Veteran nurse shares why some are leaving patient care

Behind the story of emergency room closures across the country are the workers impacted, like "Sue," a 25-year veteran nurse in Ontario who openly weeps about her decision to leave front-line medical care.

The 52-year-old, who has been independently verified to have been a nurse by CTVNews.ca but asked to protect her identity, said she loved her job caring for patients, having worked as an operating room nurse, in surgical care wards, and in rehab and palliative care.

But since February, she has been off work on stress leave and is seeing a psychologist after suffering burnout.

Following two intense years working during the peak of the COVID-19 pandemic, Sue said both she and colleagues have faced "bullying" by administrators, who she claims force them into caring for too many patients than would be considered safe. Others, she claims, are ordered to do mandatory overtime to fill in for staff shortages, due to illness, exhaustion or because colleagues were quitting.

"When I think about nursing now… I get the shakes," she said. "There was always a hint of 'don't you dare call in sick,' 'don't you dare miss work,' or 'we know you're stressed but Ontario needs you.'”

Sue has decided to retire early and said she knows of several other experienced nurses who have left to work in long-term care, public health nursing or with nursing agencies where they can pick their own working hours and assignments, lowering their stress. Two others who are planning their exit are waiting to notify managers, she added.

"Anyone I talked to has either left, retired, or is seeing a psychiatrist or counselor and on antidepressants… How sad is that?” she said.

EMERGENCY CARE ‘STRETCHED’ AND ‘UNSAFE’

This weekend, several hospitals across Canada -- particularly in rural communities -- are announcing temporary closures to emergency units and other medical services because of shortages of nurses and doctors.

Glengarry Memorial Hospital, in Alexandria, Ont. is closing its ER overnight Saturday and Sunday, while Kamsack Hospital in Kamsack, Sask. is closing hospital bed and reducing emergency hours because there aren't enough nurses to staff them.

One hospital in Perth, Ont. has seen its ER closed since July 2.

Deb Lefebvre, a registered nurse who lives in Kingston Ont., but who works outside the area in another community, described emergency care in Canada as “unsafe.”

"They're stretched and they themselves have become unsafe areas for patients to attend too," she said. “We leave the hospitals... feeling that patient care has been compromised.”

Another nurse, independently verified by CTVNews.ca, who asked not to be identified, added: “The staff to patient ratio is also not safe and many nurses are leaving now knowing that patients are not given safe care. Call bells left for hours, patients soiling themselves because there is no one to take them to the bathroom, patients dying in waiting rooms. Hospitals in Canada are not safe.”

On Friday, New Brunswick Premier Blaine Higgs replaced his health minister and the CEO of the Horizon Health Network after a patient died this week in an emergency department waiting room in Fredericton. A review process has begun into the death.

The Canadian Association of Emergency Physicians also warned in a statement earlier this month that “it has never been more important to pay attention to the current state of emergency departments,” adding that these facilities are “a window on the health of health care.”

Lefebvre said the difficult decision to close services is a huge red flag. There aren't enough people to do the job safely, she claims. Her advice to Canadians heading to emergency in the coming weeks is to have a friend or relative accompany them to make sure they get seen if their condition suddenly worsens.

In an email statement to CTVNews.ca on Friday, Paul-Émile Cloutier, president and CEO of HealthCareCAN admitted that the last two-and-a-half years have stripped Canada’s health system bare.

“Throughout the pandemic, health-care workers have worked – and continue to work – hard to provide the very best care they can under tremendously challenging circumstances, but what we’re now seeing is a health workforce that is no longer able to cover the cracks of a system that wasn’t built to handle this constant and mounting pressure,” he said. “Patient outcomes and the health workforce shortages will not improve if we simply continue pouring more money into a broken system. It must be re-envisioned to effectively address the changing needs of an aging population and the growing demand for health-care services.”

The called on all levels of government to take immediate and concrete action now to “bolster the health system for tomorrow.”

Meanwhile, Dr. Michael Howlett, president of the Canadian Association of Emergency Physicians, sympathized with emergency nurses, saying they are carrying a very heavy load.

“They become demoralized, burned out and then leave the department to work elsewhere. With fewer and fewer emergency nurses and physicians across the country we are having a difficult time keeping up with all of the care needs, and we are extremely worried about potential delays to care,” he told CTVNews.ca in an emailed statement on Friday.

SITUATION COULD GET WORSE

A survey in late 2021 by Statistics Canada said one in four nurses plan to quit due to job stress or concerns about mental health in the next three years.

With a summer wave of COVID-19 underway,departures from the front line may intensify, according to Linda Silas, head of the Canadian Federation of Nurses Union.

"What we're hearing from our provincial nurses unions is that every day they get a call from nurses wanting to either change their status, going from full-time to part-time, or part-time to casual, so reducing their hours dramatically or completely leaving by retiring early," said Silas.

Bonuses offered by some provinces like Ontario and Quebec have not worked to stem the tide, she claims. "They all fall flat on their face, because they're a flash in the pan," she said.

The underlying issues, claims Silas, are quality of life, and how nurses say they are being treated, as many are mandated to work overtime or denied vacations. Retention of these veteran, experienced nurses is the first step to "stopping the bleed" and keeping front line health care safe, they added.

"Employers have to work with nurses to see what they need to stay?” she said. “For some, it's as simple as ‘I cannot be mandated to do overtime.’ ‘I have a family.’ ‘So you guarantee me that then I will stay,’" added Silas.

A NATIONAL SOLUTION?

The premiers who met in Victoria earlier this week demanded Prime Minister Justin Trudeau call a first ministers meeting to hammer out a health-care funding deal.

Nursing groups are also calling on the federal government to develop a national plan to address the nursing shortage, including a plan for how many nurses will be needed for the coming decades.