Critical nursing shortage puts patients at risk
Posted on December 30, 2023 in Health Delivery System
Source: TheStar.com — Authors: Linda Silas
TheStar.com – Opinion/Contributors
December 30, 2023. By Linda Silas, Contributor
Without adequate staff to care for patients, nurses are being pushed to work more overtime than ever before, with some nurses working as long as 16 to 24 hours continuously.
As we head into 2024, children are still waiting in hallways to get care. Surgeries continue to be delayed. Rural emergency departments continue to see temporary closures. Our seniors are still being failed despite the lessons of COVID-19. All are symptoms of the national nursing crisis that has, sadly, become routine news in Canada.
Vacancies for nursing jobs are now at a record high. By the second quarter of 2023, Statistics Canada reports there were 44,410 vacant nurse positions – up by nearly 50 per cent over two years.
As the health care crisis rages unabated across the country, it is nurses who are holding our health systems together through grit, determination and a shocking amount of overtime.
Here’s one example: to staff in-patient units, hospitals across the country paid for 14.2 million hours of nursing overtime in 2021-2022, a 53 per cent increase over the year before. That’s the equivalent of replacing 7,300 full-time nurses with overtime shifts.
Without adequate staff to care for patients, nurses are being pushed to work more overtime than ever before, with some nurses working as long as 16 to 24 hours continuously.
I recently spoke to an experienced front-line nurse who told me about the pressure she feels to stay at work beyond her scheduled shifts to care for patients, even when it feels beyond her capacity or when it means another soccer practice without Mom there.
“We feel guilty for leaving our colleagues in an unsafe situation, so we stay and continue to work in that unsafe situation . . . you give more of yourself than you have to give, and you’re still not able to provide care to the standard that you hold yourself to.” The moral distress she describes is one of the main factors pushing nurses to leave.
The use of overtime to fill core staffing needs is not only short-sighted, it’s downright dangerous.
A new study from the Canadian Federation of Nurses Unions confirmed what many of us have feared: excessive hours of continuous work have a profound impact on nurse fatigue. Research shows that fatigue has effects similar to alcohol intoxication, posing long-term health risks such as high blood pressure, heart disease and diabetes.
Moreover, there is a growing body of evidence linking fatigue to safety incidents in health care. Canadian data shows that the rate of hospital harm has increased from pre-pandemic rates, with one in 17 hospital stays involving at least one harmful event.
So how do we protect nurses and patients from the potentially dire effects of extreme overtime demands?
Alarmingly, there are no regulatory limits to the hours a nurse can work continuously.
By contrast, commercial pilots can typically only work a maximum of 13 hours – a mechanism that protects both pilots and the safety of passengers.
This is a critical place to start. We must establish legislation and regulatory limits on consecutive work hours for nurses, mirroring the safeguards already in place for other safety-sensitive industries. Patients are surely as important as airline passengers.
Fixing the nursing shortage is not just about adding more nurses to the system; it’s about addressing the conditions that have created this dire crisis. This is the key to creating environments where nurses and patients can thrive.
Relying on excessive overtime or costly private nurse agencies as short-term fixes only exacerbates the systemic challenges facing health care. We can’t continue to slap Band-Aids on gaping wounds.
Nurse-led solutions like minimum nurse-to-patient ratios offer double-fold success: safe staffing levels have been shown to improve patient safety and would also address the top reason nurses are looking for the exit sign – insufficient staffing.
The federal government stepped up to the plate with strong increases to the Canada Health Transfer to address critical health care needs. Nurses have been calling on provinces and territories to use this funding to implement key evidence-based initiatives that would improve working conditions, increase nurse retention, create sustainable recruitment and ultimately put an end to the years-long shortage of nurses across the country.
But where are our provincial and territorial leaders? Only one province has signed their bilateral agreement. Yet months have passed since this funding was put on the table. Make no mistake – every day our leaders delay action is another day patients are in jeopardy.
Linda Silas is president of the Canadian Federation of Nurses Unions.
https://www.thestar.com/opinion/contributors/critical-nursing-shortage-puts-patients-at-risk/article_9494ab34-9f8f-11ee-ab0a-2f4819730327.html
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