BC Nurses Need Your Support: Systemic issues continue to threaten nurses’ health and safety
9ale is an elder care nurse with over 10 years of experience. One day while providing care she had her thumb bit by an elderly patient who suddenly became agitated. The severe injury to her thumb sent her to the emergency department. Vale was kept off work for three months. Years later, when Vale remembers what happened she still feels emotional and shaky.
Such stories are common in nursing. “Nurses are caregivers, however, every day they are at risk because of violent incidents on the job. It really is that bad for nurses,” says Christine Sorensen, president of the B.C. Nurses’ Union (BCNU).
General causes of workplace violence against nurses can be attributed to many factors, with patient complexities, understaffing and congestion being most prevalent. Understaffing is often to blame, Sorensen explains. “A lack of adequate staffing leads to increased wait times causing agitation and frustration, and patients are quick to unload those feelings onto the nearest nurse.” Left unaddressed those experiences are compounded and impact nurses’ long-term mental health. Post-traumatic stress disorder (PTSD) and other mental health disorders are common diagnoses. Sorensen says the government needs to recognize that violence against nurses and PTSD are correlated issues that have a direct impact on patient care.
Considering this, BCNU is campaigning for better protections for its members and working to educate the public about how things are actually worse than they imagine. The campaign brings the severity of the situation to the forefront with two new television commercials that depict the extent to which nurses are at a far greater risk of a number of negative consequences.
Violence in BC health-care facilities has reached shocking levels. According to WorkSafeBC’s 2015 annual report the overall injury rate due to workplace violence has increased over 50 percent since 2006. From the year 2006 to 2015, nurses received approximately 2,862 time-loss injuries due to violence. That is 26 nurses a month, on average, unable to perform their job due to injuries sustained from workplace violence. Despite a global nursing shortage that is also being experienced in B.C., in 2015, 13 percent of total health care time-loss injury claims were due strictly to violence.
Research from the Institute of Health Economics shows B.C. as having 943 nurses per 100,000 people – the smallest regulated nurse workforce of any province in Canada. In 2015, the Canadian average was 1,072. In a recent survey conducted by the Mustel Group on behalf of BCNU, 83 percent of nurses admit that workload is a major or significant problem, and only 21 percent agree that there is enough staff to handle the workload.
“Congested work environments cause tension,” says Sorensen. “Not only for the public who don’t understand why their loved ones are being cared for in hallways, in shower rooms, in sun rooms and in lounges with inappropriate facilities, but also for the nurses who are often literally tripping over equipment, patients and each other to provide care.”
Congestion in hospital settings is nothing new, however it is now a problem that is exacerbated by the lack of care facilities in residential or mental-health care. In 2017, over 12.6 percent of all acute care beds were being occupied by patients who did not need to be in hospital for care, increasing congestion and wait times. Patients in need of mental-health services or other types of care have become dependent on the hospital system simply because the type of facility they require either does not exist or is overfilled. “Workloads are increasing and expectations are increasing. We are expecting patients to stay in hospital for a much shorter time, so turnaround times are much quicker,” says Sorensen. “The demand gets placed on nurses, and the expectations of nurses from patients and the other health-care divisions are much higher.”
The lack of care facilities is of even greater concern when considering that B.C.’s aging population is growing. While the overall population has increased by about one percent annually, in most recent years, according to the Ministry of Health’s 2017 Action Plan, B.C.’s over-65 population has grown by 3.5 percent each year. Between 2012 and 2017, B.C.’s over-85 population grew by 21 percent while its stock of residential care beds grew by just 3.5 percent. These two age groups require special facilities, sensitive care and frequent intervention by nursing staff – many of whom see no relief in their workloads.
In 2017, 81 percent of residential care facilities fell short of the government’s minimum standard of 3.36 hours of direct care per client, per day. Consider too, that the Ministry of Health’s plan cites that 65 percent of those living in care have been diagnosed with dementia. The government predicts 465 more nurses will be needed just to meet the direct care hour requirement – a figure that does not take into account the additional thousands of hours needed from care aides, physiotherapists and other specialized health-care workers.
Not only is BCNU appealing to the government for intervention, nurses are asking the public to consider the extreme stress, trauma and suffering they are subject to due to the demands of the profession. Nurses account for nearly 12 percent of all mental disorder claims and over 10 percent of all claims registered for PTSD with WorkSafeBC. “Nurses often have people’s lives in their hands every day,” says Sorensen. “The complexity of the patients whom nurses are dedicated to providing care for has increased significantly over the years. As a result, nurses’ exposure to more traumatic situations is far greater.”
Nursing is a demanding profession. Nurses are witness and subject to extreme human suffering caused by life-threatening illnesses, disease, crime, addictions, abuse and much more. Daily, nurses are exposed to human beings who are experiencing grief, shock, distress and trauma. Due to these contributing factors, nurses are at a greater risk of developing depression, anxiety, insomnia, addictions, PTSD and many other mental-health disorders. In fact, nurses are among the highest risk for mental health-related concerns, in line with firefighters, correctional officers and police.
Across B.C. there are tens of thousands of regulated nurses providing care to patients and families in their greatest times of need. The systemic issues and the first-hand stories told by the nurses of this province are the reality of what so many of them face, and it is time to realize: it really is that bad. “Nurses are the backbone of the B.C. health-care system,” says Sorensen. “Nurses and patients deserve action on these issues now.”