There is mounting concern about a breakdown in patient care as the COVID-19 pandemic exacerbates an existing shortage of registered nurses in Ontario, according to union reps.
A spokesperson for the Ontario Nurses’ Association (ONA) said she fears a critical event is looming as nurses leave their profession in droves due to staffing shortages and increased pressures during the pandemic.
The rate of nurses who intend to leave the profession multiplied by four in 2021, according to a survey published by the Registered Nurses Association of Ontario in March.
Cathryn Hoy, president of the ONA, said that nurses are calling it quits due to “exhaustion and frustration” as the province continues to ignore the union’s pleas to develop a provincial nursing strategy that will address the shortage of healthcare workers.
“The message the public needs to know is that there is no health care without nurses. It is the nurses that are the backbone of the healthcare system,” said Hoy.
“The government recently announced that they are adding 1,200 more beds in hospitals across Ontario. That sounds exciting, but who is going to staff them? Because we can’t staff what we have right now.”
The ONA said hospitals across Ontario are experiencing critical staffing shortages, to the point where nurses are experiencing burnout as they try to take on extra responsibilities to ensure standards of care.
DJ Sanderson, an ONA spokesperson who specializes in labour relations, said that about 80 per cent of the registered nurses that he speaks to feel as though they are being overworked and underappreciated.
Nurses are consistently reporting a lack of appropriate PPE, as well as being denied scheduled days off and working in emergency departments with impossible nurse-to-patients ratios, he added.
“It’s bad out there right now. Don’t get me wrong, nurses deserve to be paid very respectable wages and to take their time off, but this issue is much larger than Bill 124,” said Sanderson, referring to a bill that limits annual salary increases for public sector workers to one per cent.
The ONA is advocating against the bill on behalf of its membership, which includes 68,000 nurses and health-care professionals and 18,000 nursing student affiliates.
“In nursing, there’s a personal involvement there,” said Sanderson.
“When the end of the shift comes, when it finally comes, nurses are completely breaking down in their cars on the way home because they cannot do enough for their patients under these conditions.”
Long before the COVID-19 pandemic started, Ontario was already facing a shortage of nurses.
“I think it started when the College of Nurses of Ontario (CNO) took away the registered nurse (RN) diploma program from colleges in Ontario,” said the president of the ONA.
“Those programs would graduate about 1,000 nurses roughly per year, and the government did not increase the number of seats in university programs by that amount.”
Over time, said Hoy, those numbers continued adding up.
“The decrease just gradually happened with less people coming into the profession. It just got worse and worse,” she said.
“If you think about it – losing 1,000 nurses per year over 10 years – it adds up. We are short 10,000 nurses in the province.”
Other factors also need to be considered when looking at the nursing shortage in Ontario, including age demographics and the impacts of the pandemic.
“We have a lot of nurses between the ages of 55 and 65 who are getting ready to retire in addition to the shortage that existed before,” said Hoy.
“On top of that, all of our new graduates over the last two years during the pandemic have not had the opportunity to get a solid foundation of nursing in clinical settings – some of them have never touched a patient.”
Because nursing students have been locked out of hands-on training opportunities, they are graduating without the practical experience necessary to practice in acute care.
“Employers are expecting the nurses who are already working with unrealistic patient assignments to help scale up these new graduates,” said Hoy.
“Many nurses who were preparing to retire are staying on because of their sense of duty to their patients and these new nurses to help train them.”
All of this adds up to what Hoy says is the worst ratio of registered nurses to the population in the country, which was 693 registered nurses per 100,000 people in 2019.
The RN-to-population ratio in the rest of Canada is 823 per 100,000 people, according to data reported by the Registered Nurses Association of Ontario (RNAO).
“There’s a lot of fear and frustration on behalf of the nurses in Ontario – who is looking after these patients?” said Hoy.
“If you factor in the COVID-19 pandemic, with increased hospitalizations and these vaccinate or terminate policies, it’s just made this perfect storm worse.”
This “perfect storm” has become a notable concern as the Omicron variant spreads like wildfire through the province.
Public Health Ontario reported a record 11,582 new cases of COVID-19 on Wednesday. New testing guidelines mean that the actual number of COVID-19 cases is likely much higher than what is currently being reported.
There are 2,081 people in the hospital testing positive for COVID-19 (although it’s unclear how many were admitted due to the virus), including 288 people in intensive care units (ICU) and 138 people on ventilators.
In northern Ontario, 60 are people in the hospital who tested positive for COVID-19.
Health Sciences North is reporting 22 confirmed cases of COVID-19 among admitted patients, including three in the ICU.
There are also 10 admitted patients who previously tested positive for COVID-19 and seven admitted patients who have been tested for the virus and are waiting for their results.
Hospitals across Canada are also reporting that hundreds of their employees either have COVID-19 or are in self-isolation due to exposure to the virus.
Health Sciences North (HSN) in Greater Sudbury said that as of Jan. 4, there were about 21 employees and medical staff who tested positive for the virus.
An additional 57 employees and medical staff are self-isolating due to a high-risk exposure to COVID-19, according to an update from HSN.
The hospital also terminated 17 nurses who were members of the ONA at the beginning of December for failing to provide proof of full vaccination, in addition to 36 other employees.
“It’s just been one thing after another. The thing about nursing is that you really have to have a heart for this job because you’re working so closely with people. It’s personal,” said Hoy.
“It’s a job that you really, really want to do, and when you can’t meet your standards of care because staffing is so poor? You’re leaving. That’s why nurses are leaving.”
Now there are reports from other provinces, including Quebec, that governments are asking COVID-19 positive health-care workers to return to work, Hoy said people are losing trust in the government’s decisions.
“A lot of these employers have banned family members from going in to see patients because they are worried about spreading COVID-19,” said Hoy.
“But you’re going to bring in COVID-19 positive staff to this very same hospital to work? Are they going to have COVID elevators designed for nurses who test positive?”
The ONA said it is “extending an olive branch” to the government of Ontario and to employers across the province for help rebuilding the healthcare workforce before it is too late.
“It’s almost like everyone’s throwing their hands up and saying we’re so deep in here with COVID that we don’t know how to get out of it,” said Hoy.
“Sit with us. Talk to us. Let us help work through this and develop some strategies. We know this is not going to be fixed overnight, but we need programs in place now.”
Colleen Romaniuk is a Local Journalism Initiative Reporter with The Sudbury Star.
The Local Journalism Initiative is made possible through funding from the federal government.
