Nova Scotia Health grappling with 'unprecedented' nurse shortage

Nova Scotia Health is in "crisis mode" as it furiously tries to fill hundreds of shifts left empty by nurses across the province who are either leaving for temporary positions at public health clinics or outright quitting, a union leader says.

Jason MacLean, president of the Nova Scotia Government and General Employees Union, said nurses are burning out.

He said at the QEII Health Sciences Centre's Halifax Infirmary emergency room, at least 25 nurses have quit in the last two months without having another job lined up.

As a result, MacLean said emergency room staff levels are at half capacity most of the time.

"When you have a place that normally runs at 18 people for nursing and it's constantly running around eight people, that is a crisis," said MacLean.

Janet Hazelton, president of the Nova Scotia Nurses' Union, said this summer marks the worst staffing shortage she has witnessed in 30 years.

Major gaps across Nova Scotia

She cited the draw of nurses to public health sites for COVID-19 testing, contacting tracing and vaccine clinics.

"Take a couple of hundred people out of the mix and it makes the problem even worse," said Hazelton. 

Major gaps in service are being felt across the entire province — from Cape Breton to Yarmouth — in hospitals big and small. 

And Nova Scotia Health isn't disputing those facts. 

Colin Stevenson, the organization's vice-president of quality and system performance, said the current situation is "unprecedented." 

In the first quarter of 2020 — when the pandemic began — the total nursing vacancy rate including registered nurses and licensed practical nurses within Nova Scotia Health was seven per cent. It has since jumped to 20 per cent.

"We do expect that we're going to, as we're coming into the summer, potentially have some reduction in services to allow for vacations ... but the fact that we're coming into this period with an already 20 per cent vacancy rate is concerning," said Stevenson. 

Resources maxed

The staffing shortage is exacerbated by the fact that some hospitals have in-patient units and critical care departments at full capacity, which means no beds are available.

Stevenson says ideally, Nova Scotia Health would like to operate at 85 per cent maximum.

"That creates a pressure that we need to respond to, that our staff are trying to respond to and we're trying to support them in a way in which they can be safe for themselves providing the care and most important that we're creating a safe environment for those that we're here to serve," he said.

The current staffing crunch can be mostly traced to the demand of COVID-19 sites, said Stevenson. 

A quarter of the approximately 800 public health positions needed for those jobs were temporarily filled by nurses who previously worked in a non-public health role, including casuals.

Nurses have been moved from critical care, emergency, surgical, medicine, mental health and addictions and ambulatory programs. 

Stevenson said with a reduction in the demand for COVID-19 services, Nova Scotia Health is looking to the some 200 registered nurses and licensed practical nurses who accepted reassignment positions to be reintegrated back into previous or new positions.

Nova Scotia Health is also focusing on staffing emergency departments. In the central health zone — which includes the Halifax Infirmary — 14 out of the approximately 19 vacant positions have recently been filled, with most nurses starting in September. 

Concerns at Cobequid

One persisting concern for the nurses' union is the fact that Cobequid Community Health Centre in Lower Sackville, N.S., has not been able to shut down overnight on several occasions over the last few months.

The hospital is scheduled to close at 12 a.m. AT and transfer patients to nearby centres such as Dartmouth General Hospital or QEII Health Sciences Centre.

"There's no capacity to take them anywhere else, so those nurses have to work and those patients have to stay," said Hazelton. "The issue with that is because Cobequid is not equipped to look after patients for long periods of time."

The health authority says in June, it needed to stay open 20 per cent of the time. In May, Cobequid didn't stay open at all. 

Hazelton said it's not ideal for patients because the hospital doesn't have a kitchen or in-patient beds, and it's exhausting for nurses because they have to stay hours beyond their scheduled shift. 

She added it's only a matter of time before the problem gets even worse.

"If you work for 24 hours straight, it's going to take you days to get over that. And if you do it often, you're going to get sick," she said.

A labour management committee is being formed between the unions and Nova Scotia Health to discuss how best to fill nursing positions in the short term.