Canadian health care: New report finds latest example of workforce crisis

Morale among health care workers in Ontario is deteriorating, according to a new report.

There is a growing staff shortage that is endangering the well-being of hospital staff and patients, according to the peer-reviewed study released Monday.

“This study has shown that our esteemed public health system is in serious trouble,” said researcher Dr. James Brophy.

“We have heard about the daily fear hospital staff feel about going to work and not being able to fulfill their duties in caring for patients due to staff shortages.”

The study is based on 26 in-depth interviews with hospital employees from the Canadian Union of Public Employees (CUPE) in Ontario and a survey of 775 of their colleagues.

The researchers concealed the identities of the health professionals participating in the study.

“We barely have time to take breaks or go to the bathroom. I don't think patients are getting the care they need,” an outpatient nurse said in an interview.

Other nurses said they used to look forward to their work but now dread going to work.

“You think it can't get any worse, and then it got even worse,” said a nurse from the emergency department.

“I was having more and more panic attacks before work and would cry before getting in the car.”

Brophy found that several of the respondents suffered from depression, physical and mental exhaustion and burnout due to their working conditions.

The concerns echo those of registered nurses in Saskatchewan, who expressed concern about staff shortages in a survey released in the fall.

Three out of five registered nurses said they had considered leaving the profession in the last 12 months, and more than 90 percent said their working conditions had had a negative impact on their mental health.

“There is an irrefutable link between registered nurse burnout and poorer patient outcomes. And right now, we are at risk of worsening the shortage as confidence in workplace support and commitment to solving the problem wanes,” said Tracy Zambory, president of the Saskatchewan Nurses Union, when the findings were released.

The Ontario researchers collected their data last fall after a summer of record-breaking emergency room closures and disruptions to care in Ontario, said Michael Hurley, president of CUPE's Ontario Council of Hospital Unions.

The report found that underfunding, staff shortages, deregulation and privatisation of the health care system all impact worker burdens.

“Over time, it eats away at people,” Hurley said.

There are concerns that these effects will become more severe as more nurses consider leaving the profession, the researchers said.

BC wants to become the first province to introduce a minimum nurse-to-patient ratio to reduce workloads and retain nurses.

Other jurisdictions that have implemented minimum nurse-to-patient ratios, such as California and Australia, have seen promising results, according to Tristan Newby, vice president of the BC Nurses' Union.

“They (the nurses) have fewer workplace injuries. There are fewer medication errors and fewer hospital-acquired infections and fewer hospital readmissions,” Newby said.

“It’s a win-win situation for nurses, the profession and patients.”

Without the minimum number of nurses, some units have one nurse caring for up to 16 patients overnight, Newby said. Another unit in BC recently operated with less than 50 percent of its base staffing.

“If you don’t have the staffing you need, you can’t provide the minimum level of care, let alone a high standard of care,” Newby said.

“You just drag yourself along, you survive. And unfortunately we see that all over the province.”

According to this minimum ratio, there would have to be at least one nurse for every four patients in medical and surgical departments at all times.

Newby said critical care facilities will begin implementing the quotas in the fall.