CFNU Study on Nurse Fatigue
As we start 2024, patients are still waiting in hallways to receive care, surgeries continue to be delayed, our community and rural emergency departments continue to see temporary closures, and seniors care continues to suffer despite the lessons of COVID-19. All are consequences of the nurse staffing shortage that has, sadly, become routine news in health-care settings across British Columbia
As the health human resource crisis rages unabated across the country, it is nurses who are holding our health-care systems together through grit, determination, and a shocking amount of overtime.
In BC, vacancies for nursing jobs are now at a record high. The most recent numbers from Statistics Canada are alarming, reporting 5,745 nurse vacancies in BC. This, coupled with untenable working conditions, is making it increasingly difficult for nurses to meet people’s health-care needs.
Without adequate staff to care for patients, nurses are being pushed by employers to work more overtime than ever before, with some working 16 to 24 hours continuously. Our nurses are telling us that this isn’t just breaking them, but severely impacting patient care. One nurse reported working alongside only one additional nurse and one health care assistant to care for 23 patients. The impacts of not being able to give each patient the time and care they deserve is morally distressing. This reality is the reason why so many are choosing to leave the profession altogether.
Emergency departments in smaller communities frequently experience temporary closures due to staffing shortages, forcing patients to travel longer distances or being transferred to other communities for care.
The use of overtime to fill core staffing needs is not only short-sighted, it’s downright dangerous.
A new study from the Canadian Federation of Nurses Unions (CFNU) confirmed what many of us have feared: excessive hours of continuous work have a profound impact on nurse fatigue. Research shows that fatigue has effects similar to alcohol intoxication, posing long-term health risks such as high blood pressure, heart disease and diabetes.
Moreover, there is a growing body of evidence linking fatigue to safety incidents in health care. Canadian data shows that the rate of hospital harm has increased from pre-pandemic rates, with one in 17 hospital stays involving at least one harmful event.
So how do we protect nurses and patients from the potentially dire effects of extreme overtime demands?
Alarmingly, there are no regulatory limits to the hours a nurse can work continuously. By contrast, pilots can only work a maximum of 13 hours – a mechanism that protects both pilots and the safety of passengers.
This is a critical place to start. We must establish legislation and regulatory limits on consecutive work hours for nurses, mirroring the safeguards already in place for other safety-sensitive industries. Patients are surely as important as airline passengers.
Fixing the nursing shortage is not just about adding more nurses to the system; it’s about addressing the conditions that have created this dire crisis. This is the key to creating environments where nurses and patients can thrive.
Relying on excessive overtime or costly private nurse agencies as short-term fixes only exacerbates the systemic challenges facing health care. We can’t continue to slap Band-Aids on gaping wounds.
Nurse-led solutions like minimum nurse-patient ratios offer double-fold success: safe staffing levels have been shown to improve patient safety and would also address the top reason nurses are looking for the exit sign – insufficient staffing.
We are optimistic the province’s health human resources strategy offers some long-term solutions that will address the staff shortage. But the government must hold provincial health employers accountable and demand that they provide safe and respectable workplaces. We fully believe that improved working conditions will bring nurses back to the profession, help increase retention, and bolster the current recruitment effort that will ultimately put an end to the years-long shortage of nurses here in BC and across the country.
Adriane Gear, President, BC Nurses’ Union, and Linda Silas, President, Canadian Federation of Nurses Unions