Stretched to the breaking point by the pandemic, nurses are leaving the nursing profession in droves. Many more are scaling back their hours. This has led to desperate shortages of nurses in many hospitals. Nurses and doctors are sounding the alarm about this “huge exodus.”
Hospitals have had to close beds, delay fully reopening their operating rooms, and even temporarily shut down their emergency departments entirely. Unfilled nursing job vacancies rose 40 per cent since the pandemic began. Québec lost 4,000 nurses in 2020, with 50 per cent cuts to nursing teams. The Registered Nurses’ Association of Ontario predicted 15.6 per cent of nurses will leave the profession within a year, up from the usual loss rate of 4.8 per cent. A Winnipeg doctor described how dire the situation is, “Morale and staffing are at all-time lows. We view the situation as critical, unsustainable and in need of immediate action.”
With the high workload and stress nurses are facing, it’s easy to see why nurses are leaving. Nurses were already overstretched before the pandemic, with an average of more than six hours of overtime a week. This ballooned to over 10 hours per week in May 2020 Canada-wide. In Québec, nurse overtime was a staggering 16.9 hours on average. This reflects the stress the healthcare system is under—especially with capitalist politicians allowing COVID-19 to run rampant. Because of these pressures, a majority of nurses say they’re under high levels of stress.
Being overworked in a pandemic comes with other dangers to nurses’ health. The physical dangers range from back injury, face bruising, to infection and death. The mental toll has been enhanced by the fact that—during the disastrous first, second, and third waves of the pandemic—nurses couldn’t even see their loved ones to recharge for the next shift. It’s no surprise that one nurse said many nurses are “in a constant state of burnout.”
The stress and trauma is particularly acute among critical-care nurses and long-term care nurses. The Canadian Nurses Association described scenes of critical-care nurses, “[w]eeping in hallways and break rooms throughout their shifts after witnessing indescribable human suffering.” On ICUs, critical-care nurses care for the most critically ill COVID-19 patients, watching them struggle to breath and tragically die—often alone.
The nightmare in ICUs, drowning in COVID-19 patients, was compounded by the astonishing recklessness of capitalist governments, rushing to reopen in their haste to keep the profits flowing. This pushed intensive care units to a breaking point. Many COVID-19 patients in the ICU require more than one nurse. Yet in many places with understaffed ICUs, one nurse has to care for multiple patients in the ICU. This is a huge source of stress for overstretched nurses, unable to give these patients the care they need. Lynnsie Gough, an intensive-care nurse in Ontario who left her job, described her workload as being two to three times higher than normal.
All of this horror has an incalculable mental toll on nurses. Some nurses have even committed suicide. “I was having anxiety attacks where I would feel or be physically ill,” Gough said. “I felt like I was going off to war or prison every day going into work.”
Yet, instead of reducing nurses’ workload by hiring and training more nurses, governments’ policy has been to kick nurses while they’re down. Most egregious are the conditions in Québec. Gough’s prison comparison is all too apt for Québec nurses, who are experiencing “stratospheric” levels of mandatory overtime. The government also cancelled nurses’ vacations, and forced part-time staff to work full-time.
This forces more nurses to leave for their own survival. Those that remain are then subject to even more mandatory overtime in a vicious circle. But this is nothing new, Québec nurses struck against the mandatory overtime in April 2019. At the time, one union representative said, “a day where they are not likely to be taken hostage: that is the goal.” Unfortunately, things have only gotten worse.
In Québec, contract negotiations between the nurses and the government have only just come to an end. The workers were so disgusted that they narrowly accepted the government’s offer of a wage increase of 6% with only 54 per cent in favour. This deal was only a slight increase over the 5 per cent over three years which Denyse Joseph, vice-president of the FIQ, a large healthcare workers’ union, called “insulting.” To add insult to injury, Legault even said he was “disappointed” that nurses protested against his original offer. This does nothing to help the fact that Quebec nurses are some of the lowest paid in the country and their wages have been eaten by inflation year after year.
In Ontario, the Doug Ford government one-upped Legault, capping public-sector wage increases at 1 per cent—below inflation. As one nurse said, this is a “slap in the face” for nurses who are “working twice as hard, longer hours and under unbearable conditions in some cases.” This slap in the face was followed by what a nurse in Alberta called a “kick in the gut” when the Alberta government demanded nurses take a 3 per cent wage rollback.
Ford called nurses “heroes” at the beginning of the pandemic, and Legault called them “guardian angels.” These pronouncements have become nothing more than a sick joke for nurses. An anonymous nurse said, “We are hailed as heroes, but right now, I just feel like an overworked tool. If you compare nurses to soldiers, we are like infantry being sent into battle every day with minimal rations, no reprieve, dwindling numbers, and a constant message in the media that we are ‘losing the battle’.”
The governments’ disgusting treatment of the nurses, their mismanagement of the pandemic, combined with decades of austerity which prepared the way—this is the recipe for the current healthcare exodus. Now ordinary working people across the country are facing a future of significantly worse healthcare. Shortages have forced hospitals to transport critically ill patients to other hospitals, despite the risk of them suffering complications from being transported. Patients in Québec can expect to receive surgical procedures in operating rooms where the nurses have been replaced with hastily trained high-school graduates. Across the country, people will have to travel long distances for emergency treatment when their local hospitals’ emergency rooms are closed. Overworked nurses, no matter how talented, will undoubtedly make preventable mistakes. The brain drain of experienced nurses also means patients can expect to be cared for by less experienced nurses, who have had less training from an experienced co-worker.
Privatization is another looming threat. Nurses who leave the public sector in Québec are often hired by private companies who offer better wages and more flexible hours. The government often then contracts them out to fill the gaps left by the shortage—paying the private sector for the same nurses. In Alberta, the government is also preparing to privatize certain services, and looking to outsource some surgeries, like hip replacements.
Worse, no end is in sight for the nurse shortage. Despite vaccines, the pandemic is not over. Canada’s unvaccinated will still get sick and require healthcare. And nurses will soon be put to work clearing Canada’s epically large surgery backlog. This is why nurses are warning that action must be taken.
Provinces like Ontario, Québec, and Nova Scotia have tried to hire nurses, mainly to replace those who are leaving, but have been unable to stem the tide. In January, nearly one in five job vacancies in Canada were for nursing positions. With such bad conditions, this is no surprise. John MacLean, from the NSGEU, Nova Scotia’s largest healthcare union, explained that they’re having no success recruiting, “because people are saying, ‘It’s not worth it for me to go there.’ … In order to get people there, you need to attract them. You’ve been posting [positions], and people haven’t been going there. So, what you need to do is start paying them a different wage.”
Exactly as MacLean says, what’s needed to solve this crisis is simple: improve working conditions by hiring and training more nurses. People want to become nurses. Many nurses love their job. What’s missing is the resources to train them and keep them. Raise wages for all nurses to attract experienced nurses back. Invest massively in healthcare infrastructure so nurses can have the best equipment to deliver the best care. Governments refuse to do this, which is why they can’t hire nurses. As Natalie Stake-Doucet, president of Québec Nurses’ Association said, the phrase “nurse shortage” is a misnomer: “It’s kind of ridiculous to say, ‘Oh, I have a shortage of water’ when you have a giant gaping hole in your bathtub.”
In other words, governments are totally unwilling to do what is necessary to stop the nurse exodus. Instead, they’ve worsened it with their insulting offers to nurses, and refusal to do what’s necessary to fix working conditions. They complain that their hands are tied—that there’s no money for proper pay raises and better conditions. They say nurses must be reasonable and accept conditions in line with their provinces’ fiscal situation.
This is a lie. The money exists, but it’s earmarked for the capitalists. Premiers like Ford and Legault love to remind us that someone has to pay for the economic crisis—and it sure as hell isn’t going to be the capitalists. This is why capitalist governments refuse to act to save the healthcare system. Their motto since the pandemic began has been wealth before health. They’re fully aware their policies will kill ordinary people. They simply don’t care.
Nurses have already begun seriously contemplating strike action. Nurses in Alberta are so exhausted and angry that some are ready to strike, even if it’s illegal. In Québec, there have already been healthcare strikes of over 60,000 workers. This energy must be focused into an all-out struggle. Healthcare unions must mobilize all of their members to fight for better working conditions, and be prepared to defy unjust back-to-work legislation. Widespread and determined mobilization is key for success.
There’s also significant potential for solidarity action. Public opinion is overwhelmingly on the side of healthcare workers. Nurses’ working conditions are inextricably tied to good quality public healthcare—so a defeat for the nurses would be a defeat for the entire working class. The wider labour movement must mobilize in solidarity. When healthcare unions take action, unions from other sectors must mobilize to defend healthcare picket lines, and be prepared to call solidarity strikes.
The struggle for improved wages and working conditions by nurses is directly related to maintaining or improving the condition of the health-care system overall. The capitalist system as a whole failed to provide an adequate response to the COVID-19 pandemic because the pursuit of profits trumps the needs of the people and workers. Decades of austerity and the resulting deterioration of the healthcare system played a major role in the inadequate response to the pandemic. Nurses and other healthcare workers did indeed play a heroic role during the pandemic while being underpaid and understaffed.
The pandemic exposed the rottenness of capitalist society for all to see. The healthcare system in Canada has been stretched beyond breaking point. The exodus of nurses is proof of this. Now, with budget deficits and debts ballooning, the capitalists want to make the working class pay for the crisis. It seems the height of absurdity that capitalist governments would target the healthcare system and workers such as nurses right now with the pandemic still lingering. But it does make sense according to the logic of capitalism, which is the logic of private profits over the needs of people and society. The proposals of austerity in the various provinces only threaten further a system already ravaged by the pandemic and teetering on the brink. Attacks on the wages and working conditions of nurses will only make things worse. The overall quality of the healthcare system suffers and will leave us less prepared for future pandemic waves.
Healthcare workers are on the front lines of this battle. Governments have already begun preparing for a struggle with healthcare workers. The unions must prepare too. With the backing of a united solidarity movement, a healthcare strike would make the darkest fears of the capitalists and their governments a reality. The struggle of healthcare workers is not just about wages and working conditions. It’s the fight against austerity and against the criminal response of governments to the pandemic. It’s the fight to ensure the bosses and not the workers pay for the crisis, and it’s the fight for a fundamental change in society, it’s the fight where the health of the people takes precedence over the profits of the few.