SUNDRE – Words of praise expressed during the annual National Nurse’s Week earlier this month don’t always seem to reflect actions taken.
While nurses at the hospital in Sundre have expressed gratitude for the site manager’s support on a local level, they’ve also expressed concerns the provincial government isn’t doing enough to address staffing shortages that are leading to burnout and stress.
And some of the steps the government has taken not only make no economic sense, but also undermine morale and the incentive for nurses trained in Alberta to stay in the province, says the president of the United Nurses of Alberta Local 134.
Travel nurses come at greater cost
“There are other hospitals in the province that are having travel nurses. My understanding is they’re paid double our wage, and so it really puts stress and distress on the part of Albertan nurses who are focused on staying in Alberta and want to make Alberta the best province as far as health care is concerned,” said Laura Kowalsky, who has been the local UNA chapter’s president going on five years, adding the local hospital’s site lead “is trying to keep that at bay.”
Kowalsky said she’s worked casually at the Sundre hospital for about 14 years and transitioned away from a position in management.
“It just doesn’t make economic sense that travel nurses should be brought in here, paid way higher than what we’re even asking for in negotiations,” she said, adding there are also what are known as internationally educated nurses (IEN) that are brought in after being transitioned for work in Canada.
“They’re not given the support and the time they need, so it’s a very rough transition for hospitals that are getting IENs, which again doesn’t make sense when LPNs – which are the licensed practical nurses – have to work so hard to transition for further education,” she said.
“Some of these things just don’t add up.”
Professional responsibility concerns
Hospital staff have the option of pursuing an official process to address issues by filling out what are called professional responsibility concern (PRC) forms, she said.
“It is a complaint that we do put in when we feel that the safety of patients is at risk,” she explained, adding that as a result, the hospital’s site manager is not only well aware of the staffing shortage but doing everything in her power to address it.
“It’s an ongoing communication between the local management and the union about making sure that staffing is at a safe level to save lives,” said Kowalsky.
While the federal government might provide some funding for health care, it’s ultimately the provincial government’s responsibility to effectively allocate and make the most out of that money, she said.
And under former premier Jason Kenney’s leadership, the provincial government wasn’t particularly forthcoming when the union sought better terms.
“The talks (have since) started again. But I know at one time, they wouldn’t even acknowledge the existence of the union, which was trying to negotiate our contract,” she said.
But at least premier Danielle Smith’s government has toned down on the rhetoric demonizing unions that was a common refrain during Kenney’s time at the helm.
Yet there among many Albertans nevertheless remains persistently negative views on unions. Asked what her response might be to people who claim unions are nothing more than undemocratic institutions that don’t even represent the memberships’ concerns, Kowalsky candidly confessed herself once harbouring similar opinions.
“You know, I used to have that impression as well,” she said, adding that becoming directly involved with the local chapter changed her perspective entirely.
“In attending the union meetings, they are very professional and they are concerned about the health care and the safety of patients,” she said.
Wages not keeping pace with inflation
“We’re not going to get the nurses if they’re not paid a decent wage,” she said, adding the staff shortage is compounded by largely stagnant wages that have not kept pace with inflation.
“If there are no nurses to hire because they are moving to better paying jobs, we are no further ahead.”
Amanda Mifsud, a Sundre High School graduate who later earned the Joanne Overguard Memorial Scholarship to pursue her health-care education in Red Deer where she completed a collaborative course through the University of Alberta in 2020, was first inspired along her career path courtesy of her experience as a junior member of the Sundre Fire Department, which involved no shortage of medical assist calls.
“I really found the medical stuff was very interesting so I decided to go to university and try out nursing,” she said. “I haven’t looked back since.”
Becoming an RN in the community where she grew up represents life coming “full circle for me,” she said.
“It never comes without its interesting challenges,” she said, adding that working with more limited resources than urban centres tends to require creative, outside-the-box thinking.
Mifsud also expressed concerns about travel nurses who are not familiar with either the facility or the local patient base.
“It’s hard because we’re trying to orient them to the unit…but we don’t have time to be teaching them,” she said, referring to the full-plate of responsibilities staff already bear without further holding the hands of someone getting paid far more.
“It makes it frustrating for us because it’s happening before our eyes and there’s not much we can do, but we’re trying to get the word out.”
Burnout also a growing concern
The biggest challenge, however, is working with “unsafe staffing levels and the risks that we’re often being mandated due to the shortages we’re experiencing,” she said, also citing burnout and emotional distress.
“So I work a long 12-hour shift – often with no breaks – and then all of a sudden I’m being mandated for a 16-hour shift,” she said, adding she must then return early the following morning for the next shift.
“Given that ongoing crisis, it’s sort of like the situation in Alberta is just getting worse and worse in the health-care system,” she said, adding it’s not just emergency departments that are struggling but also hospitals as well as continuing and home care.
“It’s time for what we think a meaningful nurse-patient staffing ratio for all health-care settings to be included. Hopefully, the government can listen to that and incorporate that into our collective agreement through our union,” she said, adding the union advocates daily on behalf of its membership.
“We’re making sure that all the RNs that are working in Sundre are aware of what the unsafe staffing is like and what we can do to get the government’s attention,” she said.
“Hopefully those statistics are what can sort of wave the government into the direction of being able to fund us so that we can get that proper staffing.”
Write your MLA
One way to show support for nurses is to advocate on their behalf, she said.
“Write a letter to your MLA if you are concerned, because that’s where change starts.”
Keiran Connolly started her health-care career in urban centres working at facilities including the Rocky View Hospital’s general surgery unit where she became all too familiar with 12-hour shifts.
The 37-year-old, who is the Local 134 secretary, also gained experience in pediatric mental health both at the Children’s Hospital and at the Foothills in Calgary. She spent four years on a general medical unit at the Foothills before coming to Sundre in 2018 to work as a rural nurse. She more recently has started taking a few shifts a month at the Didsbury hospital.
“We have horses and we needed a property for them,” Connolly said when asked what had prompted the move away from the city. “I fell in love with Sundre.”
Praising the dedication of her colleagues who are akin to a work family that does everything they can to lift one another up including the site manager who “is working really hard at increasing that staff for us,” Connolly said, “We haven’t seen a lot of support come from the provincial level.”
The union is negotiating for a 25 per cent wage increase in the first year as well as another 10 per cent hike in the second year of a contract.
“Now, that is from a bargaining standpoint. We very likely won’t get that much but that is what we think would be fair,” she said.
“The fact that they’re asking for that much of an increase really suggests that nurses in general just don’t feel like they’re being paid very appropriately for their work,” she said, adding the increased cost of living in recent years has made matters worse.
“That’s part of the respect for nurses really, is showing them that we’re valued for what we do,” she said.
Call to recognize rural nursing as specialty
Nurses also pay out of pocket for highly recommended courses to improve their training in aspects such as trauma care, managing codes and pediatric emergencies, she said.
Fortunately for staff at the Sundre hospital, the facility’s manager and educator have made their time available without taking the instructor’s portion so more nurses can afford those classes, she said.
“They go to the next level.”
The many hats rural nurses might be expected to wear due to a lack of baseline staffing include the role of a social worker, pharmacy tech, supplies management as well as some housekeeping.
“Housekeeping is there on days and evenings and they do our isolation cleans as well, but the non-isolation is actually on nurses,” she said.
Additionally, nurses know how to handle a code, deliver a baby, be knowledgeable on palliative care for the imminently dying, and are also well versed on different populations such as pediatrics, newborns, geriatrics and obstetrics, she said.
“Many of these acute cases get sent to specialty units in the city to continue their care, but we are the frontline staff that respond to their initial crisis and need to know how to give them the best care we can give,” she said.
That has led to a growing chorus calling for rural nursing to be recognized as its own discipline.
“Many nurses think it would be appropriate to have rural nursing considered to be a specialty and have our wages reflect that,” she said, adding that’s currently not the case.
“Burnout is an epidemic in our health-care system today, and we have to do something for our nurses to help prevent it. Proper pay and staffing levels would be a very good start.”
Editor’s note: this article was updated on Wednesday, May 29 to reflect the correct spelling of Amanda Mifsud’s name.
