Health-care workers logged more hours of overtime last year than they had in a decade, according to a new report detailing the impact the COVID-19 pandemic had on Canadian health-care workers.
The Canadian Institute for Health Information (CIHI) released a report on Thursday outlining some of the structural shifts that occurred within the health-care system during the pandemic — and where that system began to see the most stress.
In 2021, more than 236,000 workers averaged around eight hours per week of paid overtime and 5.8 hours per week of unpaid overtime.
Across the board, this means one in five health-care workers were consistently clocking overtime, but in some professions, it was even higher.
Around 45 per cent of paramedics, 34 per cent of family physicians and 31 per cent of respiratory therapists were clocking overtime regularly.
And the number of workers clocking in overtime has only been increasing as time goes on, according to the report. In March 2019, around 209,900 workers were logging overtime, compared to 266,900 in April 2022.
“The pandemic has intensified structural pressures on our health systems, and everyone across the country is working hard to address health workforce challenges,” Deborah Cohen, director of Pharmaceuticals and Health Workforce Information Services at CIHI, said in a press release.
“It will be important to continue to strengthen Canada’s health workforce data foundation to help find evidence-based solutions that drive toward improvements in staff health and wellness as well as patient health outcomes overall.”
Combined, workers logged more than 18 million overtime hours in Canada’s hospitals in 2020-2021, a 15 per cent increase from the previous year.
Nurses, who had the fourth-highest proportion of workers logging overtime hours at 27 per cent, were part of the staff making up more than half of the actual hospital overtime hours in 2020-2021. More than 9,770,000 overtime hours were for nursing inpatient services.
This report comes amid a huge increase in children reporting to paediatric hospitals with respiratory illnesses, with some hospitals reporting that they are operating at 100 per cent capacity.
“Access to primary care is in such a desperate state that patients are having to go to emergency departments, which puts even more pressure on staff that are already stretched too thin,” Dr. Douglas Sinclair, Vice-President of the IWK Health Centre, said in the release.
“Emergency medicine is very much a team sport; front-line nurses, emergency physicians and clerical staff are all in moral distress trying to manage the massive wait times patients face in emergency.”
The early years of the pandemic also saw the delay or pause of many non-essential surgeries, meaning fewer health care services were offered between 2020 and 2021.
However, although more services began to be offered as time went on and service volumes began to approach pre-pandemic levels by early 2021, the wait times didn’t recover, according to the CIHI report.
When comparing this time period to the same period in 2019, fewer surgeries were performed in 2021, but the wait times were higher than in 2019.
The decrease in services also meant an unprecedented decline in physician earnings for the first time in 20 years.
The report also looked at where professions are losing or gaining workers.
The rate of growth in family doctors is slowing down — between 2012 and 2014, the profession grew by 3.4 per cent on average, but between 2019 and 2021, it only grew by 1.3 per cent.
This aligns with several recent studies showing that family physicians are on the decline. One study found that the number of Ontario family doctors who stopped working doubled in the first six months of the pandemic compared to previous years, while a recent study published in the journal Canadian Family Physician this month found that nearly one in five family doctors in Ontario were planning to close their practice in the next five years.
According to CIHI, nurse practitioners kept growing steadily throughout the pandemic at an average growth rate of 9.6 per cent between 2019 and 2021.
However, many still left the workforce in 2021.
The number of registered nurse and licensed practical nurses who were employed in direct care in long-term care or community health agencies declined by 612 between 2020 and 2021.
In long-term care alone, the nurse workforce declined by 2.2 per cent overall.
In the same time period, the number of nurses increased in private care — there was an increase of 1,251 registered nurses and 667 licensed practical nurses in direct patient care jobs at private nursing agencies and health centres, as well as those working independently.
The CIHI report noted that federal and provincial governments have made several funding initiatives or interventions during the pandemic to try and recruit and retain health care worker, giving the example of a federal program that offered free training for 4,000 new personal support workers, and funding enhancements and training for staff.
Searching for flexible solutions in terms of how health care runs within Canada may be key to facilitating a full recovery from the pandemic’s impact on our health-care system, the report suggested, adding that more could be done to leverage health care workers who have been trained internationally but may not be licensed to practice here yet.
“Health care is a complex issue. There is no fast fix, but there is work being done with the provinces and territories to look at the entire health workforce,” Dr. Leigh Chapman, Chief Nursing Officer of Canada, said in the release. “Solutions include things such as integrating internationally educated nurses much more quickly, looking at nurses that have left the profession to recruit them back and retaining nurses by making working conditions better.”
