I think this has been a topic that has only begun to surface in the mainstream media and to be honest there isn’t enough focus or attention being brought forward.
Many of the things we have to see as healthcare providers is not normal by any means. The push of being asked to do more with less, the physical and mental abuse many of use face on the daily, the deaths we have seen and the lives we so desperately tried to save, and the exodus of colleagues leaving the bedside due to PTSD, depression, anxiety, and high levels of stress.
The nursing and healthcare shortage has always been there. The resource and bed shortage was magnified during the height of Covid not only across Canada but globally, whether it be the shortage of oxygen or the shortage of ICU beds and staff. However, in recent months it has only seemingly got exponentially worse. The looks of stress and defeat on my colleagues faces are inexplicable. The brushing off and lack of support from management has been defeating. Unsafe assignments have become the norm, in which you know if something were to go wrong, it all falls on your and your license. The amount of breaks that have been missed of the culture of having to stay beyond your shift to continue handover without receiving any overtime needs to stop. It’s sickening that most nights I am there 20-30 minutes beyond my shift time and arrive 15-20 min prior to getting handover and it’s frowned upon to be fairly compensated. At the very minimum hospitals walk away without 5 thousand dollars saved in free labour and all we get is maybe a pat on the back and an unempathetic expression and false reassurance that “this is just how it is right now” or “things will hopefully get better soon”.
For me, one of the hardest shifts I had recently was watching a boy come through with a suicide attempt. Seeing the aftermath of a family not understanding how this all happened was soul crushing. But even more sue based off clinical assessment what the likely outcome would be and the family having little to no understanding of the implications of someone’s else’s decision. I can’t even begin to fathom the immense strength it will take to recover or once things become more clear in the next few days the tough decisions that will lie ahead. It was my first shift in my new unit in which I actually walked home and cried feeling so helpless at the situation, knowing that in the course of minutes a family has been completely changed and there was nothing I or anyone else could help do to change or fix things.
In some cases, the stress of watching my senior nurses trying to shift plan has been tough with more patients coming through and less nurses at the bedside to staff beds or having to triple assignments, which has become a common occurrence. The amount of nurses calling in due to burn out is only getting worse. The assignments are becoming less stable with what I can only presume is fuelled by the fact that we are often so busy running around to multiple patients in an CCU environment and missing the small initial things that later on lead to an acute change in a patients condition. And in paediatrics I can tell you it doesn’t take much with neonates and young children not having the same reserves as adults. Nursing can become very task-y with many of us having to forgo breaks or lunch to care for our patients because of the guilt we feel leaving stuff to our coworkers or not having time to comfort families who are anxious or scared of what is happening. Listening to the stories of coworkers caring for such acute sick and fragile infants who are so unstable and unlikely to make it let alone tackling the conversation of quality of life based of the prognosis of surviving and facing life long disability. Having to return to the same assignment with little support day in and day out begins to take a toll.
The tsunami of grief of losing someone unexpectedly – especially a child- is inexplicably soul crushing. Learning how to wade into that ocean of fresh grief is a skill that comes with time. With the high rates of death healthcare providers has seen over the past two years, the ability to decompress has been reduced and to some extent you won’t even have time to brush things off before repeating the cycle all over. You’re expected to save yourself. You have a job to do, a family to go home to, other patients to care for. It’s expected that you turn up for your job the next day or in some cases return to the bedside to care for your other assigned patients or a new admission.
The toll nursing has taken on my body has been rough. The high expectations put on you from management, from your patients, and from yourself to offer the best care with reduced resources is rough. The sacrifices we are constantly asked to make whether it be cancelling vacation to help with “unit need” or the missing of pivotal family/friends moments because you vacation was denied takes a toll. Prior to leaving my full-time job I had 80 hours of vacation saved up, not because I didn’t want to use them but because I couldn’t a) due to my “low” seniority and b) due to “unit needs”.
Let alone starting a new position in a high intensity critical care unit (CCU) and seeing an exodus of senior nurses leave puts all of us new staff on edge. As a new nurse to the CCU there are no words to express the invaluable loss it is when seniors nurses leave the bedside. Patients lose a fantastic nurse, the unit is down another nurse, and new nurses to the CCU, such as myself, lose a mentor and leader at the bedside.
Starting a nursing career at the start of Covid was rough. But the last two years have been stressful and frustrating for everyone working in healthcare. The slap in the face from the government, the mistrust and misinformation from a minority of the public, the high stakes of having a life in your hand, and the abuse many of use face on the daily can sure take its toll. The mockery the government has made of us and the mistrust and fear perpetuated from a small minority of the public takes a toll. As someone practicing evidence-based medicine, I can full admit that I do not have answers to everything but I can assure you as a professional, along with many of my colleagues, that we do not want to partake in an agenda where we put my patients in harms way or provide unnecessary experimental treatment. None of us came into the profession with that mindset.
I chose to enter nursing because I wanted to help people and I have a passion for it. But not at the expense of my mental and physical wellbeing. The amount of give and lack of return begins to take its toll and its no question of if we can’t find solutions to fix the shortages what this will mean to new professionals entering the field and current professionals struggling to stay in it. The truth is work takes so much out of us that many of us find it hard for others not in healthcare to relate, which makes it all the more difficult to navigate feelings of frustration, sadness, grief, and guilt. While many of us use dark humour to cope as a group, it doesn’t change the trauma many of us deal with on the daily.
At the rate this is going, I don’t think even within myself I have the ability to provide 30 years of service at the bedside and I know that I am not the only one left feeling this way. But it begs the question of what else is there to do? My passion and drive has always been to find a fulfilling job to help people and while many days have been bad in recent times, I am quite fortunate to see the alternative at times in seeing children and their families given a second chance at life.
There will be no easy solutions to solving the complexities facing our healthcare system, and let alone our retaining or recruiting to our healthcare workforce. But I really hope that people remember come election time that your voice matters. When you have healthcare workers begging for help we need to rally with them and not against them. At some point in your life we will all meet or need a nurse and those decisions currently being pushed by the government (ex Bill 124) directly will impact the care you or your loved ones receive in one way or another.
As part of the team on the front line we are fighting daily to keep us all afloat. But this is coming at the cost of our mental health, your safety, and our passion for what we do We spend our careers advocating for you. Now we need the public to help advocate for us. Without those on the front lines, healthcare will fail.