Nursing crisis poses a real threat to our health-care system
DR. CHRIS KEEFER AND DR. RAGHU VENUGOPAL Dr. Chris Keefer and Dr. Raghu Venugopal practise emergency medicine in Toronto.
It is National Emergency Nurses Week, a time to honour one of Canada’s most challenging and important professions. However, this year we face a rapidly deteriorating nursing crisis requiring urgent action. The exodus of nurses during this pandemic is startling and if not stemmed, will cripple our healthcare system for at least a decade. They are overworked, face brutal working conditions, and a decade of wage suppression has been locked in even further by Bill 124. The bill ironically titled “Protecting a Sustainable Public Sector for Future Generations Act” caps wage increases of many public sector workers to one per cent annually. Most nurses therefore see an annual pay raise of less than 50 cents an hour. This is far outstripped by inflation. The Ontario government’s solution to the nursing shortage is to train more nurses rather than stemming the tide of experienced nurses leaving. The saying “a nurse is a nurse is a nurse” is patently false. Veteran nurses are not replaceable with new graduates, who need mentorship to become the skilled nurses of the future. Just like physicians, there are areas of specialization within nursing that involve years of extra training. Many emergency department (ED) nurses are critical-care trained and certified in advanced cardiac, trauma and pediatric life support. Yet during this pandemic we have been pushing inexperienced new graduates into these roles with little preparation and mentorship. On top of wage suppression, COVID-19 has burned out nurses. Many got sick themselves. They comforted dying patients, they were their patient’s de facto “family” as hospitals banned visitors and nurses supported grieving families. As a result, we personally know of circumstances in which only three nurses were caring for 60 ED patients. We have seen ED triage nurses three hours behind on a first look at a patient. Ambulance crews are lined up and cannot off-load patients for hours. Across the province, beds, wings and even entire EDs have shut down because of the nursing shortage. ED patients in hallways are robbed of their dignity and openly use urinals and bedpans. We know of a bed change that took 10 hours because the patient was large and two nurses could not be spared to attend to the patient at the same time. This is inhumane. New nurses see this reality and quit, not wanting to compromise their nursing licence or provide substandard care. Long ED waiting times stoke patient frustration and nurses bear the brunt of it. They are routinely verbally and physically assaulted and frequently sexually harassed by patients. The Ontario government hails these burned out nurses as “heroes.” Praise, however, does not pay the rent or buy groceries. In addition to scrapping Bill 124 and providing meaningful annual pay increases that retroactively make up for a decade of wage suppression, we believe that a one-time return-to-practice incentive is essential to bringing back those who have already quit. This matters because every Ontarian will require the care of a nurse. There is no escaping illness, injury and the effects of aging. As physicians we sound the alarm. We call on the Ontario government to invest in nursing, stop calling nurses heroes and start treating them like human beings. Let’s make this year’s National Emergency Nurses Week count. Gratitude is not enough. We need action.