London, Ont., hospitals facing chronic nursing shortage as pandemic fourth wave nears
Since the pandemic began, 49 nurses have resigned or retired in London
Mirroring much of the country, the London Health Sciences Centre is dealing with a chronic nursing shortage that's left those still working tired, stressed, and on the brink of burnout, advocates say.
Since the pandemic hit London in March 2020, 31 nurses in acute and critical care areas of the hospital have resigned and 18 have retired, officials say. That's double the resignations in the 18 months preceding the pandemic, and six more retirements during that time period. While recruiting is happening, many of those who have left are senior nurses who took with them years of knowledge and whose expertise will be difficult to quickly replace.
"Nurses are just mentally and physically fatigued but they feel they have to provide the care because we owe it to our patients," said James Gibbons, a registered nurse who most recently worked in the intensive care unit at the University Hospital site.
He worked the first three waves of the pandemic in the ICU, but has recently moved to the union office as the bargaining unit president for the Ontario Nurses Association.
A lot of nurses are suffering in silence.- James Gibbons, nurse and union president
"I've spoken to a lot of those nurses who have left and they just can't go through another wave and they're leaving sooner than anticipated because mentally and physically, they just can't do it."
Although the hospital provides wellness programs, many nurses are so tired and have so little free time, they're not using them, Gibbons said.
No downtime
"I think a lot of nurses right now are suffering in silence and it's challenging, because there's not a lot of services out there for when a nurse has had a terrible shift, where one of our patients may have passed away," Gibbons said.
"It's 'get the room turned over, because we've got another patient coming.' There's no down time. There's no time for us to sit back and maybe grieve with that family. That burden weighs heavily on nurses."
One night last week, there were 25 nurses working in critical care, when there should have been 35 to 40, based on patient load, Gibbons said.
The Ontario Nurses' Association estimates there's a 10 to 12 per cent vacancy rate for nursing position in Ontario hospitals. "We just can't train nurses fast enough to get out and work on specific units," Gibbons said. "The pipeline is dry. There is nobody coming in."
Right now, LHSC is caring for five or fewer COVID-19 patients in the ICU, but full beds and few staff mean there's little breathing room, he added. And nurses feel devalued because their salaries are capped by the province.
"We've got a full ICU and we have very little COVID in the ICU right now, and we can't meet our baseline staffing needs. What's going to happen when we have an outbreak and we start to see some of the projected modelling come to fruition?"
Patients who are critically ill require a lot of specialized treatment and therapies, and there's not enough trained staff to take on that type of workload, Gibbons said.
'It's been a long 18 months'
Critical care nurses assigned to one hospital are being asked to work in the other when staffing shortages on a particular shift are bad, hospital and union officials say.
Between the two adult critical care units at Victoria and University hospitals, there are currently 388 nurses working, said Carol Young-Ritchie, one of LHSC's vice-presidents and its chief nursing officer.
The hospital is funded for 70 critical care beds, which means there should be closer to 420 nurses.
"We all know the toll that this pandemic is taking on all of us as a society. It's tough right now, and I would say it's tough for all of us in health care right now. We all want this to end," said Young-Ritchie. "It's been a long 18 months."
People are tired and are bracing for the fourth wave, but at least they know what to expect in critical care, she said.
"We've learned a lot from each wave, and we're making preparations and we continue to learn how we do this better with each wave, particularly in critical care. We are certainly looking at our staffing numbers and how many more beds we could open if we needed to."
There are no nurses to hire and we are in a crisis right now.- James Gibbons, nurse and union leader
There are 27 nurses currently being trained and who will start working in September. Some are new to nursing, others have come back from the United States, and some were redeployed during the third wave to critical care and want to stay on, Young-Ritchie said.
Those nurses aren't immediately ready for the complex work of critical care, however, Gibbons said.
Knowing that it can be difficult for nurses to access wellness programs, the hospital is trying to be innovative and to figure out ways to deliver those programs without placing an additional burden on nurses, Young-Ritchie added.
The union understands the difficult position the hospital is in, with the nursing shortage across the country.
"There is no opposition from this employer to hiring more nurses. They are trying to recruit nursing, they're trying to recruit from other areas, but all the other hospitals are competing for that same nurse and the talent pool is just low. There are no nurses to hire and we are in a crisis right now," Gibbons said.
He's also concerned about how nurses will fare as numbers of patients in ICU climb in the fourth wave of the pandemic.
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