Logan Giesbrecht left his dream job as an emergency room nurse when the mental health strain of an understaffed department became unbearable, even before the pandemic's fourth wave hit and anti-vaccination protesters began gathering outside hospitals.
"The biggest frustration, and what I'm taking home from work, was basically doing the job of more than one nurse," said Giesbrecht, who feared low staffing levels would risk patient safety.
He quit working at Royal Inland Hospital in Kamloops, B.C., last April for a part-time position at a private clinic for workers assigned to a dam project on British Columbia's Peace River, but the long hours and weeks of time away from his family in Fort St. John took a toll.
Faced with a decision, Giesbrecht chose to return to his hometown where he will be helping out on the front lines at his former job starting next month.
"I'm hopeful that change will occur," he said. "Even now, as it's struggling in many ways, the citizens of Kamloops are still better off to have a hospital at some capacity than no hospital at all."
Giesbrecht, who graduated from nursing school in 2017, said rising pressures are being felt among many of his colleagues, some of whom have left the profession as staffing shortages lead to overtime and push many towards burnout.
"We just can't keep throwing new grads into the pit, and then they only last three or four years before they run away," he said.
Representatives for nurses around the country are calling on the federal government to come up with a national plan to attract and retain nurses during a "crisis" they say needed action long before the uptick in cases from the Delta variant.
Statistics Canada released data this week from the second quarter of 2021 showing a steep rise in job vacancies for both registered nurses and registered psychiatric nurses, which are part of a single category in its analysis.
Those professions had the largest increase in vacancies of all occupations over a two-year period, up by 10,400 to 22,400 — a hike of nearly 86 per cent, the agency said, adding nearly half of the vacancies had been open for 90 days or more, compared with 24 days across all occupations.
Linda Silas, president of the Canadian Federation of Nurses Unions, said it's not uncommon for some registered nursing positions to be vacant for a couple of weeks, as workers switch jobs within a hospital or health region, but having vacancies unfilled for 90 days or longer is unsustainable.
The federation is calling for urgent federal support, joining a similar plea by health unions in Alberta where the country's highest provincial COVID-19 case counts have overwhelmed nurses and hospital beds, and pushed Premier Jason Kenney to ask other jurisdictions for help.
Silas said a national "health-care workforce agency" is needed to assess the number of graduates required by provinces and territories, along with a plan to recruit and retain nurses. Further measures should include providing "bridging programs" to help licensed practical nurses train for registered nursing positions instead of starting from scratch, she added
"The federal government should have a base of expertise on health human resources," she said, noting the shortage has, in some cases, forced entire emergency departments to close and cancelled scheduled surgeries.
"Everyone is running scared. And I don't blame them. It keeps me up at night wondering what's going to happen at the end of this pandemic."
Michael Villeneuve, CEO of the Canadian Nurses Association, echoed Silas's sentiments, saying a co-ordinated approach was tried in the mid-1990s when he led a federal nursing advisory committee that lobbied for increased funding for nursing school seats after chopped budgets led to an acute shortage of nurses.
"I've never been so concerned with health-care sustainability and safety than I am right now," the former intensive care nurse said.
"It's a crisis. And if this doesn't do it then I don't know what will."
Silas and Villeneuve say they're also worried about the pressures of mandatory overtime, something they say is being used as a strategy to fill vacant jobs.
Statistics Canada said in September 2020 that nurses who put in overtime worked up to five more hours per week in April and May that year compared with the same months a year earlier. It cited the highest overtime hours in Quebec and Ontario due to a greater number of COVID-19 patients in those provinces.
Now, during the fourth wave of the pandemic, many nurses say they have no assurance that things will change but that they're "done asking." This expression was the theme of rallies in various cities last week as nurses took part in a national day of action.
Frustrations in Quebec had Premier François Legault promising up to $18,000 in bonuses Thursday for full-time nurses so more of them don't quit. He said the effort is part of a "mini revolution" in the province's health network after pandemic-induced stresses contributed to a shortage of 4,300 nurses.
British Columbia Premier John Horgan said he discussed the challenges of the nursing shortage with Legault during a meeting of premiers on Thursday.
He said every province is trying to compete with other jurisdictions to attract more health-care workers and that immigration may be one way to meet demand.
Premiers are calling on the federal government to better compensate health-care workers by boosting its share of funding to 35 per cent from 22 per cent. They've requested a meeting with Prime Minister Justin Trudeau as soon as possible to expand on ideas for improving health-care across the country.
"In order to provide services for people in health care you need health-care providers," Horgan said. "That means you have to train them, you have to pay them and you have to make sure you don't burn them out."
The problem has also prompted doctors to speak out.
Dr. Katharine Smart, president of the Canadian Medical Association, said she doesn't see the situation improving without a national plan.
She said a lack of nurses can impact physicians' ability to care for their patients.
Nurses in non-critical care wards who are sometimes redeployed to critical care are now looking after three or four patients instead of just one, Smart added.
"This crisis is on top of years of austerity in the health-care system, which has been chronically understaffed," she said.
This report by The Canadian Press was first published Sept. 24, 2021.
Camille Bains, The Canadian Press