This week, the Globe and Mail published a short article and podcast about a hospital staffing problem they believe has grown more acute during the pandemic.
A growing number of nurses are leaving hospitals. The relentless workload, the crushing experience of watching so many people get very sick from the novel coronavirus and die, and the increasingly short-staffed nature of many intensive care units has created an untenable situation for many nurses across the country. And this is having an impact on hospitals, with some emergency rooms having to close.
In fact, key staff shortages have plagued the healthcare system for years.
I’ve not written before about hospital operations despite being a close observer for decades. My wife has spent her life working as a Registered Nurse, mostly in critical care. She began in the days when nursing students wore starched bibs, aprons and caps, not to mention white stockings and clunky shoes.
Gwen has been a hospital-based RN for so long she has observed repeated examples of managers introducing previously discarded methods as “new” solutions for ever-present personnel problems. Recently appointed decision makers never see maintenance of the status quo as career-building but there are limited options for change. So inevitably, everything old becomes new again.
As in the Peter Allen / Carole Bayer Sayer song:
Don’t throw the pa-ast away
You might need it some rainy day
Dreams can come true again
When everything old is new again
While beyond usual retirement age, Gwen is asked almost daily to work. Today, the first of many requests came in before 5:00 am even though she was coming off five straight days of work.
Staff shortages, particularly in specialized fields of nursing, have existed for as long as I can remember. Like other critical care nurses, my wife was often needed to work overtime. Even double shifts were occasionally asked for, and those are not optimal with nurses working 12-hour days.
In earlier times, nursing was primarily a female occupation. As a result, practitioners were not very well paid. Less qualified male orderlies enjoyed pay rates nearly equivalent to those of RNs, despite being unable to provide many needed treatments and services. If nursing was primarily a male domain, like the safer occupations of policing and firefighting, average pay and pensions would be much improved.
In 2015, Associated Press reported on male nurses in the USA receiving higher pay than female counterparts:
The gender gap for registered nurses’ salaries amounts to a little over $5,000 yearly on average and it hasn’t budged in more than 20 years. That pay gap may not sound big — it’s smaller than in many other professions — but over a long career, it adds up to more than $150,000, said study author Ulrike Muench, a professor and researcher at the University of California, San Francisco.
Sexist attitudes have improved but not disappeared in Canada. As a reward for 16 months of stressful work during the pandemic, misogynists in the Government of Alberta recently resurrected a demand UCP first made in 2019, demanding nurses accept wage reductions. Responding to online criticism of the proposal, one UCP operative tweeted that a number of nurses earned over six-figures in a single year. I did not notice him criticizing generous rates Alberta pays social media warriors like himself.
My wife’s response? She said if Alberta nurses earned large salaries, it meant they worked long hours, including nights, evenings, and statutory holidays.
Years ago, a Vancouver hospital management brain decided that if units were having trouble recruiting and retaining workers in high-skill jobs, they should offer premium rates of pay to professionals holding advanced qualifications. The idea never got final approval. It’s a solution common in other fields.
Yet, too few people on staff means longer hours must be worked by people already there. Bean-counters were prepared to pay for large amounts of overtime but not for monetary and non-monetary premiums that would make a workplace more desirable.
Of course, there is another issue known to nurses. It was noted in a report from an American law firm that specializes in employment matters. It began:
When you think of dangerous jobs, what types of occupations come to mind? Maybe construction, logging, mining, or manufacturing? While those jobs do come with many risks, you may be surprised that one of the most dangerous careers is nursing...
Health care workers, nurses in particular, are facing higher than average levels of workplace violence, believe it or not. In fact, the rate of violence for those employed in healthcare settings is as much as twelve times higher than the rate for those in other professions.
Violent acts in health care settings are increasing in hospitals and other healthcare facilities. Safety in the workplace is something that needs to be urgently addressed…
Sometimes violent acts are predictable and hospital security can be called for assistance. Other times, danger is sudden and unexpected. Recently, my wife was attacked by an older patient suffering post-operative delirium. This was not the first assault, nor was it likely her last. With long experience, Gwen is not easily surprised but the threat of harm is ever present.
This is not intended as a complaint about the profession. Gwen has always enjoyed her interactions with patients, families, physicians and hospital staff. Almost every person in medicine enjoys serving people in need and nearly all families experience great healthcare, even if it is not apparent in times of tragedy.
But, the last 16 months have been trying times. It’s good for the Globe and Mail to articulate sympathy and understanding. On the other hand, it is appalling—but not surprising—that Jason Kenney’s repulsive crew would rather take money from nurses who seek to mend the world and give it to oil companies that want to harm the world.
Signs that a service might be dictated by the needs of a bent economy rather than those of the people making up the majority of the citizenry.
The personal perspective makes this all the more poignant. Thank you.
Like everything else in this world, our systems (political, economic, military, and yes our medical system too) is run by incompetent psychopaths. And we, the great unwashed, have to live with and put up with them.
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Norm is bang on again, and strikes a familiar refrain.
My wife worked at LGH for almost 25 years, and her four sisters (2 RNs, 1 LPN, one care aide) all worked in hospital settings until they retired. One of my daughters-in-law is a practicing RN. One of my sons and his wife recently retired as EHS operations superintendents in Alberta. I’ve listened to tales of the inner workings of the health care system for years whether I wanted to or not. There was no escape, especially at large family gatherings when notes were compared.
In my observation the health care system has operated in spite of management for years due to the almost universal dedication of its workforce. I’ve been a reluctant consumer on a frequent basis in the past couple of years and can say I’ve received nothing but the best attempt from all involved. But the warning signs around the edges are there.
The general public has no idea how close the system is to meltdown.
Unfortunately I think it’s about to find out.
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Lew’s last line, he’s correct. Nurses in North American have had enough. Lots of them are thinking of quitting. What will we do then?
Jason doesn’t like women or at least nurses. If he has a deficiet its his own fault and the fault of Alberta voters. All they have to agree to is a small tax, like other provinces. You buy something, you pay a tax. Even if the tax were only 2% he’d have his problems more than solved. Jason just thinks punishing women for being women will change things. About all it will change is Alberta will be loosing nurses. I can see the arrival of the American recruiters now. Some may move to B.C. because it is doubtful things will get better in Alberta.
Any job which is a female dominated occupation is usually paid less than a male dominated occupation. Decades ago when equal pay for equal work was getting started a researcher checked in with Russian doctors who were mostly women. It was a poorly paid profession. Men in occupations which didn’t require the skills of a doctor made more. It had nothing to do with the job and everything to do with the sex of the person doing the job.
The people of Alberta voted for Jason,, now they can learn to live with it or die because of it.
I’ve seen it before in the teaching profession, when contract stripping and unscrupulous “bargaining” were going on in B.C.: if you kill the morale, you get a corresponding response in absenteeism and withdrawal from unpaid extra efforts, such as committee work and coaching. It’s not orchestrated; it just happens — and good will doesn’t just pop back into place when the ‘beating’ stops.
This cost-saving measure will cost the Kenney government.