Recently retired nurse, union say election promise to hire more nurses won't fix 'acute' shortage

The head of the Manitoba Nurses Union says she is not surprised by figures that show an increase this year in vacant nursing positions — and what she describes as record numbers of nursing vacancies in the health-care system. 

"It's exactly what nurses have been saying for the past two-and-a-half years," said Darlene Jackson.

"What I am hearing on the front line is that we have gone from a chronic nursing shortage to an acute nursing shortage. The vacancy rate speaks for itself."

Winnipeg regional health authority figures provided to CBC News on Thursday actually show there were 88 more active nurse positions as of Aug. 24 this year than in August 2018 — 7,615 active nurses as opposed to 7,527.

However, those figures also show the vacancy rate in those nursing positions has gone up.

According to the WRHA, there were 1,350 active vacant nurse positions in the Winnipeg health authority region and Shared Health areas of Winnipeg as of Aug. 24, which represents 17.7 per cent of the nursing workforce.

Those numbers are up from August 2018, when the WRHA says there were 1,171 vacant nurse positions — a rate of 15.6 per cent.

A spokesperson for the WRHA said there is a potential for the vacancy rate to be artificially inflated, due to the changes in the health-care system as part of the Progressive Conservative government's health-care overhaul, which began in 2017.

"As positions are created and deleted, there is potential for overlap in new/old positions in the tracking system, which can artificially inflate vacancy rates during the period of change," a WRHA spokesperson wrote in a statement to CBC News.

A new methodology to track vacancies was brought into effect in November 2018, so "comparison to prior periods should be done with caution as the same monitoring was not in place," the spokesperson said.

Jackson, though, is not convinced the numbers are inflated. She also suspects the increase in the number of active nursing positions may be due to more part-time than full time nurses in the system.

She says an increased workload, an increased patient-to-nurse ratio and mandated overtime are leaving nurses concerned for their patients.

Deletions amount to cuts, says retired nurse

A woman CBC is calling Karen is one of those nurses. 

Karen, who has 25 years of experience as a nurse, doesn't want her real name used as she fears reprisals for speaking out about her experience.

Her nursing position was recently deleted.

Nurses in that position aren't technically laid off, but have options that include accepting a new position, applying for a different one, bumping into another role or choosing to take a layoff.

Instead of bumping into a less senior position, Karen decided to retire to figure out her next step. She doesn't want to burn any bridges.

Choosing to leave a career that she loved and was passionate about was a gut-wrenching decision, she says. But it was all starting to take a toll on her health.

"Ethically, I had a really hard time being part of a system that was looking like it was going to collapse. Speaking up and fighting for that system becomes exhausting as well."

She's not alone. Karen claims 10 to 15 of her colleagues, all senior nurses, have similar stories.

Some had their positions deleted, some chose to retire because they were told their jobs would be cut. After they left, their jobs — including hers, Karen says — were not filled, which she feels constitutes a cut.

During an Aug. 26 campaign announcement at which he vowed to hire 200 more nurses if re-elected on Sept. 10, PC Leader Brian Pallister told reporters there have been no cuts to front-line health services under his government.

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"Yes, we have trimmed at the top of the health-care system, absolutely true — so we could take the resources and shore up the front line of our health-care system, and that's what we've done," Pallister said at that announcement.

Karen doesn't accept that.

"It's not accurate at all.… People's jobs were deleted or they left — but the bottom line is those jobs were not filled," she said.

Jackson says Karen's story is all too familiar, and senior nurses are choosing to walk out the door with their experience and expertise because their positions have been deleted.

"That is someone who could be mentoring, who could be assisting a young nurse to be more confident and more experienced in her work," Jackson said.

Karen wonders how the province can be saving money if more is being paid out for overtime, sickness and retraining nurses in areas they originally didn't chose to work in.

Both Karen and the MNU's Jackson want more specifics on Pallister's promise to hire 200 new nurses. With more than 1,300 vacancies, they wonder how the 200 promised new positions will be filled — especially with 75 nursing school spots recently eliminated at Red River College.

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They point out that the vacancies report does not even take in account the needs in rural Manitoba.

"There are positions posted at Prairie Mountain Health Region, positions in the Interlake and the north — so how are you going to fill these 200 new positions? What are the positions?" asked Karen.

A nurse is not a nurse

When asked for comment, the Progressive Conservative Party of Manitoba sent a statement on behalf of Health Minister Cameron Friesen, who is running for re-election in the Morden-Winkler constituency.

"We are transforming what had been an overly complex, inefficient, top-heavy health system under the NDP for one reason and one reason only: to improve patient care and outcomes," Friesen's written statement said.

"To improve health care, staffing resources throughout the Winnipeg Regional Health Authority have been reviewed and, as needed, schedules adjusted and positions redeployed elsewhere to better match system-wide needs."

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Friesen also said any qualified nurse working in the health care system who wants a job will have one, reiterating that deletion notices are not layoffs.

He also adds all new hires receive proper training and the support they need when starting in a new position.

Both Jackson and Karen take exception to those claims.

Karen's mantra throughout her career was that a nurse is not a nurse. A nursing degree, she maintains, does not make anyone an expert in everything. Just because there is a vacant job, she adds, doesn't mean any nurse can fill it.

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"Nursing requires an education. Good nursing requires experience. Great nursing requires compassion, knowledge, competency, experience. All those things lead to expert nursing," she said.

"And if I were the public, and I am the public, I would want experts looking after my loved ones. Not someone that's trying to figure it out on the job."

Karen says she has seen near misses happen — medication that almost gets missed, or wrong appointment dates may have gone out for a particular treatment, for example, or a patient sent to the wrong place because there have been changes in where clinics are located.

She worries there is more potential for something to go wrong with fewer experts there to stop it. 

"You need more experts. You need better care. You need better numbers," she said.

"To profess you are saving money as opposed to providing care, I think, is dangerous. You can cut and cut and cut, and all you will do is create poorer outcomes for people. People will come back in and they will be sicker," she said.

Karen also acknowledges many nurses, fearing for their jobs, are too afraid to come forward to talk about the issues she's raising.

"I recognize that while I am one voice, I am confident that behind me there are hundreds of nurses feeling the same way."