After months without rest, Anne Boutillier, an emergency room nurse in Dartmouth, NS, took a much-needed vacation at the beginning of the summer.
But I got a call almost every day to help again. Shortly after returning, he worked a 19-hour shift.
Boutillier had been on the schedule for 13 hours, but due to staff shortages, he stayed for six more.
“I feel guilty when I can’t do it, because I know my team and I know the burden that patients go through,” he said.
“I love my co-workers and I also care about my community. So when I can’t be here, it makes me feel like I’m letting the system down and letting my colleagues down.”
Nova Scotia, in particular, saw one of the biggest increases in the share of nurses working overtime during the pandemic, according to Statistics Canada data compiled by CBC News.
As emergency rooms in parts of Canada cut their hours due to staff shortages and analysts warn the system is cracking under the strain, nurse representatives say signs of problems were evident before the pandemic.
Linda Silas, president of the Canadian Federation of Nurses Unions (CFNU), said the reliance on overtime to fill staff shortages has had a detrimental effect on the profession.
He said a lack of work-life balance is driving many from full-time positions.
“It’s a vicious cycle, but we have to stop it,” he said. “For 10, 15 years we have been talking about the working conditions, the bad working conditions of nurses”.
Along with Nova Scotia, the amount of overtime required has been particularly high in New Brunswick, Saskatchewan and British Columbia, the data show, compared to the national average.
September 2021 appears to have been a particularly difficult month for Nova Scotia’s health care system, with 47% of its nurses working overtime that month, marking the highest reliance on OT of any province in any month during the pandemic .
More data indicates that nurses who work overtime work more hours. In July, the average overtime nurse worked nine hours of overtime, the highest number since the early months of the pandemic.
Staffing shortages have led to the closure of emergency rooms in parts of the country, including Ontario and Quebec.
Silas said the lack of nurses was evident before the pandemic and the need is even more acute now.
Already, in 2019, a third of registered nurses – who make up the majority of the nursing workforce – were over 50, with many close to retirement, according to the CFNU.
“Fix the workplace”
A recent survey of federation members found that 94% of respondents suffered from burnout. Younger nurses said they were more likely to leave the profession.
Silas said many are tempted to leave full-time positions to work for agencies where they have better hours and pay.
“What we need to do is fix the workplace,” he said. “We need to make sure there’s flexibility so they can enjoy a day off and we have a safe nurse-patient relationship.”
Although OT work among all health workers increased significantly after March 2020, the rate has since leveled off among non-nursing health workers. The proportion of nurses working overtime, however, continues to rise.
“It’s important to recognize that we have a problem and we need to address it immediately,” said Sylvain Brousseau, head of the Canadian Nurses Association.
Brousseau is also a professor at the University of Quebec in Outaouais and researches the working conditions of nurses.
He said the increase in overtime is a symptom of a problem in the system: OT is now built into the management structure of many hospitals.
“When you don’t fix the problem, people leave the health care system,” he said.
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Lauren Byrne quit her full-time job as an emergency nurse in Newfoundland and Labrador due to an overwhelming workload and went casual, something her nursing colleagues are also considering.
Boutillier, for his part, wants to see the nurses still on the job rewarded, with better pay and time off when they request it.
“It is the reconciliation of work and family life that we do not have. And this is not being respected,” he said. “I feel like lately we’re just a cog in a wheel, filling a flooded system.”