Exhausted nurses seeking relief
Union, hospital meeting to find solution to staffing crisis in the ER
Nearly three dozen registered nurses have left the St. Paul’s Hospital emergency department in the past year, with many citing too much overtime and challenging work conditions caused partly by the opioid epidemic, according to their union.
The downtown Vancouver hospital says there are now five vacancies after five positions were filled in the past week with nurses from other areas of the hospital. But the B.C. Nurses’ Union said it has evidence the number of vacancies is vastly higher.
Either way, the union has used a clause in its contract to demand a formal review of the emergency department. Next week, union officials will meet with hospital leaders and the Health Employers Association of B.C. as part of that process.
Christine Sorensen, president of the BCNU, said the review is a “collaborative, problem-solving exercise meant to find solutions” to a very worrisome situation.
She said that, on every 12-hour ER shift, four or five registered nurses are working overtime to cover the shortfall. About 20 nurses are in the ER for each shift. Routine overtime is a problem because it subjects those who already work long shifts to excessive fatigue, burnout, and a higher risk of disability leaves, the union said.
The emergency department at St. Paul’s gets nearly 90,000 patient visits a year. According to St. Paul’s, there are 150 nurses in the department, including 72 fulltimers, 26 part-timers and 52 casual or temporary positions.
Sorensen said nurses and their shop stewards have reported low staff morale and concerns about not being able to provide safe, quality care in a department that has complex and unique challenges.
Among those challenges is being on the front lines of Vancouver’s opioid epidemic because many resuscitated drug users are brought to St. Paul’s for observation and treatment. The downtown hospital has grappled for years with homeless patients, people with a variety of addictions, and a vast array of mental health conditions, besides all the other medical issues.
“Nurses who choose to work in the emergency department of any hospital like that kind of work. They don’t leave units if they’re happy and if they feel they can manage with their workloads,” Sorensen said.
“Nurses are resilient and it takes a lot for them to finally report problems to their union,” she said, noting that in the past six to 12 months, frustrations have boiled over and many have documented their low morale and other concerns.
Sorensen said she expects the review will lead to some concrete solutions. She said the new CEO of the hospital, Fiona Dalton, is committed to addressing staff workload and safety issues caused by the constant threat of aggression toward hospital staff by patients and their visitors.
Amanda Harvey, director of the emergency department, attributed the nurse shortage to several factors.
When employees leave, they are asked for their reasons. Harvey said the reasons cited include the challenging patient demographics, the need for a change in work environment, and the housing affordability crisis in Vancouver, which means nurses — their average wage is about $36 an hour — are quitting jobs here and moving to areas like the Interior and Vancouver Island, where the cost of housing is lower.
Harvey said all health-care agencies in Metro Vancouver are struggling with housing costs.
“It’s a complex issue, a significant problem,” she said, noting that health regions have to pay similar wages so higher-paying regions don’t pull talent away.
Vancouver General Hospital suggested a wage bonus for operating room nurses a few years ago, but did not carry through after being met with a chorus of opposition from health-care leaders. They said it would hamper their own efforts to recruit nurses. They said VGH would poach nurses from other short-staffed hospitals and that a bonus would set a dangerous precedent for side-deals outside collective agreements.
Sorensen said a nursing shortage is also affecting other hospitals like Royal Columbian in New Westminster and Kelowna General Hospital.
It’s especially urgent that solutions are found, because with flu season approaching, more nurses will be calling in sick and there will be a pressing need for “surge capacity.”
Nurses are resilient and it takes a lot for them to finally report problems to their union.