Overcapacity, overworked, and understaffed; the state of healthcare in the North

As it stands, 15 per cent of nursing positions in Northern Health are sitting vacant.

That’s according to a report conducted by the Office of the Auditor General for the province, with that percentage translating to 121 positions being left open in 2017.

Northern Health was unable to fill the workloads of almost 65 registered nurse and close to seven nurse practitioners, all of which are the equivalent of full-time work. However, some were covered by contracted nurses at a higher hourly wage.

It’s just one example of the overall issue that surrounds the nursing shortage, not only in Northern Health, not even just the province of British Columbia, but across the entire country.

Northern Health is responsible for providing care to about two-thirds of the province, with much of the area being rural and remote.

Jacqollyne Keath, Chair for the Nurse and Nurse Practitioners of British Columbia told MyPGNow that with the aging nurses we presently have in the province, there will be 46,000 job openings come 2027.

According to the Canadian Institute of Health Information, British Columbia has averaged 1,303 graduates who are qualified to become registered nurses.

As Keath explained, that may seem like a fair ways away, however, when you take into consideration that it takes four years for a student to achieve a degree in nursing, whether that be a Registered Nurse or a Registered Psychiatric Nurse, or even just two years for someone to earn the title as a Licenced Practical Nurse (a less formal program) — It’s a short period for hospitals to have to fill tens of thousands of openings.

“We know there’s not enough graduating each year to replace the vacancies from retiring nurses,” said Keath.

To further add to the issue, CIHI also finds that of the 12,484 graduates from registered nursing programs in 2016, only 75 per cent of those obtained a licence to practice in Canada.

In 2017, Canada experienced the lowest annual growth rate of employed regulated nurses over the course of the last decade, seeing less than 1 per cent growth. And to add to that, just 57 per cent of nurses that were regulated were employed full-time that same year.

It’s a crisis across the country that has resulted in over-crowded floors in hospitals.

It’s suggested that the ideal nurse-to-patient ratio for emergency departments, as well as in-patients, is one nurse to every four patients. However, the current situation has a single nurse looking after upwards to ten.

A nurse from Northern Health, who spoke to MyPGNow on grounds of anonymity, said the nursing shortage is just one piece of the overlying issue, stating the shortage of beds is also leading to issues in hospitals.

“When we have the bed shortage, the floors go over capacity patients. Emergency sometimes has 24 over capacity patients in a 17-bed department. We still have to treat everyone coming through the door. Floors sometimes go eight patients over capacity, which is one entire nurse extra that they’re not getting staffed for.”

According to the nurse, hospitals are not making anymore extended care beds, nor do they plan to add more.

“They figure the baby-boomers are going to start dying off soon, and so they don’t feel like we’re going to need more extended care beds,” they said. “But because health care has moved forward, people are living much longer with much more complicated issues, needing much more resources. Because they’re not making more extended care beds, we’re getting a backlog of extended care patients in the hospitals, and our hospitals are functioning at dangerously over-capacity levels.”

“You try to give really good care,” said Keath, who up until last year was a clinical instructor. “You go into the field to help people and then you’re strapped with all this paperwork you have to do and you just don’t have the time in the day to spend quality time with everyone, as well as your minimum requirement of written stuff done.”

Due to the shortage, nurses are left working overtime, as well as working their days off in some cases.

Working short-staffed has made it difficult for nurses to meet the needs of patients and long-term care residents. Increased hours and workload as a result of the shortage has led to a greater risk of burnout, illness, and even injury.

In 2016, approximately 52 registered nurses were worked at an overtime rate.