CALGARY -- When Michelle Senkow worked as a labour and delivery nurse in
Grande Prairie, Alta., she and a colleague were responsible for up to seven
women in labour at a time.
Staff shortages were so bad that the veteran nurse would routinely work a
12-hour shift without a break, be called in to work overtime on virtually
every day off and find herself delivering babies alone almost daily.
"The work conditions were so bad that I was afraid I was going to end up
with a dead mother and baby on my hands," she said.
"It was either leave those conditions or leave nursing."
According to a study being published today, Ms. Senkow's experience and her
frustration are frighteningly common. Researchers in Canada, the United
States and Europe say that the work conditions of front-line nurses have
become so poor that patient care is suffering, medical errors are increasing
and nurses are leaving the profession in droves.
Almost 17 per cent of nurses working in Canadian hospitals plan to leave
their jobs in the next year, the study says. Among nurses age 30 and
younger, almost 30 per cent are considering quitting, which could exacerbate
the nursing shortage, the researchers warn.
"There's clearly a pressing need to rethink the way nurses' work in
hospitals is designed," Linda Aiken, director of the Center for Health
Outcomes and Policy Research at the University of Pennsylvania, writes in
Health Affairs. "Hospital executives should take a hard look at management
practices."
To collect data, researchers surveyed more than 43,000 nurses in 700
hospitals in Canada, the United States, Germany, England and Scotland.
Nurses at every acute-care hospital in British Columbia, Alberta and Ontario
were polled.
The Canadian Nurses Association predicts that, within a decade, Canada will
be short 113,000 nurses, the equivalent of half the country's entire nursing
work force today. Academics and pundits blame an aging work force and
growing demand, but say the major reason institutions cannot retain workers
is poor conditions.
The new study lends credence to that view and provides ammunition for nurses
in contract negotiations, notably in B.C. and Ontario, where there are
continuing job actions.
Researchers found that nearly one-third of Canadian nurses are dissatisfied
with their jobs -- more than three times the average rate for workers -- and
an even greater number are suffering from burnout.
More than two-thirds of nurses surveyed feel that staffing levels are not
sufficient to provide quality care for their patients.
Judith Shamian, executive director of nursing policy at Health Canada and
the lead Canadian author in the study, said the data should make employers
and policy analysts sit up and take notice.
"Research like this has driven me to the conclusion that our focus has to
be
on the unhealthy workplace. The challenge is clear: Fix the workplace or we
will not have a sufficient number of nurses to provide care," she said in
an
interview.
Dr. Shamian noted that absenteeism among nurses, 8.5 per cent daily, is
twice the national average, and that there is a vacancy rate of about 10 per
cent nationally.
That means nearly 20 per cent of all work is being done on overtime and, at
that pace, nurses are burning out and unable to deliver adequate patient
care, driving them out of the profession.
Ms. Senkow, who has worked as a nurse for 20 years, resolved her problem by
moving to a new institution, Foothills Medical Centre. There, she cares for
one birthing mother at a time, and another nurse covers her break.
"It's wonderful at Foothills; it's the kind of nursing job I've strived to
find for 20 years," she said.
"It made me realize just how important a good work environment is for me
and
my patients. When you have decent staffing, when you have resources, you can
provide good care," she said.
According to the study, hospitals like the Foothills are the minority.
Fewer than 35 per cent of Canadian nurses said the administration of their
hospitals listen and respond to nurses' concerns.
One of those concerns is that fewer than one-third of nurses in Canada can
self-schedule. The researchers say this is a very simple administrative
issue, but flexible shifts matter a lot to nurses, many of whom have
children.
At the same time, the survey found that seven in 10 nurses feel their pay is
adequate.
"This shows the quality-of-work-life issues matter a lot more than pay; it
shows that the media don't really understand what's at stake in the contract
negotiations that are going on at this time," Dr. Shamian said.