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Understaffing puts patients at risk, nurses say

Union wants mandatory nurse-to-patient ratios

by Robert Devet

Ginger Hampton, RN, "Nurses are exhausted."  Photo Robert Devet
Ginger Hampton, RN, "Nurses are exhausted." Photo Robert Devet
Joan Jessome, President of the NSGEU, "Every single bargaining table we have been at since the Liberals took power has been a disaster." Photo Robert Devet
Joan Jessome, President of the NSGEU, "Every single bargaining table we have been at since the Liberals took power has been a disaster." Photo Robert Devet

K'JIPUKTUK (Halifax) - Some of the largest hospitals in Halifax are so understaffed that the health of patients is being jeopardized, nurses say.

These same nurses, the 2600 members of Local 97 of the Nova Scotia Government Employees Union (NSGEU) say that mandatory staff-to-patient ratios are the only way to solve the problem.

Nurses are willing to go on strike if their employer, Capital Health, doesn't listen to their demands. Last month 90 per cent of the nurses voted in favour of strike action if safe patient care is not addressed.

"Nurses are exhausted...", Ginger Hampton, RN

"Currently there is a policy where the first and sometimes even the second nurse who calls in sick is not replaced," says Ginger Hampton, a registered nurse who works in the Neurosurgical Intensive Care Unit.

"Nurses are exhausted. There are nurses who work for hours on end without sitting down, having a drink of water, or using the bathroom."

"Meanwhile these nurses are dealing with potentially harmful medications. A single slip-up could cost a life."

Accidents do happen. Capital Health staff filed 40,000 Patient Safety Reports over the last two years.

A summary report suggests that three per cent of the affected patients suffered severe harm, or even death, because something was amiss. That amounts to 600 patients each year.

Having more nurses on duty reduces the risk of harm. A new study finds that across Europe every extra patient added to a nurse's workload increases the risk of death within a month of surgery by seven per cent.

"It's not about money, it isn't about their wages..", Joan Jessome, President NSGEU

Joan Jessome, President of the NSGEU, advocates for mandatory minimum staff-to-patient ratios.

"I met with 500 nurses a few weeks ago, and nurse after nurse shared their story of working conditions and the impact on patient safety, the near misses and nurses not getting breaks, not being able to go the bathroom," Jessome told the Halifax Media Co-op.

"It's not about money, it isn't about their wages, they can't function under these working conditions anymore," Jessome says.

Capital Health authorities say that there is a formal process for nurses to report on situations when being shortstaffed might jeopardize patients' health. But Jessome counters that nurses have long lost faith in a process that is cumbersome, lengthy, and never delivers concrete results.

Capital Health also says that hiring more nurses is too expensive.

Kathy MacNeil, vice-president of Human Resources, believes Capital Health would need to hire 800 new nurses to the tune of $60 million annually to meet the nurses' demands.

"A mandatory ratio would not guarantee us an improved level of care or safety as a result, only an additional cost to doing what we do today," MacNeil wrote in an op-ed in the Chronicle Herald.

Jessome thinks, based on what people on the ground tell her, that the real number is more like an extra 150 nurses. Savings in overtime would go a long way in balancing out the cost of new hires, she argues.

Hampton adds that there are all kinds of hidden costs to working the hospital floor without the right support.

"Patients don't do as well, they don't get mobilized as fast, they don't get their pain controls as quickly, they just don't do better, which increases the length of their stay," she says. "That really increases your healt care cost."

"If you can't provide the care you want to, it breaks your heart..", Ginger Hampton, RN

It is often said that it takes a special kind of person to be a nurse. But working without adequate supports is taking its toll, Hampton says.

"A lot of nurses cry in the bathroom, cry on their way home because they can't believe what they just have endured," she says. "The heartbreak we witness on an everyday basis, the horrors we see, you can't just erase it from your memory."

"We see patients in shock and crying because the doctor has just told them they have a terminal brain tumor, and we don't have time to spend with them. We look at that poor patient and we have to run away."

"If you can't provide the care you want to, it breaks your heart," says Hampton.

Understaffing is not the only problem.

Nurses say that new shift scheduling software, which cost Capital Health $1.6 million to implement, is too rigid and doesn't work well.

The software makes it harder to switch shifts at short notice, they say.

"Shift work is hard in and of itself, if you take any flexibility away from it it makes it harder," says Hampton. "There are a lot of mothers who find it too difficult with these scheduling changes to take care of their children."

"I have been asked many times, where is collective bargaining going to go? I don't think it is going to exist...", Joan Jessome

Just a few weeks ago striking Home Support Workers, members of the NSGEU, were legislated back to work. The legislation mandates that during a strike a significant portion of home support workers stay on the job to perform so-called essential services.

Meanwhile the majority Liberal government rejected an offer by the union to avert a strike through arbitration.

Not only does the legislation impede the right to strike, it also sends the home support workers back to the bargaining table for a protracted process to define those essential services, a process that Jessome believes could take close to a year.

In view of all this, is Jessome optimistic that the government will listen to the nurses demands?

"I have been asked many times, 'where is collective bargaining going to go [under this majority Liberal government?]'. I don't think it is going to exist. Every single bargaining table we have been at since the Liberals took power has been a disaster," she says.

Jessome predicts the Liberals will use essential services legislation to dampen a looming nurses' strike.

During the most recent bargaining session Capital Health demanded that 84 per cent of nurses be deemed essential and not be allowed to participate in strike action, Jessome says.

"It doesn't solve the patient safety issue, it doesn't solve the sick leave issue. What it does, it insults nurses," says Jessome.


Follow Robert Devet on Twitter @DevetRobert

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Topics: HealthLabour
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