My colleague sobbed in my arms; she was so tired and beaten. We were working very short-staffed and had been slammed with patient admissions.
This is not new. Over the past decade, more than 7,300 nurse positions in Ontario have been lost due to layoffs, eliminations of vacant positions and cuts to services and programs, according to the Ontario Nurses’ Association. Ontario has the lowest ratio of registered nurses in Canada, with 609.3 nurses for every 100,000 people, according to 2020 data. The pandemic has only exacerbated the situation by causing a nursing shortage of crisis proportions. This results in you or your loved one waiting longer for care, while the workload breaks nurses’ backs and spirits.
In these challenging conditions, the burden falls on nurses to juggle larger workloads under extreme duress. Poor mental health among nurses has grown at an alarming rate. In a Statistics Canada study conducted between September and November 2021, about nine in 10 nurses reported feeling more stressed at work. Emotional fatigue can reduce cognitive functioning, including abilities such as decision-making, memory and attention. In other words, when nurses are stretched thin, things can be missed and patient care can be compromised.
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Further, nurses are frequently deprived of work breaks due to unmanageable workloads and the demands of patient care. Due to the nursing shortage, this happens a lot. In fact, as I write this piece, my employer has called to offer me double overtime pay for any shift and any part of a shift this weekend, because the unit is critically short — again.
The public seems unaware of the sacrifice nurses make to ensure the best quality patient care under these conditions. By virtue of the nature of the profession and the expectations taught in the nursing curriculum, nurses tend to put the well-being of patients ahead of their own. The public does not fully see the reality of the health-care system, because nurses often compensate for its shortcomings, usually at their expense.
In 2019, the provincial government introduced wage suppression legislation that negatively impacts nurses. Known as Bill 124, this bill limits wage increases to a maximum of one percent per year for three years, suppressing a nurse’s democratic right to negotiate for a higher salary. Many nurses view this legislation as a slap in the face. The combination of unsafe working conditions, short staffing, lack of respect and chronic trauma and stress exact a tremendous cost on nurses’ well-being and patient care.
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Despite all this, I remain hopeful. With ongoing advocacy and greater investments in the restoration of nurse positions, nursing leadership, education and mental health supports, the joy and meaning in nursing can be recaptured. Applications to baccalaureate nursing programs in Ontario are up by 35 per cent this year, according to the Registered Nurses’ Association of Ontario. This is welcome news, although these candidates will not graduate for four years.
We are in a crisis that demands creative systemic solutions to support tired but committed nurses. Last year, Ontario introduced externships to employ nursing students and support patient care amid pandemic staffing pressures. Another provincial initiative, the Community Commitment Program for Nurses, entices retired nurses to return to the workforce, offering a maximum of $25,000 per nurse for two years of work.
Creative programs like these are useful nursing recruitment and retention strategies that will get us through this crisis in the short term. But now and for the long term, we should all care about the state of health care and nurse well-being, because it impacts nurse retention, joy at work and the quality and safety of care that you and your loved ones receive.
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Debra Lefebvre is a trauma-informed nurse, specializing in acute care and mental health. She lives in Kingston, Ont. You can find her on Twitter at @debralefebvre
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