HSC's emergency nurses raise concerns about departure of skilled staff and long wait times
Patients waiting well over 10 hours for care, they say
After undergoing weeks of "terrible" and "unsustainable" working conditions, two emergency nurses who work at Health Sciences Centre are speaking out about an urgent staff shortage and calling for change.
The nurses say the adult emergency department is constantly understaffed because highly trained nurses are burnt out and leaving at an alarming rate.
They worry if current trends continue, HSC will no longer have skilled nurses to tend to emergency patients, who they say are waiting anywhere from 10 to 16 hours for care.
"It's disheartening to see all the other colleagues just getting burnt out and losing the spark they have," said the first nurse who spoke to CBC.
"They're realizing that it's not sustainable for them mentally, and they have to move on to something better for their mental health because it's fatiguing," the nurse said.
CBC is protecting the identity of the two nurses because they fear losing their jobs for speaking on the record.
Around 9 nurses short per shift
A second nurse who spoke to CBC said in the last few weeks said the department is typically short eight to nine nurses per shift.
On Saturday, only 13 out of 25 nurses were working in the ER and one of them was a nursing educator, the nurse said.
"[It's] been actually quite terrible," said the second nurse.
"We're exhausted. I've seen co-workers cry at work. I've seen people that were strong not being able to come in."
According to data provided to the Manitoba Nurses Union by the Winnipeg Regional Health Authority and Shared Health, the facility-wide vacancy rate for HSC in July was 19 per cent. For the emergency department, it was 21.2 per cent.
The vacancy data was provided as a snapshot in time and has not been retroactively adjusted.
Not enough beds
The nurses said on a typical night, there are around 40 to 50 patients in the waiting room of the ER.
The first nurse said there's nowhere for emergency patients to go because all the beds in other departments of the hospital are full.
'They just end up staying in the emergency department, being treated by nurses who are more specialized and focused on emergency care as opposed to a longer-term care," the nurse said.
The second nurse said HSC had to shut down two out of six resuscitation rooms to accommodate the staff shortage. Resuscitation rooms are designed to look after critically ill patients, such as those with trauma or cardiac arrest.
Shared Health says nursing resources were directly and indirectly affected by COVID-19 and the second and third wave of the pandemic.
"The challenge has been further compounded by the emergence of patients who delayed seeking out care due to COVID," a spokesperson said via email.
It also said that nurses who tend to pick up emergency shifts are now choosing to work in critical care.
ER nurses promised $6/hour retroactively
Shared Health says staff call-out, overtime offers and managers assisting on the floor in the unit are strategies being implemented to address the problem. It says a retroactive pay premium to emergency nurses is also in place.
The two nurses say they've been promised $6 per hour retroactive to May of this year, but it's still not enough.
"It may be too late ... plenty of colleagues have left," the first nurse said.
The second nurse says it's "insulting" to not be recognized at the start of the pandemic — when the province offered the extra money to nurses working in COVID-19 wards.
"That was so insulting to all of the emergency room nurses.… We deal with COVID patients daily," the nurse said.
Problem with retention
The first nurse said in the span of six months, there's been at least 10 highly trained nurses who left the ER in pursuit of other jobs and some have gone to other provinces.
"You can't just come in there and have the knowledge and skills of an emergency room nurse," the first nurse said. "It takes time to train and mentor these people."
The nurses say they feel undervalued by the province and Shared Health Services.
"They hold us as heroes, but we certainly don't feel that way," said the first nurse, who is also considering leaving HSC.
Darlene Jackson, president of the Manitoba Nurses Union, said they're seeing high vacancy rates in every emergency room in Manitoba.
"It's very frightening," Jackson said. "We're going into wave four and nurses are just saying, I just cannot keep this pace up any longer."
Manitoba needs to make nursing attractive for highly trained staff to stay in the province, she said.
In a statement, a government spokesperson said patient volumes at Winnipeg emergency departments and urgent care centres are a high priority for new Health Minister Audrey Gordon.
"Efforts continue to recruit, train and retain nurses across the health-care system," the spokesperson said.
The spokesperson said the WRHA and Shared Health are now participating in an "incident command structure" to stabilize staffing, create capacity and improve patient flow.
Patients will be redirected
To address exceptionally long wait times at St. Boniface Hospital, the Winnipeg Regional Health Authority told staff it will implement a "modified EMS redirect status" to divert some of their ER patients to other emergency departments.
The nurses say HSC already regularly accepts the majority of patients with mental health and addiction issues, which can require more staffing, and they have less than an hour to find space for patients offloaded by paramedics.
"I have no beds to put them in so we end up doing things like putting them in the waiting room in front of our desks so we can watch them, or putting them in a stretcher in a hallway, trying to watch them while we're watching 40 other people," the second nurse said. They say they have no capacity to absorb patients from St. Boniface Hospital too.
In an emailed statement, a spokesperson from the WRHA said facilities in the region work together to ensure patients are cared for in the most appropriate location with capacity.
Arrivals by ambulance are managed through EMS redirect protocols when a site is experiencing higher volumes, has a lack of available beds or is impacted by staffing challenges, the spokesperson said.
Some sites are responsible for specialized services — such as cardiac services at St. Boniface and stroke services at HSC — and modified redirect protocols ensure specialized patients are directed to the best sites to meet their needs, he said.
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