Kate MacWilliams, a nurse manager at Toronto's St. Joseph's Health Centre, has taken on a lot more responsibility since the start of the COVID-19 pandemic.
It has put the native of Summerside, P.E.I., in a position to see the stress that each of the three waves of the pandemic has put on nurses in Ontario.
"The worst keeps coming," said MacWilliams. "When I look back to where we were in March and April of last year, you know, here in the west end of Toronto, we were pretty scared. [We were] uncertain about what was to come. And it never really came to the extent that we thought it would."
But she said those early fears are now being realized in the third wave of the pandemic.
Back before the pandemic started, MacWilliams was in charge of a team of nurses that provided relief staffing around the hospital, sending extra staff to surgery, emergency, mental health — wherever it was needed.
Her role has expanded since the pandemic started, and she now works with the hospital's HR director to redirect staff from all over the hospital to where they are most critically needed.
It breaks my heart, honestly, people are really struggling. — Kate MacWilliams
She is also in charge of a unit that cares for patients who are awaiting the results of COVID-19 tests. These are people sick enough to be in hospital, but who don't know yet if their problem is COVID.
"It's such a terrible time," said MacWilliams.
"We can't really have patient and family visitors. You know, it is really scary, definitely, for patients and families."
Life and death decisions
Adding to the stress for staff is the realization that conditions in the third wave of the pandemic are expected to get worse in the coming weeks.
Some health-care professionals in Ontario are now talking about an imminent need to reserve health-care resources for people with the best chances of surviving.
"No one enters health care, really, to make those kinds of decisions," said MacWilliams.
"I don't think people have ever imagined having to do that here at St. Joe's. We're not quite there yet."
I never thought that I would move to Toronto and never be able to go home. — Kate MacWilliams
But she said her hospital is anticipating that it will come to a point where it will not be able to care for all patients the way it normally would. MacWilliams has been talking to her staff, preparing them for that eventuality.
They are difficult conversations to have with people who are already deeply tired after 13 months of the pandemic.
"It breaks my heart, honestly, people are really struggling," said MacWilliams.
"In the first wave everyone was, I wouldn't say excited, but everyone was gung-ho. It's like, let's do this, let's work overtime, we can beat this virus. And then, yeah, 13 months later, I mean, the amount of resignations we've had across the hospital is unreal."
Home seems far away
MacWilliams is encouraging her team to stay as rested as they can, and despite the stress on the job tries to find some time for laughter while working.
It's been difficult for her, she admits, rallying the troops month after month. At the same time, she is dealing with a different problem that so many Canadians are. Public health restrictions are keeping her away from P.E.I., and she misses her home and family.
"I never thought that I would move to Toronto and never be able to go home," she said.
"It definitely seems very far away. And my parents live in Summerside and I miss them terribly and I would love to be able to see them again soon."
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