Nurse shortages mean dozens of residents of Pleasant View Towers in St. John's have been moved within the facility in order to provide care, with admissions on hold there and at three other long-term care homes in the city as a chronic staffing problem worsens.
One registered nurse per every 80 to 100 residents in long-term care homes has become the norm, with some nurses on night shift caring for up to 150 residents, according to the Registered Nurses' Union of Newfoundland and Labrador. The daytime ratio should be closer to one RN for every 29 residents, says the union.
"They're struggling. You can't give the care that you want to give," said union president Yvette Coffey.
Adding to the stress, long-term care nurses are also being mandated to work 16- to 24-hour shifts. Nurses at Pleasant View Towers, Coffey said, are getting just two or three vacation days between May and October, due to a lack of backfill.
"They're working long hours, and all of this pressure is becoming unbearable," Coffey told CBC Radio's On The Go on Monday.
"You know if you don't stay, or come in when you're called, you know it's leaving your team and your residents short."
Working in long-term care comes with a host of challenges, including caring for patients with complex needs. That workload makes it hard to recruit registered nurses, Coffey said, with 45 to 40 vacant positions in long-term care in St. John's alone.
"People do not want to go and work like that," she said.
Addressing the issue
In a statement, Eastern Health said nursing vacancies in long-term care have created "staffing challenges," and as a result, some Pleasant View Towers residents had to move. The nurses' union pegs that number at close to 60.
The health authority's statement says it has suspended admissions there and at Saint Luke's, Glenbrook Lodge and St. Pat's Mercy Home while it works on "recruitment initiatives."
There is constant, open communication between Eastern Health and the union, said Coffey, who commended the health authority for numerous initiatives to address the problem. Those ideas include redeploying nurses from elsewhere in the system to long-term care, offering perks to casual nurses like career development options, and offering vacation options outside the summer crunch.
"They're going above and beyond to try to get some short-term solutions to help out, but we're still falling short," Coffey said.
The health authority said it's looking at long-term solutions in the education system and eyeing recruiting internationally educated nurses.
But the lack of registered nurses and workplace issues don't end at Eastern Health's borders, according to Coffey.
She pointed to St. Anthony, where Labrador-Grenfell Health announced June 2 it was adjusting its services for the summer "to allow for employees to receive rest/break times," a move it said was normal. In Port aux Basques as well, she said, nurses struggle to get more than three days of vacation.
"This is everywhere — everywhere in heath care in the province of Newfoundland right now," she said.
The problems have been building for years, she said, with the pandemic shining more light on the systemic issues within long-term care. A recent report said Canada's nursing homes had the worst record for COVID-19 deaths among wealthy nations, with outbreaks at 2,500 homes resulting in 14,000 residents' deaths.
The pandemic has strained the situation, she said, as nurses have been needed to staff vaccination clinics. Casual backfill nurses have signed up for that duty, she said, along with former nurses coming out of retirement to help with that as well as COVID-19 testing.
The union has launched a campaign to raise public awareness of the nurses' plight, and letting people know of the trickle-down effects.
"If it's impacting [nurses] negatively, it's impacting residents," she said.