Nurses waiting outside the isolation room help the team working inside the isolation room of COVID-19 patient inside the intensive care unit of Humber River Hospital in Toronto on April 15.CARLOS OSORIO/Reuters
Nurse Lynnsie Gough tried to hang on, but in the end, the workload and sorrow of COVID-19 were more than she could bear.
“It just kept getting worse and worse,” Ms. Gough, 35, said of her job as an intensive-care nurse at a hospital in Ontario’s Niagara area. “I was having anxiety attacks where I would feel or be physically ill. I felt like I was going off to war or prison every day going into work.”
The only way to preserve her well-being, Ms. Gough concluded, was to quit.
Last month, she joined the growing ranks of Canadian nurses who are retiring early, switching to part-time schedules, departing to work for private staffing agencies or leaving the profession after 16 merciless months on the front lines of the pandemic.
The nursing shortage, a long-standing problem exacerbated by COVID-19, is now forcing some hospitals to close beds temporarily, scale back emergency-department hours over the summer and delay the full reopening of operating rooms. In Ontario, the government has begun offering bonuses as high as $75,000 to attract experienced, out-of-province critical-care nurses to strapped hospitals.
“We’ve seen nurses leave and leave and leave,” said Bernard Mathieu, an emergency physician at Montreal’s Maisonneuve-Rosemont Hospital. “We see new, fresh nurses come in for orientation who decide not to stay because they see the quality of life they’re being offered is terrible.”
“Stratospheric” levels of mandatory overtime in Quebec hospitals have spurred nurses to leave for private staffing agencies that offer better pay and flexible schedules, he added.
Dr. Mathieu penned an open letter on behalf of his emergency-department colleagues this week begging Quebec’s health minister to help resolve the shortages. Dr. Mathieu wrote that half of all nursing posts and three-quarters of all respiratory-therapist jobs at Maisonneuve-Rosemont were vacant, compelling the hospital to temporarily close about a quarter of its acute-care beds.
Catherine Dion, a spokeswoman for the regional health authority that oversees the hospital, said by e-mail: “We are doing everything we can to limit [the staffing shortage’s] impact while providing the best health care to the population we serve.”
Exhausted medical workers need time off over the summer, she wrote, adding that pandemic-related burnout is a problem across Quebec’s health system. Nursing shortfalls also led to the temporary closing of an emergency department in Gatineau last month, and to plans for nightly shutdowns or reduced hours at some other Quebec emergency rooms over the summer.
Dr. Mathieu’s letter came on the heels of a June 3 missive signed by more than 60 emergency doctors from three hospitals in Winnipeg warning of epic levels of burnout. “Many senior experienced nurses in our EDs have resigned, while many others are planning to leave,” the letter said. “Morale and staffing are at all-time lows. We view the situation as critical, unsustainable and in need of immediate action.”
Nunavut Health Minister Lorne Kusugak announced on Friday that two of the territory’s health centres would close temporarily in mid-August, while another five would close to all but emergency cases for a few weeks over the summer because a “nationwide shortage of health care staff [has] made the recruitment of nurses into the territory very difficult.”
In Alberta, meanwhile, the United Nurses of Alberta, which is in the midst of acrimonious contract negotiations with the United Conservative Party government, said nursing shortfalls have led to summertime bed cuts in about a dozen emergency departments, including at the Royal Alexandra Hospital in Edmonton and the St. Therese-St. Paul Healthcare Centre northeast of Edmonton.
James Wood, a spokesman for Alberta Health Services, said more than 98.5 per cent of the province’s 8,400 acute-care beds remain open, despite staffing challenges.
Mr. Wood noted that staffing challenges aren’t new and are especially common during the summer, when badly needed vacations deplete the nursing and physician work forces.
But Shazma Mithani, an emergency physician at Royal Alexandra, said that in the seven years she’s worked as an attending physician at the hospital, she has “never seen anything like this before, ever.” Her hospital is closing a minimum of six of the emergency department’s 27 acute-care beds for the summer because it can’t fill nursing shifts, Dr. Mithani said.
Statistics Canada reported last month that in the first quarter of 2021, the health care and social-assistance sector saw a larger year-over-year increase in job vacancies than any other sector, led by postings for registered nurses, registered psychiatric nurses, nurse’s aides or orderlies and licensed practical nurses.
Total vacancies in the sector rose to 98,700, an increase of nearly 40 per cent over the same time a year earlier. Nearly half the want ads for registered nurses and registered psychiatric nurses had gone unfilled for 90 days or more.
Individual hospitals see signs of the exodus in their own numbers. Windsor Regional Hospital, across the border from Detroit, had 59 experienced nurses retire during COVID-19, nearly twice the 31 nurses who retired in the 16 months immediately before the pandemic. “Replacing that work force is really critical,” said Karen Riddell, Windsor Regional’s chief nursing executive. “We have to do it before we lose all of that expertise and experience.”
Windsor Regional, which has long competed with hospitals in Michigan for nurses, is one of the beneficiaries of a new Ontario government program offering bonuses of between $10,000 and $75,000 to experienced nurses who come from outside the province or return to the profession from retirement or unemployment.
The temporary program was available to nearly 50 Ontario hospitals where the provincial government funded extra critical-care beds for the treatment of COVID-19, according to Ontario Ministry of Health spokesman Bill Campbell.
Windsor Regional has hired six nurses through the program so far, and another 12 are in interviews, Ms. Riddell said.
Doris Grinspun, the CEO of the Registered Nurses’ Association of Ontario, said bonuses “do nothing” and encouraged the government to instead focus on retention by improving working conditions and training existing nurses to fill gaps in critical care and other specialties.
An online survey Ms. Grinspun’s organization conducted in January and February found that 9.3 per cent of 2,102 respondents planned to leave the profession after the pandemic, nearly twice the proportion that leave the profession in a typical year.
Ms. Gough is now among them. Although she hasn’t ruled out a return to nursing, she is haunted by the pressures she faced during the pandemic, when her workload was twice or three times as heavy as normal. She oversaw redeployed nurses with little or no ICU experience. She worried all the time that, as she rushed between patients, she would make a mistake.
Her sister, a registered practical nurse in long-term care, is equally demoralized, Ms. Gough said. “We both are feeling like we don’t want to have anything to do with nursing anymore,” she said. “It seems that no matter where you go at this point in time, everywhere is short.”
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