There was already a shortage of registered nurses across Canada prior to the pandemic, but that’s been exacerbated as experienced nurses leave the profession or retire early. Burnout, inadequate compensation and staffing shortages have not only hurt nurses, but also impacted the quality of care they can provide for patients, says Birgit Umaigba, an ICU nurse working at hospitals across the Greater Toronto Area. Below, she shares what she’s seen working on the front lines.
What does the ICU look like on any given day?
It’s stressful and so chaotic. One of the ICUs I work at was short six nurses until the end of the year, and it’s only getting worse. You’re always walking into a shift knowing that you’re working short staffed and a lot of the time, you’re working beyond your 12-hour shift because nobody’s showing up to take over from you. You have simultaneous code blues [signalling cardiac arrest] happening on some shifts. And a lot of nurses are monitoring two or three patients who are critically ill on ventilators with multiple medications, which is completely unsafe. The normal ratio is one patient to one nurse.
It becomes impossible to take breaks or even use the bathroom, especially when patients are that sick. You have to cover your colleagues’ patients when they’re on break, so you end up monitoring five or six patients at once. It’s very intense. Sometimes we go seven hours without breaks and I’ve had shifts where I couldn’t use the bathroom for hours. There’s lots of chaos, alarms and people snapping at each other. It’s like everything is set up to work against nurses.
What do you think about after you come home from work?
I’ve never seen these many deaths in my life [both COVID-related and not], but now it’s become the norm. I’m so tired and emotionally drained from the stress at work, even on the days that I’m not working. The anxiety is palpable in the ICU. As much as we try to detach from what happens at work, it’s hard. Sometimes we bring those patient experiences, especially the awful ones, home with us.
Experts have said that we need to create better working conditions to retain nurses instead of just hiring more nurses. What changes do you want to see made?
Nursing leaders in Ontario have been calling for a repeal of Bill 124, which is a bill that was implemented by the Ford government to cap nursing wages at a one percent increase over three years. This is one of the main reasons nurses are quitting [in this province]. I’d also like to see more mental health support made available to every nurse irrespective of their work contract.
There are internationally educated nurses here in Canada with years of experience that aren’t being employed. I don’t think the shortage and crisis we’re experiencing in the nursing profession can be averted by waiting to train new nurses: it takes four years to become a registered nurse and then you have to learn how to become an experienced nurse. Internationally educated nurses have the experience, knowledge and skill set needed already—they just need more support to transition in to and learn the psychosocial and the cultural aspects of nursing here in Canada.
What will ICUs look like as the pandemic continues?
I expect to see a lot of nurses falling sick and staying at home to isolate. How can you have an ICU with six beds but only two nurses because everyone else is sick? It’s going to be a disaster if measures are not put in place to stop the spread of this virus, like having free rapid tests and N95 masks made available to everyone. Those from the disabled community and people from low-income neighbourhoods might not be able to afford them otherwise. We cannot approach this pandemic without an equity lens: We’re not protected until everybody is.
Politicians have been calling healthcare workers “heroes” throughout the pandemic. How does that make you feel?
I can’t stand that term. I see it as a slap in the face and it’s hypocritical: You’re telling us that we’re heroes because we can recover fast, and we can work overtime. But these governments also cap our wages and don’t repeal Bill 124. I understand that people are trying to be supportive, but we need meaningful, tangible support in the form of policies. I have colleagues that have been diagnosed with depression, PTSD and anxiety just from working in this pandemic. These decisions affect people’s lives. We need to vote in governments that respect female-dominated professions.
This interview has been edited and condensed.