ICU nurse to retire in response to changes to Winnipeg's health care system

A Winnipeg nurse says she is retiring because she says she can’t continue to work for the Winnipeg Regional Health Authority after sweeping changes were brought in last fall.

Nurse agrees with ICU consolidation plan, doesn't agree with way it's rolling out

The nurse says it's no longer the type of nursing she wants to deliver at one of the community ICUs slated to close. (CBC)

A Winnipeg nurse says she is retiring because she can't continue to work under the Winnipeg Regional Health Authority after sweeping changes were brought in last fall. 

The registered nurse, whom the CBC has agreed not to name, has been working at a community hospital intensive care unit that is slated to close as part of the next round of changes. She plans to leave when the ICU closes, but she doesn't know yet when that will be.

Under the plan, beds from each unit have been or will be absorbed by the St. Boniface Hospital, Grace Hospital and Health Sciences Centre. The nurse says while she supports the plan of ICU consolidation, she does not agree with the way the health authority has executed it, adding it's resulted in a loss of co-workers and a lapse in patient care.

We want to do our job properly. Not just hanging on by the skin of our teeth-  ICU nurse

"The changes have absolutely made me decide that I need to leave, because it's not working the way I'm accustomed to doing my job and to taking care of patients," she said. 

She believes the changes to Manitoba's health system are "not about the patient experience. I think it's about the numbers."

She said since the changes were announced last spring, her specialized unit has lost 50 per cent of its nurses and often operates short-staffed, or with a float nurse. The nurses are rushed, miss their breaks, and are constantly in fear that something bad will happen to a patient, she said.

"You just can't do your job properly," she said. 

"It's not a healthy work environment. People are being mandated and working overtime and picking up extra shifts and it's still not quite enough to keep the place staffed."

Since the beginning, she said, there has been a lack of transparency and communication from the WRHA about the changes. She points to the process at the Victoria General ICU, which closed last year, and says she and her co-workers remain in the dark about when the same will happen to Concordia and Seven Oaks — Concordia has five ICU beds open; Seven Oaks has seven.

"We've heard from anywhere from spring to fall to early 2019 our unit will be closing down," she said. "What kind of a plan is that?"
Seven Oaks Hospital in the north, Concordia Hospital in the northeast and Victoria General Hospital in the south will join Victoria General as community hospitals with no emergency rooms once the next phase of the health system changes take place.

Some of her co-workers have gone to other hospitals, others left critical care entirely; a couple even left the province in search of job security, she said. They were told they would have the option of working in the units of the bigger hospitals when their units close, but which hospitals, and when, remains unknown.

"People have left for a bunch of different reasons but a lot of it is the autonomy, of saying 'I want to work here; I don't want to work over there.'"

'Toxic' work environment

"There isn't a plan as to what they're going to do in the interim while our staff is bleeding out," she said, adding the feedback from the health authority has been to do the best they can. 

"None of us wants to do the best we can. We want to do the best for the patients and that doesn't seem to be a huge concern," she said. "We want to do our job properly. Not just hanging on by the skin-of-our-teeth kind of thing."

Fewer staff hasn't necessarily resulted in an increase in critical incidents, she said, however it has resulted in her and co-workers having less time with patients and families. 

"The work environment is quite toxic because of the uncertainty of the changes that are coming," she said.

"People are feeling we're on a sinking ship."

The Manitoba Nurses' Union says tensions are particularly high among staff at Concordia and Seven Oaks hospitals because of the prolonged uncertainty, and says this nurse is not the only one who has talked about leaving. 

'Morale is suffering': Nurses' union

"It's disturbing. Certainly we're hearing that morale is suffering across the whole system, just basically related to the chaos, the disruption related to the deletions, the changes," said Sandi Mowat, president of the Manitoba Nurses' Union.
ICU is a stressful, highly specialized area of the hospital to work, according to Sandi Mowat with the Manitoba Nurses Union. (Kelly Bennett/CBC)

She said the union is aware of the "staffing issues" at this particular ICU unit, as well as others, she said, which hospitals try to manage by closing beds. She says it's 'fairly unsafe' to run an ICU unit under baseline nursing numbers.

"You have this unit that not everybody can work on, you have these specialized people that need to work there, so you know, if there's no one to work that day, that's a problem," she said. 

The ICU is a highly specialized area, she said; the environment is stressful, the patients are very ill and it can be difficult to recruit and retain staff. A 24-week course is required in order to work there. She says this nurse's decision to retire is "concerning."

"We certainly can't afford to lose nurses and we certainly can't afford to lose a highly trained ICU nurse."

'I know it can be better': health minister

According to Lori Lamont, acting chief operations officer for the WRHA, plans for ICU consolidation have not changed since April 2017, but the timing for Phase 2 roll-out is still being worked out to ensure it's done safely. 

"Nurses will not know exactly when these changes will be made but as was done with Phase 1, information regarding the change and the positions available at the HSC and St. B will be provided well in advance of the actual change," she said in a statement.

A Winnipeg nurse says she is retiring because she says she can’t continue to work for the Winnipeg Regional Health Authority after sweeping changes were brought in last fall. 2:09

She said when Concordia and Seven Oaks ICUs close, one bed will be added to St. Boniface and six to the Health Sciences Centre. She said once consolidation is complete, there will be a net loss of seven ICU beds across the system, from 72 ICU beds to 65. However, the acute coronary care unit at St. Boniface Hospital will expand from six to 10 beds, she added.

"Over the past 10 years, there have been challenges keeping all of the beds at the community hospitals fully staffed.   These units are small and even a relatively small number of vacancies caused by resignations or maternity leaves has resulted in temporary bed closures," she said, with regards to staffing issues at community ICUs. The WRHA will continue to offer ICU training biannually.

When asked about complaints from health care staff about lack of communication at a press conference last week, Health Minister Kelvin Goertzen said he takes "that criticism to heart," adding he recently met with 800 health-care professionals at a phone-in town hall meeting and heard some of the same feedback. He said he plans to have more of these meetings to improve the level of communication.

"It can never be perfect but I know it can be better. As a minister I take accountability for that," he said.

Getting out before Phase 2

The nurse plans to retire before the next round of changes. 

"It's really discouraging. We've had a great team, we've had a very positive work environment, and that has changed significantly,"she said.  

It will mean the loss of her career and her passion, but she said she feels she has no other choice. 

"It's already been taken away from me. This was not of my doing and I don't want to be a part of this new way of doing things. It doesn't interest me at all."

About the Author

Erin Brohman

Health reporter

Erin Brohman worked as a pediatric nurse at the Stollery Children Hospital in Edmonton, where she's from, then at the IWK Health Centre in Halifax. After graduating from King's College with a journalism degree, she took off to Yellowknife to work for CBC North. She remains a registered nurse in Alberta and continues to blend her passion for nursing and journalism at CBC Manitoba.