Nurses are among Canada's sickest workers because they toil in abysmal
conditions, a new report says.
A poor work environment can be blamed, at least in part, for the
ever-worsening nursing shortage, say the researchers who conducted the
study. They warn that the situation is getting so bad that it is undermining
the quality of patient care.
"The Canadian health-care system is facing a nursing shortage that
threatens
patient care," wrote Andrea Baumann, co-director of the Nursing
Effectiveness, Utilization and Outcomes Research Unit at McMaster University
in Hamilton.
"While caring for the sick and dying has always been demanding, many of the
problems facing nurses today seem to arise from work environments that have
grown increasingly difficult through the cutbacks and upheavals of the
1990s."
The study, commissioned by the Canadian Health Services Research Foundation,
is a summary of existing research. It says:
8.5 per cent of nurses call in sick every day, one of the highest rates of
absenteeism of any profession;
Nurses suffer more and costlier job-related injuries than traditional
high-risk professions such as firefighting and police work;
Nurses are facing increasing violence and abuse on the job;
Growing workloads are adding to stress and illness rates among nurses, which
may harm patients;
Unless changes are made, the situation will grow worse, exacerbating the
nursing shortage.
Canada needs another 20,000 nurses, and the shortfall could reach 113,000
within a decade, the Canadian Nurses Association says.
"Canada's nursing shortage is at least in part due to a work environment
that burns out the experienced and discourages new recruits," the
researchers wrote. "But that environment can be changed."
The 30-page report, entitled Commitment and Care: The Benefits of a Healthy
Workplace for Nurses, Their Patients and the System, makes 48
recommendations for improving the work environment.
They range from long-term financing commitments so nurses have some job
security to parking spots close to the hospital for the safety of nurses on
night shifts.
The researchers also recommended that the working conditions of nurses be
monitored and made an integral part of hospital accreditations, that all
institutions have chief nursing officers, and that the widespread practice
of casualization (hiring nurses as casual workers, rather than providing
permanent full- or part-time work) be abandoned.
"Good health care is synonymous with continuity of care," Dr. Baumann
said
in an interview. "You don't get continuity with casualization."
She said some institutions have casuals filling up to 70 per cent of their
nursing hours.
Only half of Canadian nurses now work full-time, down from 75 per cent a
decade ago.
Dr. Baumann said that, while the timing is just a coincidence, the report
could address some of the issues raised by nurses who are staging job
actions in British Columbia, Nova Scotia and Ontario.
"If people are sitting around a bargaining table, negotiating what working
conditions should be, this report is a good template for discussion," she
said. "Given what we have learned about working conditions, this labour
unrest was predictable."
Instead of improving work conditions, employers and governments have
increasingly turned to Draconian measures, such as making overtime and
on-call shifts mandatory and denying holidays -- policies that exacerbate
the stress and burnout of nurses.
The report says one of the fundamental problems in nursing is that nurses do
not have enough autonomy and input into decision-making, so they feel
marginalized, even though they are the largest group of health-care
professionals.
"Nursing fails to attract and retain recruits because it does not offer
them
a sufficient stake in the health-care industry. Recent graduates are
increasingly unwilling to remain in a career that gives them little scope
for career growth, and in which they feel vulnerable to factors beyond their
control," the researchers wrote.
Today, the research team will conduct a national video conference during
which they will explain their findings to employers and health-policy
makers.