This crisis has been years in the making. Even before the pandemic, burnout rates among nurses were extreme. More than 60 per cent experienced some symptoms of burnout, while almost 30 per cent were experiencing clinical burnout. Since the pandemic, those numbers have increased to 94 per cent of nurses experiencing burnout, with almost half now classified as clinical, meaning they need mental health supports.
The very people Manitobans depend upon to care for them are no longer able to care for themselves.
As a result, many nurses are quitting, and positions aren’t being filled. In Manitoba, we have a province-wide vacancy rate of 21.4 per cent. All of our six regions have double-digit vacancy rates, with the highest at 33.3 per cent and the lowest at 18 per cent.
And more than half of all nurses in Canada are considering leaving their current position in the next year, including 19 per cent who are considering leaving nursing altogether.
We know of serious staffing shortages at HSC, Grace Hospital and St. Boniface Hospital in Winnipeg, as well as at rural Manitoba facilities, which have been forced to close for weeks. Concerted government action is urgently needed to turn the tide and stem the exodus of nurses from the system.
For starters, we need to restore hope in two ways. First, by giving them a light at the end of the tunnel with firm timelines and real accountability for improving nurse-to-patient ratios. That means funding proven programs to retain and recruit more nurses, including returning those who have left the profession. And funding for more nursing seats, bridging programs, new mentorship initiatives, and support for transitioning internationally educated nurses.
And second, by providing immediate and ongoing support for nurses’ mental health programs.
Nursing has always been a tough job, done by those who want to help people and aren’t afraid of a challenge. The problem is it’s not a tough job anymore, it’s an impossible one. Canada’s nurses are some of the strongest, most resilient people we know. They have seen great hardship and suffering in their patients, so they do not ask for help lightly.
And if we don’t take immediate action, we risk suffering a system-wide failure of our treasured universal public health-care system.
For years, the Manitoba governments of Brian Pallister and now Heather Stefanson have been asking the federal government to increase health transfers. Next week, federal, provincial and territorial governments will assemble at the Council of the Federation meeting in Victoria, B.C., to discuss health care. We would like to see a clear commitment on the part of the Manitoba government to invest any additional funds into directly improving patient care by rebuilding the nursing workforce.
Our message has never been clearer. Our health-care system is on the brink of catastrophe. We must fix the dire shortage of nurses.
Darlene Jackson is a registered nurse and president of the Manitoba Nurses Union, and Linda Silas is the president of the Canadian Federation of Nurses Unions. The Manitoba Nurses Union recently produced a mini-documentary series, titled "The Frontline is Not Okay."