A specialist who monitors employee stress at a Hamilton hospital says health-care workers generally showed signs of burnout before COVID-19 exacerbated capacity issues when it surged in Ontario two years ago.
Diana Tikasz, a resilience integration specialist within Hamilton Health Sciences (HHS) PEaCE program, says most staffers already had “too much to do and not enough time to do it” even before the pandemic caused coworker absences and reassignments.
“I think something that’s important to recognize in health care is we do what I call ‘trauma exposed work,’ meaning the nature of our work is that on a daily basis,” Tikasz told 900 CHML’s Good Morning Hamilton.
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Over the past two years, both of Hamilton’s hospital networks have been running close to or at 100 per cent capacity – well above the 85 to 95 per cent typically seen pre-pandemic.
Surgical activity has fluctuated in the facilities since 2020 and in some cases resulted in a decline of as much as 30 per cent contributing to a current backlog of about 15,000 surgeries between HHS and St Joseph’s Healthcare (St. Joe’s) as of early May.
A recent release from the Ontario Medical Association (OMA) says that equates to between 33 and 45 per cent of people having waited longer for knee surgery and 59 to 67 per cent waiting longer for hip surgery at Hamilton hospitals.
Province-wide, about 29 per cent of Ontarians receiving knee surgery waited longer than provincial targets along with 43 per cent who had hip surgery, according to the latest public data from Ontario Health.
Ontario guidelines recommend those surgeries should be performed within 42 to 182 days from the time a physician’s decision is made to go that route.
A CHML listener, who only wanted to be identified as Cathy, says her mother has been waiting for knee surgery for more than two years now, after four cancelations due to capacity issues.
“She can barely do anything,” Cathy said. “She can’t stand at the counter and do dishes ’cause her knees are very weak. She can walk maybe 10 feet and then has to sit down.”
The family hopes to hear good news next week that the surgery will be back, which would mean they would only have another two month wait.
“Otherwise she’s going to sit in the house again all summer,” according to Cathy.
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In late April, HHS chronicled their issues in a series of social media posts saying surgical activity was scaled back due to high patient volumes and issues with staffing.
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Adding to the troubles are staff missing work due to COVID-related infections which as of Thursday were affecting close to 400 hospital workers.
During the City of Hamilton’s Board of Health meeting on Tuesday, associate medical officer of health Dr. Bart Harvey told councillors the staffing issue surrounds workers off isolating for COVID, some opting for early retirement and others just outright quitting.
“A number of people, many of them being nurses, have just taken COVID as the opportunity to step out of the profession,” Harvey said.
In March, a Canadian Medical Association (CMA) survey revealed more than half of physicians and medical learners (53 per cent) have experienced burnout, compared to 30 per cent in a similar survey conducted in 2017.
Nearly half (46 per cent) of the physicians polled say they will consider reducing their clinical work in the next 24 months.
“We should be deeply alarmed that half of the physician workforce is considering reducing their clinical workload.” Dr. Katharine Smart, CMA president said.
“The downstream impact to patient care will be significant as we are already experiencing access to care issues.”
A pair of Ontario organizations that represent the provinces nurses say short supply in that profession is more about provincial budgets and education.
The Ontario Nurses’ Association (ONA) and Registered Nurses’ Association of Ontario (RNAO) have gone as far to say the recent Ford government’s provincial budget is not likely to present a solution to the issue.
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Recent numbers from the Canadian Institute for Health Information reveal there are 304,558 RNs licensed to practise in Canada with 84 per cent with a single employer.
Canada has 824 nurses per 100,000 people while Ontario’s ratio is only at 688 per 100,000 – suggesting a gap of about 20,000 RNs and nurse practitioners in the province.
The Canadian Nurses Association (CNA) says, as of 2022, Canada is short an estimated 60,000 nurses and will need some 11,000 more to meet general care needs going forward.
In Hamilton, HHS says they are currently looking to fill 155 nursing positions out of 488 total vacancies at the hospital, while St. Joe’s is looking to replace 160 out of 250 openings.
The Registered Nurses’ Association of Ontario (RNAO) suggests the Ford government’s miss is in the education sector and the shoring up of future nurses by committing to increase the number of seats in education programs by 10 per cent this year with further increases of 10 per cent in subsequent years.
“This is surprising given the government’s awareness of attrition from the profession,” says RNAO CEO Dr. Doris Grinspun.
“The needs in school will continue to be heightened for years to come.”
Grinspin said the RNAO was looking for a commitment that would see the 625 RN positions dedicated to schools through the budget, along with funding for an additional 50 community wellness nurses in First Nations communities.
In November, McMaster University revealed a 20 per cent increase in nursing applicants to its four-year program suggesting despite the pandemic, candidates are still choosing the profession as a career.
Assistant dean and associate professor of Undergraduate Nursing Programs at McMaster Dr. Joanna Pierazzo confirms the schools nursing programs, including the accelerated Bachelor of Science, have continued to see increases in applicants year over year.
“We are exploring the option of adding additional students to the class this fall and look forward to a longer-term investment in more seats from the provincial government,” Pierazzo told Global News.
Both of Hamilton’s hospitals actually utilized McMaster’s School of Nursing (SON) program to cover current shortages with 87 ‘externs’ doing regular shifts as part of a pathway to full-time work after graduation. HHS says they have taken on 57 while another 30 are at St. Joe’s.
Tikasz says health-care workers remaining in the profession are ‘inherently resilient’ but will need help due to the “sheer volume and magnitude” of their exposure which has really “lowered their capacity.”
“It’s not necessarily that the current conditions are not appealing to attract new folks,” said Tikasz. “I really do think we need to be looking at how do we make some systemic changes so that we are supporting staff.”
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