This piece is an MNU-CFNU op-ed that was published by the Winnipeg Free Press on January 22, 2024.
As we start 2024, hospitals are seeing an increasing number of patients, there continue to be long wait times in emergency departments, our rural health-care facilities have seen temporary closures, and our seniors are still being failed despite the lessons of COVID-19.
All are symptoms of the nursing crisis that has, sadly, become routine news.
In Manitoba, there were almost 3,000 vacant nursing positions in June 2023.
As the health-care crisis rages unabated across the country, nurses are being pushed to work more overtime than ever before, with some working as long as 24 hours continuously.
During the span of only five months of 2023, the Northern Regional Health Authority (NRHA) reports that nursing staff worked a total of 32,816 overtime hours. Without a sustainable staffing plan, the use of private nurse agencies is also skyrocketing. The NRHA spent $2.5 million on for-profit agencies in just one month last year.
In early December, one nurse from a hospital in Winnipeg shared the toll it was taking on her.
“Bedside nurses and staff deal with the moral distress of dealing with guilt. We are doing our best with less resources than ever before; nursing is not sustainable. The system has failed patients and caregivers because we are set up to fail.”
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, evidence strongly links fatigue to health-care safety incidents. Canadian data show that one in 17 hospital stays now involves 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, pilots can 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.
We have the funding available.
Yet months have passed since the federal government announced increases to the Canada Health Transfer to address critical health-care needs. Nurses in Manitoba have been calling on the provincial government to use this money to implement evidence-based initiatives that would improve working conditions, increase retention and create sustainable recruitment and ultimately put an end to the years-long shortage of nurses across the province.
If the state of health care at the end of 2023 tells us anything, it’s that time is no longer on our side. Every day our leaders delay action is another day patients are in jeopardy, and we are urging the new NDP government in Manitoba to sign the bilateral agreement as quickly as possible.
Darlene Jackson is president of the Manitoba Nurses Union, and Linda Silas is the president of the Canadian Federation of Nurses Unions.