Toronto Star Referrer

‘We’re on the brink of collapse’

URBI KHAN STAFF REPORTER

Ontario hospitals are facing the grim reality of a nursing shortage.

Conditions of being overworked and experiencing burnout predate COVID-19, but the pandemic has only exacerbated these issues. Furthermore Bill 124, introduced in 2019, disincentivizes nurses by limiting wage increases. Many nurses have said repealing the bill would go a long way in retaining nurses. Others say removing barriers for internationally educated nurses would help fill in gaps.

The Star spoke to eight nurses — some still working in the field and others who have left — to hear what they had to say about the state of their profession.

Birgit Umaigba, registered nurse, intensive care unit

Birgit Umaigba is an agency nurse who fills gaps at hospitals in the Greater Toronto Area that are short staffed. She mainly works in the intensive care units of two hospitals. She says what is happening in nursing is a “state of emergency” — one that has been years in the making.

“These problems have always been here, we were just not talking about them,” said Umaigba, who has worked as a nurse for five years.

Umaigba considers herself a precarious worker as an agency nurse without access to benefits or paid sick days. She says there is a lack of support for nurses in her position. “I go to different hospitals, so we are considered outsiders.”

For Umaigba, part of the solution rests with repealing Bill 124.

“We cannot afford to keep losing experienced nurses. It’s not about recruiting new grads, it’s about retaining experienced nurses.”

Another part rests with nurses trained abroad. As a clinical instructor, Umaigba has taught in programs geared to internationally educated nurses. She says the hurdles they have to jump through to practise in Canada are numerous and more should be done to help “bridge the knowledge gap.”

“They have the experience, they have the knowledge, they just need to know the psychosocial piece, the cultural aspects, and know how to use the equipment,” said Umaigba. “But there’s tons of them driving Uber or working at Walmart … instead of utilizing their skills to help with the shortage.”

Leah Waxman, registered nurse, emergency room

Leah Waxman is a full-time nurse working in the emergency department. She has been in the profession for 11 years and in emergency

for eight. She says the situation and working conditions for nurses inside the hospital have gotten progressively worse during the pandemic.

“We had a first wave of nurses that left because of COVID. And then we have the second, third and fourth wave of nurses leaving, just because (of being) short staffed,” said Waxman, who is a co-founder of the advocacy group NurseWithSign416. “We’ve been running on empty.”

Waxman noted that while some new nurses are leaving, it’s the nurses who have been doing it forever leaving that is a major concern.

“If you’re an emerge nurse, your spectrum of what you can do and what you know, takes years to learn. And, you know, you can’t just replace that with a new nurse.”

“We’re on the brink of collapse. I just think if things don’t change and if the public isn’t standing up and making a change right now while the nurses are making a stance, the public health system is going to collapse.”

Waxman said that repealing Bill 124 would be a show of support for nurses from both the government and public alike.

“That would be a great first move. And then, depending what goes from there, after (repealing) the bill, nurses could come back into the profession. (And maybe) nurses wouldn’t leave.

Nancy Halupa, registered nurse, emergency room

For Nancy Halupa, who has worked in the emergency department for 23 years, retaining the existing nursing force is crucial. Now that there are so few veteran nurses left, they cannot take new hires or grads under their wings, which results in them being “thrown to the wolves.”

“I feel for them because (the new nurses) will burn out,” said Halupa, who along with Waxman, cofounded the advocacy group NurseWithSign416.

Emergency room departments are not operating with the appropriate nurse-to-patient ratio right now because of staffing shortages, Halupa said.

“In a (cardiac) arrest situation when the patient needs to be put on a ventilator, we need a nurse to do the meds, we need a nurse to do the charting, we need a nurse to do port access, like catheters and help the doctor with a central line. We need another nurse to get the meds for us and mix the meds for us, as most of our meds are not pre-mixed.”

“And then, if God forbid, the patient goes into cardiac arrest, we need bodies to do CPR. You can only do compressions for two minutes before you have to tap out because it’s exhausting. And then it starts to become ineffective so you need to switch off (to) someone else. And we just don’t have the manpower anymore.”

Sara Fung, registered nurse, master’s in nursing

Sara Fung works as a professional practice specialist, home and community care. She has worked in nursing for almost 14 years and held positions as a bedside postpartum nurse and a newborn intensive care unit nurse. She co-hosts a podcast, “The Gritty Nurse,” where she addresses issues with the profession.

“We have been in a situation in health care where it’s been cutting, cutting, cutting for so long that a lot of nurses don’t even know what safe staff-to-patient ratios look like,” she said.

“I’ve never worked in a single unit in any hospital where we’re not constantly short-staffed … We’re not built to look after more than four patients at a time in certain areas and we’re constantly told that this is the expectation, and it just becomes a vicious cycle.”

Amie Archibald-Varley, registered nurse, masters in nursing

Amie Archibald-Varley, who has been a nurse since 2010 and cohosts “The Gritty Nurse” with Fung, said calling nurses “heroes” during the pandemic was more about politics than a true reflection of how nurses were feeling.

“We were drowning. We were scared and we were terrified,” said Archibald-Varley, who works as a quality and patient safety specialist. “I think there would have been a different name that nurses would have chosen for themselves instead of (front-line heroes).”

Jennifer Maddigan, registered nurse, formerly in emergency

After working 20 years in the emergency department, Jennifer Maddigan quit in June. She now works in vaccine clinics, as well as in dental offices administering IV sedation.

“It came down to one particular day back in February,” she recalled. “We had a patient come in and unfortunately he did not make it. It was a very sudden passing and very difficult for the family. And I sat there and I was so burnt out that I could not provide them with the appropriate, and much deserved, empathy that they needed in those moments.”

That was when Maddigan knew no matter what her skill level was as a nurse, her “empathy was gone” and she felt she was “no good” to take care of a patient. She was tired of leaving work feeling like she was unable to do her job properly.

“When you go home every day thinking, I gave 150 per cent, however, I was only able to provide about 50 per cent of the care that I know I’m capable of because of staffing shortages, because of hallway nursing — (the) overall morale is non-existent.”

‘‘ We have been in a situation in health care where it’s been cutting, cutting, cutting for so long that a lot of nurses don’t even know what safe staff-topatient ratios look like.

SARA FUNG REGISTERD NURSE

Sophie Brindamour-Durocher, former full-time registered nurse in the emergency room

Sophie Brindamour-Durocher worked as an emergency room nurse for 17 years and, three years ago, became the unit co-ordinator in the emergency department.

“I left because I just felt like the department in itself was not the image of what I was used to, I didn’t feel like it was a safe environment for the patients and even us as nurses,” said Brindamour-Durocher, who has now transitioned from a full-time role to a casual one.

She says she would have stayed if there was better support for nurses and better pay.

“I knew that no matter what I was doing, it wasn’t enough. The ship was already sinking.”

‘‘ I knew that no matter what I was doing, it wasn’t enough. The ship was already sinking.

SOPHIE BRINDAMOURDUROCHER, REGISTERED NURSE

Marida Etherington, former hospital nurse who was working in acute mental health

Marida Etherington resigned from her job as an acute mental health care nurse in March 2020 just as the pandemic hit. She had worked through SARS, and felt she had to leave her work to keep her family safe during the pandemic.

She has now started two private nursing businesses.

Etherington agrees that the pandemic has exacerbated the problems within the profession. She says nurses are working with less and trying to do more because patients are sicker.

“When nurses are giving and caring, who’s pouring into the nurse? You hear reports of the ICU being x number of nurses short. They’re caring for really sick people. And what happens if the nurse makes a mistake? If their workload has doubled or tripled, how is one person supposed to carry that load? And for how long can a nurse carry that?”

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2021-11-28T08:00:00.0000000Z

2021-11-28T08:00:00.0000000Z

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