An outbreak of antibiotic-resistant bacteria on a hospital floor doesn’t often draw a sigh of relief from a healthcare worker.
But for Noémie Doiron, a graduate nurse working directly with hospital patients at the Dr. Georges-L.-Dumont University Hospital Centre in Moncton, N.B., the outbreak halted patient admissions for a while. This provided a much-needed respite for Doiron, who was then able to go about her duties more effectively and provide better care for her existing patients.
“For a little while, the workload was normal, and it was amazing. It was the work we are supposed to do,” she said.
Doiron’s worries about unreasonable workloads leading to burnout and insufficient patient care are not uncommon in her industry.
A report by Statistics Canada showed employment fell 0.2 per cent by the end of 2022 in non-profit institutions serving healthcare, with this decline partly attributed to fatigue from heavy workloads since the beginning of the COVID-19 pandemic.
Canadian hospitals have been hit hard by these shortages. However, many healthcare professionals believe that drops in employment were a long time coming due to issues that have been plaguing the Canadian healthcare system for years. In 2019, over 70 per cent of nurses felt their workplaces were over capacity. Over 80 per cent felt their institution’s health care staff were not enough to meet patient needs.
Dr. Farinaz Havaei, a health system researcher at the University of British Columbia, believes that the pandemic simply exacerbated pre-existing challenges.
“It’s really unfortunate. We’ve been saying all along, even prior to 2019, how staffing is a huge problem in healthcare,” she said.
“Many nurses choose healthcare as a profession because they want to be taking care of other people. They have that sense of selflessness, but when you have those qualities in a not very well functioning system, it really takes a toll on you,” she said.
Nursing fatigue often results in a vicious cycle of events where nurses need more time away from work, exacerbating the shortage. As a result, there is a smaller pool of staff that is being constantly relied upon to make up the hours. This often results in negative outcomes for not only nurses, but also for healthcare organizations and patients.
Robin Quinn was an emergency nurse at a Winnipeg hospital for four years. They quit their job and switched to community nursing after being constantly exposed to moral distress and emotional fatigue.
Quinn described a situation where overwhelming work pressures took their toll.
“I had a patient who, basically because I couldn’t do 20 things at once, deteriorated quite quickly. And you know, that weighs really heavily on you. You wish you could do more, but it becomes impossible with the limited resources and staffing available.”
The unreasonable demands of the hospital environment led Quinn to permanently leave the emergency room after four years — a job they thought they would retire in.
“I think the main reason why I ended up leaving was the constant moral stress that I was under,” they said. “You want to provide a certain level of care. But there is no physical way possible to provide that level because of the lack of resources and support. The responsibility is crushing.”
Even pre-COVID-19, Quinn had been constantly asking for safer patient ratios and better rotations. When a friend got promoted to management, Quinn had hoped things would get better. Nothing did. Quinn realized it was the system that was the issue.
“At that point, I was like, ‘Do I even want to be a nurse anymore?’” said Quinn.
Quinn switched to working as a community health nurse in April 2021. They now provide care for clients in residences, community shelters, and transitional housing.
“I will never work in a hospital ever again,” said Quinn.
“[Community nursing] aligns with what I believe in, which is helping. I like being able to keep people in their homes and out of the hospitals if I can.”
According to the Canadian Federation of Nurses Unions’ national survey in 2022, more than half of nurses were then considering leaving their current job within the next year, with 19 per cent of nurses considering leaving the profession entirely. Of nurses suffering from clinical symptoms associated with burnout, 41 per cent were considering leaving nursing permanently.
As a graduate nurse, Doiron is currently working under supervision and will soon sit for her National Council Licensure Examination for registered nurses. After her exam, Doiron is planning on leaving bedside nursing at the hospital.
“I won’t stay on this unit [bedside nursing] for long when I am able to move around. I’m going to, like, an external clinic in the hospital or just, you know, have a job that’s not just bad.”