It’s a job described as the backbone of BC’s healthcare system.
Nurses make up one-third of the entire healthcare workforce.
Government data from 2012 shows there will be more than 25,000 job openings in the nursing profession by 2022.
That’s the second highest of all occupations in the province requiring a University degree.
Job postings in Vancouver Coastal Health alone show 132 nursing jobs are available right now.
And because of the demand, B.C. is experiencing a shortage of nurses in specialty areas, like the operating room, emergency and intensive care units.
President of the Association of Nurses of BC, Zak Matieschyn, says there has been efforts to increase the supply.
“There was efforts through BCIT in the last year or two to increase the number of seats. As much as possible we are trying to address the supply side. The challenge is part of it is a practical experience, and you do that with a preceptor in the hospital, and there is only so many preceptor opportunities to match the students, so that is where the bottleneck occurs.
Further, there is a lack of educators and we are seeing the average age of nursing educators increase and retiring. Further there is a disparity in remuneration. A specialty nurse may consider becoming a specialty nurse educator, but note a drop in pay, so not a great incentive there.”
But Matieschyn says another big issue is retention.
“So what is causing nurses to leave the practice? We are seeing a disturbing number of nurses in general graduate from school but not actually entering the work force. We are seeing overworked and overburdened nurses leaving mid-career and this almost has a cascading effect where the less properly staffed departments are, the more intense they become.”
A retired nurse in VGH’s OR says the BIGGEST point of contention is the disconnect between administrators and the nurses on the ground.
Penny Oyama, who spent 38 years working in the hospital’s operating rooms, says nurses also have a distaste for the grueling shift rotations.
“Scheduling has become such a bone of contention and it seems to be the biggest source of dissatisfaction. I think it is just logical that if the dissatisfaction is cleared up, then people will want to stay. It is unworkable, it is difficult to live with, and it is inadequate in so many ways, like, for an example, people being called back on their time off.”
READ MORE: Nurses fight “excessive” workload
Oyama says operating room nurses are stretching themselves to the limit to ensure staffing levels don’t effect safe patient care.
“There are many times when there is just so much to do and technically speaking not enough people to do it properly so people end up trimming things and making ends meet, making things work, and that usually ends up leading to nurses having their backs against the wall, and saying we have no more left, we can’t make this last any longer.”
But the staffing shortages in the operating rooms are having an impact on patients.
Dr. Ahmer Karimuddin is a surgeon at St. Paul’s Hospital.
He co-authored an article published in BC’s Medical Journal last October.
It found BC’s surgical wait times have not declined, in part, due to a shortage of OR nurses, but the situation is improving.
“In a complex healthcare environment like ours, things came to an acute head back in the late fall of 2015 when there was an acute shortage of nurses at Vancouver General Hospital. Along with that, there was just a large backlog of cases and patients who had waited for an extraordinarily significant amount of time. Since then across Vancouver Coastal Health and the entire province of British Columbia, the health authorities have worked really hard to try and get some of those complex issues figured out, so that has meant in Vancouver Coastal Health and Providence Health having surgeries done at hospitals like UBC Hospital and Mount St. Joseph’s Hospital. It’s meant outsourcing surgeries through organizations like False Creek and other private settings where surgeries can be done in an environment that is not as complicated as a large hospital.”
The nursing shortages can also mean costly overtime.
Data obtained by CKNW shows the Vancouver Coastal Health Authority dished out $18.6-million in overtime in the 2014 fiscal year.
The hardest-working nurse earned a whopping $120-thousand in overtime pay for more than 1,400 hours of overtime work at $84/hour.
Earlier this year the health authority updated its fatigue policy, stating staff are not authorized to work more than 390 overtime hours in a year without approval.
It says given the complexity and unpredictable nature of health care work – there will always be a need for overtime.
So what is the province doing about it?
READ MORE: Some nurses amassing huge overtime dollars
Solving the crunch
The latest labour market outlook shows registered nurses, specialty nurses, nurse practitioners and licensed practical nurses make up 4 of the top 10 priority health professions in the province.
B.C.’s Health Minister Terry Lake says says the government is making progress.
“If you look back at 2001 to today, we’ve more than doubled the number of nurse training spaces, more than 4,500 new spaces. So we’ve been working on this for awhile, seeing it coming, but there is more to do. And as the population ages, particularly nursing, not just in acute situations in hospitals, but also home and community situations I think will become more and more important because we want to shift healthcare into home and community more and more so that people don’t end up in hospitals. We want to keep them in their homes as long as possible.”
Back in January the province promised 1,600 new nursing positions by the end of March.
So far, more than 1,000 nurses have been hired.
And more are on the way, but how many? We don’t know.
In early April, the B.C. Nurses Union, representing 42,000 nurses across the province, announced a five-year tentative deal had been reached with the province.
But the details are kept under wraps until the agreement is ratified.
Here’s union President Gayle Duteil.
“We’ve been speaking out about shortages and the failure to replace and educate the nurses needed to provide safe patient care. These conditions often forced us to work short, with excessive amounts of overtime and on-call, and this can negatively impact the safety of our patients, and the health of our nurses. So addressing those issues was critical for our bargaining team.”
READ MORE: Tentative deal for BC nurses
And while the province works on addressing the union’s concerns, it’s also looking at how to streamline the assessment process to help get more international nurses working in the health system.
24-year-old Kathryn Berg from Langley earned her Bachelors of Science in nursing at a U.S. College in Northern Indiana.
She’s been trying to transfer her skills here for more than two years, finishing up the “Graduate Nurse Internationally Educated re-entry program” at Kwantlen Polytechnic University.
“I do think that it takes a long time and it is very hard for people, but I do think that they need to go through this year course because there are a lot of gaps and there needs to be a closure of those gaps. But in saying that, even taking the SEC exam, which is the exam for your skills to be evaluated to determine how much further education you need, if you’re living abroad then you have to fly here to do your exam. You have to pay for your flights and accommodations on top of that and if you’re a mother and have kids at home, it pulls you away from your family, but they are all trying to get a better life for their families, so it is difficult.”
Lake says it’s important to ensure B.C. maintains a high standard of practice.
“We are working with key stakeholders to streamline that process so we can bring more international nurses into the health system. You can imagine if you’re coming here from another country the processes are different, the bureaucracy is different, and some aspects of healthcare would be different. So we want to make sure we ease that transition as much as possible. A pilot phase of the project was completed in November of last year and we are working to expand that work later this year. Meanwhile, through Health Match BC, we are advertising in journals in the United Kingdom, Ireland and the United States so we are seeing nurses interested in coming here to B.C.”
Whether you’re a nurse from abroad, or trained right here in B.C., practicing healthcare professionals like Dr. Ahmer Karimuddin say it’s a great time to enter the field.
“British Columbia needs more nurses, physicians, pharmacists, dietitians, health aids, no matter what facet of the healthcare industry you look at, we need more people. Not only are current people retiring, the population itself is getting older, that means they need more care. So if you are a young person or even an older person trying to figure out what you are going to do with your life, being involved in the healthcare field is a really great idea.”