After working the front lines through three gruelling waves of the pandemic, and now facing the prospect of pay cuts, some Alberta nurses say they're exhausted, demoralized and looking to get out — prompting concerns about the future of health care in the province.
"It was terrifying. … other people were told to stay home and we were told to go to work," said Edmonton emergency room registered nurse Jessica McGrath, who described facing heartbreaking scenes of patients needing to be intubated, struggling for their lives and dying alone.
"We are the ones that are seeing COVID at its worst."
But as the province emerged from its most recent COVID-19 surge — and negotiations between the United Nurses of Alberta (UNA), Alberta Health Services and Covenant Health resumed — nurses were presented with a three per cent wage rollback proposal. Including other changes, UNA argues it amounts to a five per cent cut.
"That was a huge slap in the face to a lot of us," said McGrath.
All this prompted McGrath to take a temporary one-year position — away from the front lines.
"I've never seen morale this low," she said. "We don't have the same spirit that we used to."
'I've never been more burned out'
McGrath is not alone.
A registered nurse in the emergency department at Edmonton's Royal Alexandra Hospital — which temporarily closed a number of beds recently due to staffing shortages — says she too is looking to get off the front lines.
CBC has agreed to withhold her name because she is concerned about professional repercussions.
"I've worked in this department for close to 15 years and I've never felt so physically and emotionally drained as I do now. I've never been more burned out," she said.
The Edmonton nurse reviews the AHS job board every day, looking for a position outside of the ER.
Senior staff, she said, started leaving her department about a year ago. That intensified when negotiations resumed, punctuated by the proposed wage cut.
"People have even gone into the private sector. People have taken travel nursing contracts. People need out," she said.
Nurses leaving the province
"I've never had so many conversations with my colleagues on the job postings in different provinces," said Christopher Picard, an Edmonton-based registered nurse and spokesperson for the National Emergency Nurses Association of Alberta.
He plans to wait out the negotiations but said a move out of province has been on his mind.
"Having proposed wage cuts brought in after a once in a century pandemic — it does seem like a little bit of a betrayal," he said.
"Are people having these discussions? Yeah. Are people leaving? Yeah."
Despite these stories, Premier Jason Kenney refutes the idea that nurses are leaving.
"I wouldn't agree that people would move from Alberta to receive lower pay in other provinces and to pay higher taxes. That wouldn't add up," he said when asked by CBC News on Thursday.
"He's wrong," said Heather Smith, president of the United Nurses of Alberta, the union that represents registered nurses in Alberta.
Some senior nurses have already taken jobs in B.C., according to Smith. Anecdotally, she's heard of nurses leaving for Ontario too, where some hospitals are offering signing bonuses as a recruitment incentive.
"[Alberta nurses] are just not prepared to deal with the kind of disrespect they're feeling here in the province," she said. "They want workplaces that respect them and value [their] contributions … And they're quite prepared to do it in other locations."
The frustration among nurses — who haven't had a raise for five years — is ballooning, according to Smith, who compares today's tensions with the turmoil that led to a strike in 1988 when thousands of nurses walked off the job.
"I haven't seen this kind of anger and demand for action in decades," she said.
According to Smith, there is growing support for a strike which, by law, would require several steps including formal mediation since nurses are deemed essential workers.
She said discussions about non-union-sanctioned wildcat strikes are percolating and UNA is working to set up a day of action in August — along with other health-care unions — including information pickets at hospitals around the province.
"Increasingly there are members saying, 'Why wait?'" said Smith. "But we will do everything we can to attempt to respect the process by law."
Province holds line on wage cuts
Even with the growing unrest, Jason Kenney isn't wavering.
He's made no secret of the fact he wants to balance Alberta's books and that health-care spending, which accounts for nearly 45 per cent of the provincial budget, is a prime target.
Kenney said he appreciates the hard work of nurses through the pandemic and repeated his government's stance that Alberta nurses receive on average 5.6 per cent higher compensation than those in the rest of Canada.
"Alberta has a $16-billion deficit. We've been running massive deficits for a decade. We cannot continue to do that indefinitely," he said. "This government, at least, is not going to raise taxes to punish people who've already been hurting in the private sector — so we have to learn how to operate a little more efficiently. And that's the basis of our initial position in the collective bargaining agreement."
Government actions seen as 'needlessly aggressive'
Kenney's tactics could be seen as "needlessly aggressive" at a time when support for Alberta health-care workers has skyrocketed due to the pandemic, according to Lori Williams, associate professor of policy studies at Mount Royal University.
"It looks to me like there's a lot more support for health-care workers in general than there is for the government's response to health-care workers," said Williams, pointing to the acrimonious relationship with Alberta doctors after the province tore up their master agreement last year and announced a plan last fall to lay off many as 11,000 AHS employees and outsource their jobs to private companies.
The Alberta Union of Provincial Employees (AUPE) recently went back to the bargaining table too and was presented with a wage cut proposal of its own: four per cent for general support workers.
"The government keeps saying that it appreciates the sacrifices that were made by front-line health-care workers, but doesn't indicate that by their actions," said Williams.
Kenney's methods are strikingly reminiscent of the deep health-care cuts levelled by Premier Ralph Klein during the 1990s, according to Lorian Hardcastle, associate professor specializing in health law and policy at the University of Calgary.
"I think when you cut too quickly and too deeply, you risk really destabilizing the healthcare system," said Hardcastle. "That's what we saw during the Klein years and it took subsequent governments years to rebuild that health workforce, to rebuild that health-care system. And I think we may be putting ourselves in a difficult position right now."
If the Kenney government holds the line on wage cuts for nurses, Hardcastle said the relationship between the two sides will likely grow more acrimonious and it could have lasting effects on a system already battling staffing shortages and bed closures.
"Not only will there be disruption in the short term, but [there] could be longer-term problems with recruitment and retention that affect the health-care system for many years. And that can play out in terms of longer wait times for surgeries … it can result in more hallway medicine," she said.
"And that's the sort of thing that it takes a long time to recover from and rebuild."