Province relying on contract workers as Manitoba struggles to fill shortage of public nurses
Hours worked by private nurses have doubled in the last 4 years, provincial data shows
The province of Manitoba is increasingly turning to contract nurses to fill staff shortages — a trend that's causing frustration and resentment among hospital staff, says a public nurse.
"It infuriates everyone. We feel so powerless and so angry because these agency nurses seem to have so much power," said the medicine nurse at Grace Hospital in Winnipeg.
CBC is protecting her identity because she fears she could lose her job for speaking on the record.
The number of hours worked by private nurses in the province doubled in the last four years, according to data provided by Shared Health and the Winnipeg Regional Health Authority to the Manitoba Nurses Union.
In the 2017-2018 fiscal year, agency nurses worked 181,378 hours provincewide. In 2020-2021 year, that had climbed to 368,775 hours.
The jump in hours worked by agency nurses was even more pronounced in Winnipeg's hospitals specifically between the 2018-19 and 2019-20 fiscal years: from 9,493 hours to 66,359 by the time the pandemic hit.
Manitoba, like the rest of Canada, is grappling with a critical nursing shortage and struggling to retain public nurses.
In recent months, nurses at Winnipeg's St. Boniface Hospital, Health Sciences Centre and Grace Hospital have spoken to CBC News about poor working conditions — including consistently mandated overtime to deal with a surge of patients in ERs without adequate staffing and resources.
Nursing vacancies have also reached unprecedented levels, with 2,000 vacancies provincewide. There are 1,500 in Winnipeg alone, Manitoba Nurses Union president Darlene Jackson said.
With a shortage of public nurses, private nurses are used everywhere in the province, she said. But that affects continuity of care — and is expensive, Jackson said.
"Going through a contract with a private company, the cost is phenomenal."
From April 1, 2019 to Aug. 31, 2021, the Winnipeg Regional Health Authority spent more than $1.2 million on agency nurses at St. Boniface Hospital, with a total of 16,479 hours worked.
For the 2020-21 fiscal year, Shared Health spent $60,827 on agency nurses at Health Sciences Centre for 947 hours worked. HSC didn't hire agency nurses in the previous fiscal years.
CBC requested the amount of money spent at Grace Hospital but didn't get that number by deadline. The Winnipeg health authority says since April 2019, a total of 43,408 hours have been worked by agency nurses at Grace Hospital.
'Causing a lot of resentment': nurse
The nurse at Grace Hospital said she's being pulled from the medicine unit to work in the ER nearly daily. An agency nurse fills her role in medicine.
She feels nurses pulled to into the emergency room are not trained or equipped to work in the department, which creates a stressful situation.
Agency nurses, meanwhile, get better pay with more flexibility in work responsibilities and hours, she said.
"It's an unfamiliar situation. It's an unsafe situation and that's what they're putting us into.… It's causing a lot of resentment," the Grace nurse said.
"We've been loyal to the hospital. Many of us have not chosen to go work for agency [companies] … and we're treated poorly."
In an email, a WRHA spokesperson said general orientation is given to all nurses who are unfamiliar with the emergency department. Staff are not asked to do tasks that would require higher-level emergency training, such as running a resuscitation room, the spokesperson said.
Jackson said she's seeing more public nurses leaving their jobs to work with private agencies.
Shared Health, which is responsible for Winnipeg's Health Sciences Centre, says recruitment efforts are ongoing to lower vacancy rates in that hospital's emergency department. That vacancy rate is expected to drop from 20 to 14 per cent next month as new hires come in, Shared Health said.
The Winnipeg Regional Health Authority — which is in charge of the city's other hospitals — says staffing has been affected by COVID-19 but a regionwide co-ordinated effort is underway to help sites in need of nurses to fill shifts.
Agency nurses fill important role: expert
Sonia Udod, an assistant professor at the University of Manitoba's faculty of nursing, says agency nurses are better suited in surgical or medical units, not in emergency or intensive care.
"The more agency nurses you have, there's a risk for adverse patient outcomes," she said. "It takes time for the nurses who are actually employed in the facility to orientate those nurses to the unit and also support junior nurses as well."
Udod specializes in health-care leadership and nurse work environments. She said agency nurses fill an important void by providing a much-needed break for public nurses and decreasing workload.
Having medicine nurses backfill in the ER and intensive care units, and agency nurses backfill medicine, is the best solution at this point, she said.
"I think that in a crisis, it's all you can do. But in the long-term sort of forward thinking, we need to think a little bit differently."
Udod said senior health leaders can better retain public nurses by providing compassionate care and having a mental health worker in the organization.
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