Island Health's new fatigue policy is fuelling staff shortages and burnout, union leaders say

Staffing shortages in health care have been a chronic issue since the pandemic, but new restrictions on overtime in Vancouver Island's health authority is making the problem worse, according to union leaders representing health-care workers.

This spring, Island Health implemented a fatigue policy. Broadly speaking, it stipulates that employees must work less than 16 hours in a 24-hour period, and must work fewer consecutive days in a row.

The health authority states that its goal is to ensure front-line staff get the rest they need to reduce injuries and sick time, and to ensure patients get quality care. But union leaders say the restrictions on overtime are having the opposite effect.

They report that health units are going understaffed even when there are people willing to work, and the result is added strain on staff at the expense of patients.

"We don't want to be relying on overtime as a long term solution," said Sarah Kooner, president of the Health Sciences Association of B.C. which represents health professionals such as lab technologists and physiotherapists.

"But our members also know that in the face of chronic staffing shortages, overtime is often the only way to make sure that patients are getting the care that they need," Kooner said. 

Limiting overtime may also be costing the health-care system money in the long run, she warned. For instance, when occupational therapists are short-staffed, patients have to wait a longer time to be assessed for discharge from hospital. The ripple effects include delays to new patient admissions and overcrowded emergency rooms. 

Teams short-staffed

The Hospital Employees' Union, which represents support staff such as care aides, housekeepers, activity workers and more, is also reporting that its members are routinely being denied overtime shifts, leaving care teams short-staffed.

The B.C. Nurses' Union is also seeing difficulties, and president Adriane Gear said there are both direct and indirect impacts on nurses. Nurses are being denied overtime hours, which is resulting in too few nurses on the floor. Furthermore, their support staff — such as care aides — are also being denied overtime, leaving the nurses on shift to pick up the extra work.

"The burnout factor for nurses alone, I would think, would be enough to reconsider the strategy," Gear said. 

Island Health did not grant an interview about the fatigue policy. In a statement it said that overtime has not been eliminated, and that its policy is about wellbeing. However, it also made reference to cost-cutting, saying it's reviewing its scheduling practices to reduce how frequently staff are working an "inordinate" number of shifts in a row or working shifts "at premium rates of pay beyond the expected norm."

Leaked memo

An internal memo obtained by CBC News sheds light on how the fatigue policy is being implemented.

In a July 11 letter from an Island Health manager to staff members, it says no overtime is to be approved for health care assistants, nursing unit assistants, or for general workload coverage. However, in some circumstances, a health unit can make an appeal to senior leadership for overtime approval "if the impact is significant enough."