As nurses in the Netherlands leave their full-time jobs, the province turns to expensive private agencies

Lauren Byrne’s daughter wept with joy the day her mother came home and announced that she was no longer a full-time permanent nurse in rural Newfoundland.

After 13 years dressing wounds, caring for patients, comforting families and losing his own life, Byrne decided to give up his pension and his permanent career.

Being a casual employee meant she could be home for Christmas and New Year’s. Go to birthday parties. And keep the promises.

“It’s a lot, you know, ‘I’m working tonight and tomorrow is the last day of school and I’m going to come home and we’ll take pictures,'” Byrne said in a recent interview.

“And then the next morning comes and there’s a sick call and there’s no one to fill that spot.”

Nurses in Newfoundland and Labrador are leaving the profession at a rapid rate, with more than 600 current vacancies and another 900 nurses set to retire. Byrne and another RN are speaking publicly about why they think the current system no longer works.

The health care workforce shortage has left not only the province, but also the country, grappling with a dwindling number of nurses, leading governments and health agencies to rely on a much more expensive option: traveling nurses.

But the union that represents nurses in Newfoundland and Labrador says it’s a dangerous precedent to set and will cost taxpayers more in the long run. Your leader continues to call for quick changes to mitigate the disaster.

It follows a Statistics Canada report in June on job demand in the national health care system that showed there are twice as many vacancies in the health care and social assistance sectors this year than there were two years ago.

Niki Parsons, a longtime nurse in rural Newfoundland, says her profession is in crisis and she’s speaking out so the public knows the reality of the situation. (Union of Registered Nurses NL)

Niki Parsons never dreamed of retiring, but now it’s a habitual thought.

But retirement will be in name only, he predicts.

“Four nurses retired two years ago. They retired on a Friday and went back to work on Monday,” said Parsons, who works as a registered nurse in rural Newfoundland.

Parsons went through some of the most tumultuous times of the 1990s, when nurses and the government disagreed over staffing and salaries.

But nothing, he says, compares to what he is seeing now: a workplace in constant crisis management, where staff shortages are the norm.

Annual leave denied, nurses burned

“It makes me angry that I can’t go in and provide the level of care that I know my patients want and expect,” Parsons said.

“And it makes me mad that there’s nowhere to go because it’s almost commonplace now.”

Parsons said it’s not just nurses that are understaffed. She said her hospital routinely has doormen, licensed practical nurses, personal care assistants and secretaries, all crucial jobs that keep the health care system afloat.

But it’s not possible to work short-time in an ER, says Lauren Byrne.

“We don’t know what’s going to come in. So we have to work through Christmas and New Years. You ask for a day off six months in advance, but there’s no one to take that day,” Byrne said.

A nurse places an oxygen mask over a patient's face as the woman lies in a hospital bed.
Parsons says she is speaking publicly to let patients know that nurses are doing the best they can with the resources they have. (Union of Registered Nurses NL)

A March survey by the provincial government and the nurses’ union found that 90 percent of registered nurses and nurse practitioners experience burnout. Sixteen percent of nurses indicated that they are considering leaving the profession for good.

Half of all registered nurses are considering quitting their position to go informal.

Byrne is one of them.

“I still love the people I work with, I still love the job, and I just need to have more autonomy over my own schedule and my own life,” she said.

“I will work occasionally and save money for my own pension, but I can schedule my own shifts and I am not required to work a certain number of shifts.”

‘A slippery slope’

One of the short-term solutions being used is private agencies that pay nurses a higher rate to travel to hospitals and facilities across the country to fill a need.

The use of agency or travel nurses is increasing across Canada, according to provincial and national nurses’ unions. Agency nurses are ultimately paid from public funds, even though they work for private companies.

This is public money for a publicly funded health care system that is spent by private industry.-Yvette Coffey

CBC News requested data from the four provincial health authorities on the use of travel nurses this year from January 1 to June 30.

Central Health said it has hired 46 traveling nurses, some of whom have completed multiple stints with the health authority. In an email, a spokesperson said $410,516 has been spent to date.

Eastern Health began using private duty nursing in May and has used 14 nurses. The average cost per 12-hour day worked, which varies by assignment area, is around $1,100. The health authority did not provide total costs by deadline.

In the Labrador-Grenfell Health region, 46 traveling nurses have worked, at a total cost of $1,085,788.

Western Health said that to date it had not used travel nurses. However, a spokesperson later confirmed that the health authority has signed a contract to bring nurses from the agency to its facility, but the nurses have not yet started work.

Byrne’s daughter dressed as her mother for career day at her school in early 2020. (Submitted by Lauren Byrne)

“This is public money for a publicly funded health care system that is being spent on private industry,” said Yvette Coffey, president of the Newfoundland and Labrador Registered Nurses Union.

“And it’s a short-term fix. It’s a slippery slope because our members want flexibility. Our members want time off. And they see this. And we have people leaving our system now to join agencies in other provinces.”

Overworked Dutch nurse quits her permanent job

Lauren Byrne quit her full-time job as an ER nurse in Newfoundland and Labrador due to an overwhelming workload and went casual, something her nursing colleagues are also considering.

Last week, the Ontario Council of Hospital Unions and the SEIU Healthcare union called for a ban on the use of travel agency nurses in that province.

Coffey wants the provincial government to explain what would happen if health authority nurses left their public sector jobs only to return later to a private agency; such was the case at a Manitoba hospital recently, she said.

‘Mandatory shifts should be illegal’

Linda Silas, president of the Canadian Federation of Nurses’ Unions, echoes Coffey’s pleas nationally.

Silas said nurses across Canada are on a limb, and provinces and territories shouldn’t bear the brunt alone.

“No one will solve this crisis by themselves and there will be no miracle solution. It will have to be multifaceted,” Silas said.

“So right now we’re not seeing much from the federal government, but we’re working with all the prime ministers to put pressure on the federal government to sit at the table on human resources for health.”

Linda Silas, president of the Canadian Federation of Nurses Unions, leads members in a solidarity chant outside the Fredericton Convention Center in February 2020. (Jennifer Sweet/CBC)

Silas said the focus should be on bolstering the public health sector with nurses who are already available.

“We really have to ask nurses to come back into the workforce because you have to understand that a lot of nurses retire early or go to agencies, for example, and then work through a strong recruitment program.”

Focus on recruitment and retention

Tom Osborne, health minister for Newfoundland and Labrador, said last week that there would be an upcoming announcement to help address the nursing crisis.

He did not go into details.

However, a nursing think tank held in the spring turned up a list of short-term solutions, including incentives to bring retirees back, incentives for casual workers to fill jobs and help with child care. .

Osborne said he doesn’t want the public sector to rely on itinerant nurses.

Provincial Health Minister Tom Osborne acknowledges that using travel agency nurses should not be the solution to the staffing crisis. (Daryl Murphy/CBC)

“I respect and appreciate health authorities who use creative approaches to fill in the gaps. However, we need to recruit. We need to retain,” Osborne said.

“We need public servants within this province to cover those roles. And that’s a priority for me.”

But even with the nursing industry on shaky ground, both Parsons and Byrne say they would do it again because of their passion for the work.

They hope that with the right relief, incentives, and planning, it will be the medicine you need.

Read more from CBC Newfoundland and Labrador

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