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ont. emergency order holds nurses 'basically hostage'

an interview with cathryn hoy, the vice president of the ontario nurses association, on why her colleagues are leaving.

don’t call us heroes: ontario nurses
a respiratory therapist and six nurses prepare to prone a coronavirus disease at the intensive care unit of humber river hospital in toronto. carlos osorio / reuters carlos osorio / reuters
cathryn hoy became a registered nurse because she wanted to help people. but there’s a big difference between wanting to help, and being dehumanized and forced to sacrifice your own wellbeing — which is what the ontario government forced nurses to do over the course of the pandemic, she says.

hoy, vice president of the ontario nurses association, says she’s not surprised by the endless headlines about nurses across the country leaving the industry in droves job vacancies in healthcare have risen by nearly 40 per cent since last year, according to statistics canada , with the most need for registered nurses, registered psychiatric nurses, nurses aides, and practical nurses. provincially, quebec’s er doctors wrote an open letter to the ministry of health in july, warning of potential closures due to nursing staff shortages. emergency physician dr. bernard mathieu told the cbc that at the hospital where he works, maisonneuve-rosemont hospital in montreal, half the nursing and three-quarters of the respiratory therapist positions are vacant.

to the west, alberta has been in a bitter contract fight with its nurses for months now, with catholic healthcare provider covenant health urging nurses — overworked and burned out from the pandemic — to take a pay cut. ( shazma mithani, an emergency physician at edmonton’s royal alexandra, told the globe and mail that her hospital is closing at least six acute care beds because it simply can’t fill nursing shifts. she says she has “never seen anything like this.”

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we talked to hoy about the situation in ontario, and why nurses don’t want to be called heroes.
this interview has been edited and condensed for clarity.

how are ontario nurses feeling?
we have a lot of registered nurses who are retiring, and we also have newer nurses questioning if they want to continue. they are our future, and they’re leaving the profession.

with the pandemic, and the increase of critical patients, the workload has escalated. everyone needs time to recharge their batteries, but with the emergency orders, no one can get vacation. if you’re working 90, 100, 110 hours, every two weeks, you need a day off.

maybe that sounds a little bit self-serving, but i think people forget that nursing is 24/7. there is no christmas, there is no new year’s holiday. people get excited over long weekends — there isn’t that for nurses.

also, if you’re short on nurses and and you have critical patients, you don’t leave. you stay. and if you know that tomorrow, your unit is short and your patients need you, you’re not going to say no. you’re going to come in. there’s that stress, too.

what was it like at the beginning of the pandemic?
we have a lot of registered nurses in home care, community care, and long-term care who had to fight for personal protective equipment (ppe). ppe was put under lock and key, and nurses had to make a case [for why they needed it]. the shortage of masks at the beginning of the pandemic was also a concern which lasted well into the spring.

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so these nurses were going home wondering, ‘am i going to give my loved ones covid?’ that took an emotional toll. some actually moved out of their family homes and paid out of their own pockets to rent apartments, camping trailers and rvs, so they didn’t put their families at risk.
that’s the cruel reality of it all. registered nurses had to fight to take care of their patients, when staffing levels are low, but they also had to fight to take care of themselves.
what those nurses really needed to know was that they were supported with the appropriate staff. the government was announcing bonuses for retired nurses and for those from out of province [to join the nursing workforce] — but they were not all experienced and required training.
at some of the hospitals, nurses were actually training family physicians to work in the icu, in addition to caring for their own patients.

how did we get to this point? 
the [premier doug] ford government left healthcare professionals feeling very targeted with bill 124. [the provincial legislation, enacted in 2019, aimed to balance the budget by taking aim at public sector jobs. that meant salary caps, yearly raises that start at no more than one per cent, increasing gradually as a worker gains experience, and limits on bargaining power.] when the government took away our right to collectively bargain — that was really the key. that is our constitutional right.

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the emergency order meant nurses couldn’t get vacation — they still can’t — and ford isn’t lifting any of these emergency orders. you can’t hold nurses basically hostage because you have a staffing shortage.
[in march 2020, the province issued an order under the emergency management act authorizing health service providers the right to defer nurses’ vacation. a spokesperson for the government was unable to respond to healthing’s question about when that order will be lifted by publication time. this story will be updated when we get an official response.]
doug ford called nurses “heroes” at the height of the pandemic.

a lot of our nurses did not like being called heroes. they’re not superheroes, they’re professionals. they’re highly skilled, highly educated, and they’re dedicated to what they do. they want to be recognized for their work.

nursing is a female-dominated profession, and our male counterparts are police [officers] and firefighters. we have the utmost respect for police and fire, but they were not capped at the one per cent increases. it leaves nurses feeling devalued. why is a female-dominated profession worth less than a male profession?
ford or [health minister] christine elliot will sit there and say ‘we don’t control fire and police, they’re municipal,’ but at the end of the day they could control it if they really wanted to. the province does transfer payments to all those municipalities. they didn’t say to municipalities ‘we’re going to decrease your funding,’ but they targeted healthcare.

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i’ve never thought about it that way, that nurses are the female equivalent of the overwhelmingly male workforces of police and firefighters.
if you think about those three areas, they’re all high-risk. but if anyone hit a police officer or firefighter, that person would be arrested. now let’s flip the coin: nurses are at risk for disease from needle pricks, they’re at risk for violence. emergency units, post-op delirium — there are more incidents of violence against nurses than firefighters and police officers combined . nurses are physically and verbally abused on a daily basis, but they are not encouraged to charge their patients.

what needs to happen for conditions to get better?
some of them are quick fixes and some aren’t. the government really needs to dedicate sustained funding to fix the rn shortage just to bring us up to the canadian rn-to-patient average , which isn’t even enough.

it would take four or five years, but if they opened up more registered nursing seats in the universities, [that would really help].
for some reason, a lot of the employers, and most acute care [employers], are only hiring part-time. at the end of the day, that’s actually more expensive [for them], so i don’t understand it.

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what do you wish more people understood about your work?
a lot of times, people don’t think about healthcare, they just assume it’s going to be there. you don’t really think about it until it touches you. and covid did touch a lot of people. 

nurses want to give the best care that they can, but it’s hard for them to practice in this setting. they honestly just want to take care of the people of ontario. that’s why they’re doing this job.

healthing reached out to the ontario government for comment on this article. a spokesperson for the province’s treasury board said that “any suggestion that [bill 124] is discriminatory or targets any demographic group is totally baseless.”

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