Soaring syphilis rates making workload unmanageable and affecting quality of care, say nurses

The ongoing syphilis outbreak in Winnipeg is becoming a serious cause for concern for public health nurses, who say they're dealing with a 1,000 per cent increase in infections since 2013.

In a letter to Minister of Health Cameron Friesen, nurses wrote the scarcity of resources and support to combat the growing epidemic have led to a drop in the quality of care patients are receiving.

"This has been a concern that the nurses have been voicing for a very long time, they've brought it to their employer, they brought it to their directors and just feel that the situation is now at a point where they have to bring the situation further," said Darlene Jackson, president of the Manitoba Nurses' Union.

Earlier this month, the Winnipeg Regional Health Authority confirmed the city is on pace to shatter the mark reported in 2018 of 400 infectious syphilis cases, with that number projected to surpass 600 this year.

In the letter, nurses cited "ineffective outbreak management" and a slowed response to the crisis which has amounted to unmatchable standards of care. 

The letter also noted there have been no increases in staffing levels since 2013 and said the the increasing number of cases have made it tougher to follow and adhere to the quality of care laid out in clinical and provincial practices. 

"There's just not enough nurses and so what's happening is if we're not catching them, or we're not treating them, that infection is just continuing to be spread out there and the problem is just getting bigger all the time," said Jackson.

For months, the WRHA has publicly stated the outbreak is largely affecting people who live in the inner city or methamphetamine users, but that problem is more complex then it seems.

"You have to find every contact that they've had — every sexual contact or any contact that they may have exchanged blood or body fluids with. [Then] you have to track those contacts and they have to be tested and either treated and if they are positive then you've got to find all of their contacts," said Jackson.  "We're not talking about one person that is infected — we may be talking about 30 or 40."

The nurses wrote that most of the clients they're seeing are often transient with unstable housing and battling mental health and substance issues.

Friesen said they understand the population they are dealing with, and they are doing their best to try to get through to them.

"At this time there's a lot of creativity and innovation being used to being able to use resources in new ways to make contact, [with] difficult to reach sub-populations," said Friesen.

In the letter, the nurses state the current workload is not manageable, and that with every case they're spending a laborious amount of time trying to track down potential cases of syphilis, but are yet to see any increase in manpower.

NDP Opposition Leader Wab Kinew said the government is to blame for the lack of nurses readily available to offset the crisis.

"They can't uphold their clinical guidelines, which essentially means that they're concerned that they can't deliver the quality of care that patients deserve given their current situation," said Kinew. "So all this seems to be another example of the provincial government's cuts impacting the quality of care for patients."

Friesen said he plans to leave the decision to increase staffing up to Dr. Michael Isaac, acting chief provincial public health officer, on whose advice he said the province has already increased resources to battle the ongoing epidemic.

"These are not our challenges alone. In fact, these same trends are being seen across Canada, in many parts of the U.S. Midwest, nevertheless we must respond and we are responding," said Friesen.

Friesen previously stated that they are looking at new avenues to help those at risk, but didn't clarify what those would be.