On January 23rd, nurses working in the Halifax Infirmary Emergency Department (ED) wrote a letter to the Premier, Minister of Health, and CEO of Nova Scotia Health. That letter expressed the nurses’ deep distress following the government’s failure to address the retention crisis in our emergency department.
NSGEU, with agreement of the nurses involved, sent the letter to NSH, and government in hopes that government and the employer would take immediate action. They have not.
NSGEU is now making the nurses’ letter public so Nova Scotians are aware of how the frontline workers are feeling, and that their requests are being ignored.
That letter reads as follows:
January 23rd, 2023
Honourable Tim Houston, Premier of Nova Scotia
Honourable Michelle Thompson, M.L.A, Minister of Health and Wellness
Karen Oldfield, President and CEO, Nova Scotia Health
Dear Premier Houston, Minister Thompson and Ms. Oldfield,
We are writing to you with grave and sincere concern for the citizens of Nova Scotia accessing care at the Charles V. Keating Emergency and Trauma Centre at the QEII in Halifax. We, the front-line Registered Nurses in the ED, have bore witness to the ongoing health care crisis with beginnings far outdating the pandemic. Now, as we stand on the other side of that pandemic, it’s in an unraveling and hazardous health care landscape that’s experiencing a “brain drain” of skilled RNs. The recent press conference on ED improvements instilled one last glimmer of hope in our RNs. We envisioned our calls for help were finally answered. To everyone’s bitter disappointment, it is now clear that the Nova Scotia government is completely blind to the needs of and issues facing RNs in our collapsing ED.
The measures announced do not address one of the major issues contributing to increased morbidity and mortality in the ED: retention and recruitment of skilled RNs. Our ED now operates RN staffing levels at an average of 50-60%. With patient to nurse ratios worsening, the burnout experienced by RNs has ballooned. This is affecting our ability to retain and recruit RNs. It is driving our existing RN staff to move to casual positions, sign lucrative travel nurse contracts or leave the profession altogether. Our daily operations are now totally dependent on casual staff and travel RNs, with our core staffing being begged to cancel their vacation, come in for overtime or extend their shifts. The QEII ED is a revolving door for RNs. As soon as our new hires complete their orientation, they realize their licence to practice nursing is at risk by being forced to do the impossible with limited resources, and they leave the department. Without immediate action and interventions focused on RN retention, we fear unnecessary suffering will continue in the ED. We simply cannot be expected to spread ourselves any thinner. W
We implore you to save lives and our EDs: implement RN recruitment and retention strategies immediately. Every experienced RN that leaves the ED is taking invaluable experience and expertise with them. The suggested incentives include higher wages, retention bonuses, improved night/weekend shift premiums and work short premiums. These incentives in the ED will entice RNs who have left to return, and will help to retain the few skilled ED RNs who remain. Without these incentives, the “brain drain” will continue, and it will undoubtedly sink our community EDs.
The Registered Nurse group, Charles V. Keating Emergency and Trauma Centre
“The nurses and healthcare workers that remain in our emergency departments are the only support that remains to hold up our health care system right now. They cannot continue to prop up the system without help,” said NSGEU 1st Vice President Hugh Gillis, “They need more skilled staff at the bedside, now. The only way to accomplish that is to incentivize healthcare workers to come work in that department.”
On January 9th, the NSGEU sent a letter and list of 59 recommendations for the HI ED to the government and employer. That letter clearly stated: “However, the most pressing issue is the retention of experienced staff. In order to achieve this, the employer must offer financial incentive – otherwise, the department will continue to lose staff to other areas of the health care system, and their nurses to private travel nursing agencies, where they can earn two to three times their hourly wage, have the freedom to pick and choose when they work, and receive other perks, like paid parking. To be frank, who can blame them for making this choice?”
The NSGEU received a response from NSH to the union’s original letter and recommendations late last week and is in the process of arranging a meeting with them to discuss those matters further.
While government has acted on some of those 59 recommendations, they continue to ignore the central request: to immediately address the issue of staff retention through incentives like working short premiums, increased wages and/or bonuses. Any of those options could be implemented outside of the ongoing nurse bargaining process.
“Premier Houston, Minister Thompson, and Ms. Oldfield owe these members a response to their request, and they owe it to all Nova Scotians to act immediately to ensure that our emergency departments are staffed with experienced, skilled nurses and healthcare workers, not agency staff who are not even able to work to the full scope of practice,” said Gillis.