The union representing registered nurses in Newfoundland and Labrador is fired up and speaking out following controversial comments from the deputy minister of health.
Union president Debbie Forward is accusing the government of bad faith bargaining and outright betrayal of the more than 5,500 RNs in the province.
"Our members today are feeling like they've been slapped in the face by this government. And quite frankly they're angry and I'm angry at the comments that were made," Forward said in an interview.
Nurses not productive
Meanwhile, deputy health minister John Abbott, the man who caused the furor by saying things like, "We don't have as productive of a nursing workforce as we should," is softening his position.
In a statement released Friday, Abbot said his comments were not intended to reflect government policy.
"As such, I apologize for any heightened concern my remarks may have caused," he wrote.
It all stems from a population symposium at Memorial University recently, in which Abbott was a panellist.
He made a series of strong comments about the challenges with health care in the province, and later agreed to an interview with CBC News.
In very candid terms, Abbott suggested there are too many nurses and doctors in the province, that every aspect of the system will undergo significant change in the coming years, and that the health care, at $3 billion annually, was simply unaffordable.
"We have put in a lot of services and facilities that we no longer need and no longer can afford," he said.
Replacing RNs with LPNs
When asked about a new campaign by the nurses union to lobby for more RNs, Abbott said he's reached a different conclusion. He said the province already has far more nurses than the national average, and that sick leave rates were unacceptably high.
"I think to say we need more nurses in light of that [I] would suggest probably isn't the answer," he said, adding that he believes there are opportunities to replace RNs with licensed practical nurses, who have less training and are paid less.
It's rare that a deputy minister would agree to an interview, and Abbott's candour raised eyebrows, especially with the nurses' union.
"Essentially this government has told registered nurses that they're not working hard enough. That they really don't have a workload issue. That there are too many of them in this province. That they're going to be replaced by lesser-trained workers in the future," said Forward.
Delicate bargaining process
The tension comes at a delicate time, with the province and the nurses union engaged in collective bargaining.
Forward said the reaction from her members was swift and widespread.
"My members are ringing my phone off the hook. I'm getting email after email saying, 'What is this government up to? How can we trust them? How can we trust that they're going to do anything positive for health care?" she said.
'Essentially this government has told registered nurses that they're not working hard enough.' - Debbie Forward
Forward said it appears government doesn't understand the challenging circumstances faced by RNs.
She said nurses are struggling to provide good quality care because of a shortage of staff, which is resulting in difficult working conditions and heightened stress levels.
This, she said, is contributing to the high rates of sick leave.
"If they could go to work with reasonable workloads, then they probably wouldn't need to call in sick tomorrow because they can't face another shift like the shift they worked today," Forward said.
Twenty-four-hour shifts are still occurring, she added, and there were more than 1,200 shifts last year where a nurse worked more than 16 hours.
Forward said the staffing shortage is so acute that it's common for nurses to be denied a day of leave, even if the request is made six months in advance.
She said there's a desperate need for more nurses in order to reduce sick-leave rates, improve care and actually save money for the government.
"We've given them all that information, and yet in the face of all that, they have the audacity to come out and say we have too many of you. Really? They're not listening to people who are on the ground," Forward said.
As for Newfoundland and Labrador's larger than average nursing workforce, Forward said that's a consequence of geography, and a largely unhealthy population.