“Have you been drinking and do you have childcare issues?” This is not the kind of question a nurse wants to hear after being called at home by their director, and then being ordered to work on their day off. But that’s exactly what happened to BCNU members working at Lions Gate Hospital over the holiday season. Management there had invoked mandatory overtime – an old tactic from the nineties – to address chronic overcapacity that was exacerbated by the seasonal surge.
Christmas and New Year’s and cold and flu season are as predictable as night and day, yet somehow health authorities once again found themselves caught off guard when it came to ensuring there would be adequate nursing staff needed to handle the onslaught of patients.
This is unacceptable. Nurses in British Columbia are already coming to work early, leaving late and often missing their own rest periods in an attempt to provide care for patients in hallways, lounges and other areas not equipped for safe care. Royal Inland Hospital continues to experience record high levels of overcapacity – one day recently it reached 138 percent. Victoria General Hospital recently had the highest number of extra patients in its history and on Boxing Day Kelowna General Hospital’s ER had its busiest day ever, treating over 320 patients.
In addition to mandatory overtime, the past holiday season also saw BCNU members subjected to excessive amounts of regular overtime, including routine 16-hour shifts, with some extending to 20 or even 24 hours in order to staff worksites.
There are over 30 vacancies in the Abbotsford Regional Hospital ER, over 20 positions sit empty at Children’s and Women’s NICU and PICU units, and Dawson Creek Hospital is missing half of its operating room staff. These are just a few examples of current staffing conditions that have led to nurses being ordered to work overtime.
Meanwhile, in the lead up to a provincial election, this government has announced spending of $417-million for a new patient care tower with 11 new operating rooms in Kamloops and over $100-million on new operating room theatres at Vancouver General Hospital. At the same time, BC is experiencing the most acute shortage of operating room nurses in over 20 years. Does this make any sense?
There’s no question that nurses working in hospitals and the community are experiencing unmanageable caseloads with inadequate staffing levels to meet the needs of the patients. The disturbing levels of staffing across this province and the continued number of unfilled vacancies mean that we can no longer ignore what needs to happen.
Nurses’ collective voice must be heard when it comes to determining safe staffing levels. There are currently no Canadian standards defining minimum staffing levels, and patient loads are determined on an ad hoc basis. They differ from unit to unit, and hospital to hospital and are often motivated by budgetary constraints rather than concern for safe patient care.
Why? Would anyone board a plane without safe, mandated staffing levels?
Nursing work is measurable and quantifiable. There are many available workload assessment tools but these remain mostly unused at the unit level. Instead, nurses are handed patient loads determined by management without a system for protecting the work of the nurse and the care of the patient.
There has never been a time when evidence-based nurse-to-patient ratios were needed more. Instead of accepting mandatory overtime, nurses at every level of our system must advocate for mandatory minimum staffing ratios in order to protect our patients and ourselves. It’s time.
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