“More than an RN, less than enough”

Registered nurses speak on challenges they face, the impact on patient care and solutions needed to help

Overwhelmed, understaffed, scared, frustrated. These are some of the words Yvette Coffey says Newfoundland and Labrador registered nurses (RNS) are using to describe how they are feeling due to the province’s nursing crisis.

Coffey is the president of the Registered Nurses’ Union Newfoundland and Labrador (RNU) and says registered nurses and nurse practitioners (NPS) cannot continue working under the conditions they have been facing for many years and continue to face every day at work.

“Right now, registered nurses in Newfoundland and Labrador are spread so thin due to the nursing shortage and unsafe staffing practices,” she says.

“We have members working upwards of 24-hour shifts, mandated overtime and our long-term care system is also in crisis. Our members are saying they’ve had enough, and things need to change.”

‘THE WORST I’VE SEEN IT’

Coffey says province-wide staffing shortages in Newfoundland and Labrador mean the nursing profession is in crisis, and that as a result, health care is not being delivered to the right standard in the province.

Overworked registered nurses and nurse practitioners are also often required to work 16-hour shifts or longer and have been facing a growing number of violent incidents, as patients become more frustrated with health care delivery. More than 1,100 “code whites” for violent acts involving RNS were called just last year

Coffey says these conditions are causing RNS to leave the profession more quickly than they are being replaced.

“We are more than RNS, but less than enough,” says Coffey. “There has to be respect for our profession. If this pandemic has done anything, it’s shone a light on the vital role registered nurses and nurse practitioners play in our health-care system. But it’s critical to understand that this has been a crisis since long before COVID-19.”

Jodi Nolan is a registered nurse and RNU board member and says she and her fellow members are mentally and physically exhausted when they leave work every day. Nolan works in the emergency room, where she says the nursing shortage is acutely felt.

“I’ve been working as a registered nurse for 12 years now, and this is the worst I’ve seen it since I started. It’s disheartening and very frustrating, especially on the front lines — we are the ones patients take out their frustration on, even though we’re doing the best we can,” she says.

Like everyone else, Coffey says RNS and NPS are also people with lives and limits, but that they’ve had to sacrifice their personal lives and well-being to ensure patient care.

She says this exhaustion is now impacting Newfoundland and Labrador patients. Because of the nursing shortage, RNS can’t get time off when they need it. And because they are committed to patient care, they will not walk away.

“The well-being of nurses contributes greatly to the well-being of the health-care system. When you have an exhausted registered nurse, or a nurse practitioner with double the workload they signed up for, patients are not getting the care they deserve,” says Coffey.

WHAT IS NEEDED

Coffey says the Economic Recovery Report released by Moya Greene is recommending cutting health-care funding in the province by as much as 25 per cent. Coffey says this will do nothing to fix the crisis since more, not less, support is needed to help.

“We keep saying, ‘you need to invest in health care because we need to change this cycle,’” says Coffey. “If our leaders don’t invest in retention and recruitment, we’ll never get ahead of the nursing crisis and shortage. We’ll also continue to increase spending. Overtime for RNS alone already costs $25 million a year.”

Nolan says filling core staffing needs would make for a better and safer work environment for nurses, and that time off would mean she and her colleagues could finally stop sacrificing their personal lives and get the balance they need to provide top-tier care.

“Nothing will fix it overnight, but that would be a good place to start,” she says.

With a previously negotiated core staffing review stalled due to the COVID-19 pandemic, Coffey says short-term and long-term solutions are needed to address inadequate staffing and the recruitment and retention of RNS and NPS.

Coffey says the province’s key players and stakeholders need to come to the table to help develop a health-care human resources strategy.

She says pinpointing how many registered and nurse practitioners are needed, creating recruitment strategies to encourage people to enter the profession and proper investment from the province would be a first step in ensuring this crisis is addressed.

“Changing health outcomes for people in Newfoundland and Labrador will only happen once everybody is at the table. It can’t be on the backs of RNS and NPS,” she says.

“We cannot continue to take and take from registered nurses and expect to get more and more from them. We cannot do more with less, and that’s what’s happening right now.”

Our members are saying they’ve had enough, and things need to change. Yvette Coffey RNUNL president