Nfld. & Labrador·CBC Investigates

As N.L. nurses leave full-time jobs, province calls in costly private agencies

Nurses in Newfoundland and Labrador are leaving the profession at a high rate, and two nurses who work in the system are breaking ranks to say why the current system is no longer working.

RNs Niki Parsons and Lauren Byrne describe overworked hospitals

N.L. fills nursing gaps with pricey, private agencies

11 days ago
Duration 2:13
Many nurses in Newfoundland and Labrador have left full-time jobs and the province is filling the staffing gap with nurses from costly private agencies, a move some say is not sustainable.

Lauren Byrne's daughter cried with joy the day her mom came home and announced she was no longer a full-time, permanent nurse in rural Newfoundland. 

After 13 years dressing wounds, caring for patients, consoling families and missing out on her own life, Byrne decided to forgo her pension and permanent career.

Being a casual employee meant she could be home for Christmas and New Year's. Go to birthday parties. And keep promises. 

"It's a lot of, you know, 'I'm working tonight and tomorrow is the last day of school and I'm going to come home and we'll take pictures,'" Byrne said in a recent interview.

Registered nurse Lauren Byrne is still working in the same rural hospital but has decided to take on casual employment to better balance her home life and work. (Paul Pickett/CBC)

"And then the next morning comes and there's a sick call and there's nobody to fill that spot."

Nurses in Newfoundland and Labrador are leaving the profession at a rapid rate, with more than 600 current vacancies and another 900 nurses able to retire. Byrne and another registered nurse are speaking publicly on why they believe the current system is no longer working.

The labour shortage in health care has left not only the province, but also the country, grappling with a dwindling number of nurses, leading to governments and health agencies to rely on a much more expensive option: travel nurses.

But the union that represents nurses in Newfoundland and Labrador says it is a dangerous precedent to set and will cost taxpayers more in the long run. Its leader is continuing to call for swift changes to mitigate disaster. 

It follows a Statistics Canada report in June on the labour demand in the national health-care system that showed there are double the number of vacancies in the health-care and social-assistance sectors this year than there were two years ago.

Nurse Niki Parsons is wearing a mask in the foreground with a patient in a bed in the background.
Niki Parsons, a longtime nurse in rural Newfoundland, says her profession is in crisis, and she's speaking out so the public knows the realities of the situation. (Registered Nurses' Union NL)

Niki Parsons never dreamed of retiring, but now it's a regular thought. 

But retirement will be in name only, she predicts.

"We had four nurses retire two years ago. They retired on a Friday and they're back to work on Monday," said Parsons, who works as a registered nurse in rural Newfoundland. 

Parsons worked through some of the most tumultuous times in the 1990s, when nurses and government were at loggerheads over staffing and pay. 

But nothing, she says, can compare to what she is seeing now: a workplace in constant crisis management, where being short-staffed is the norm.

Annual leave denied, nurses burning out

"It makes me angry that I can't go in and provide the level of care that I know my patients want and expect," Parsons said.

"And it makes me angry that there's nowhere for me to turn because it's almost so commonplace now."

Parsons said it's not only nurses who are short-staffed. She said her hospital is routinely down porters, licensed practical nurses, personal-care attendants and secretaries — all crucial jobs that keep the health-care system afloat. 

But working short isn't possible in an emergency room, says Lauren Byrne.

"We don't know what's coming in. So we're having to work Christmas and New Year's. You ask for a day off six months in advance, but there's nobody to take that day," Byrne said.

A nurse places an oxygen mask over a patient's face as the woman lies on a hospital bed.
Parsons says she is speaking publicly so patients know nurses are trying the best they can with the resources they have. (Registered Nurses' Union NL)

A survey conducted in March by the provincial government and nurses' union found that 90 per cent of registered nurses and nurse practitioners experience burnout. Sixteen per cent of nurses indicated they are considering leaving the profession for good. 

Half of all registered nurses are considering resigning their position to go casual.

Byrne is one of them.

"I still love the people I work with, I still love the job, and I just need it to have more autonomy over my own schedule and my own life," she said.

"I will work casual and I will put money away for my own pension, but I can schedule my own shifts in and I'm not obligated to work a certain amount of shifts."

'A slippery slope'

One of the short-term solutions that's being used is private agencies that pay nurses a higher rate to travel to hospitals and facilities across the country to fill a need.

The use of agency or travel nurses is rising across Canada, according to both provincial and national nurses' unions. Agency nurses are ultimately paid with public funds, even though they work for private companies.

This is public money for a publicly funded health care system being spent on private industry- Yvette Coffey

CBC News requested data from all four provincial health authorities on the use of travel nurses this year from Jan. 1 to June 30.

Central Health said it has hired 46 travel nurses, some of whom have completed multiple stints with the health authority. In an email, a spokesperson said $410,516 has been spent to date. 

Eastern Health began using private nurses in May and has used 14 nurses. The average cost per 12-hour day worked, which varies, depending on the area of assignment, is about $1,100. The health authority did not provide the total costs by deadline. 

In the Labrador-Grenfell Health region 46 travel nurses have worked, at a total cost of $1,085,788.

Western Health said it had not used any travel nurses to date. However, a spokesperson later confirmed that the health authority signed a contract to bring agency nurses into its facilities but the nurses have not started work yet. 

Byrne's daughter dressed up like her mom for career day at her school in early 2020. (Submitted by Lauren Byrne)

"This is public money for a publicly funded health-care system being spent on private industry," said Yvette Coffey, president of the Registered Nurses' Union of Newfoundland and Labrador. 

"And it's a short-term fix. It's a slippery slope because our members want flexibility. Our members want time off. And they see this. And we have people leaving our system now to join agencies in other provinces."

Overworked N.L. nurse quits permanent job

14 days ago
Duration 2:12
Lauren Byrne quit her full-time job as an emergency room nurse in Newfoundland and Labrador because of a crushing workload and went casual, something her nursing colleagues are also considering.

Last week, the Ontario Council of Hospital Unions and the SEIU Healthcare union called for a ban on the use of travel agency nurses in that province. 

Coffey wants the provincial government to explain what would happen if nurses at the health authorities left their public sector jobs to return later with a private agency — such was the case at a Manitoba hospital recently, she said. 

'Mandated shifts should be illegal'

Coffey's pleas are being echoed on a national level by Linda Silas, president of the Canadian Federation of Nurses Unions.

Silas said nurses across Canada are holding on by a thread, and provinces and territories shouldn't bear the brunt alone. 

"Nobody will solve this crisis by themselves and there won't be one miracle solution. It'll have to be multifaceted," Silas said. 

"So right now we're not seeing much from the federal government, but we're working with all the premiers to put pressure on the federal government to come to the health human resource table."

Linda Silas, president of the Canadian Federation of Nurses Unions, leads members in a solidarity chant outside the Fredericton Convention Centre in February 2020. (Jennifer Sweet/CBC)

Silas said the focus has to be on beefing up the public health sector with nurses who are already out there.

"We have to really ask nurses to return to the workforce because you have to understand that a lot of nurses are retired early or went to agencies, for example, and then work on a solid recruitment program."

Focus on recruitment and retention

Tom Osborne, Newfoundland and Labrador's health minister, said last week that there would be an upcoming announcement to help address the nursing crisis.

He did not get into the specifics. 

However, a nursing think-tank held in the spring resulted in a list of short-term solutions, including incentives for bringing retirees back, incentives to get casuals to take positions, and help with child care. 

Osborne said he doesn't want the public sector to rely on travel nurses.

Provincial Health Minister Tom Osborne acknowledges that using travel agency nurses should not be the solution to the staffing crisis. (Darryl Murphy/CBC)

"I respect and appreciate the health authorities using creative approaches to fill the gaps. However, we need to recruit. We need to retain," Osborne said.

"We need public servants within this province filling those roles. And that is a priority for me."

But even with the nursing sector on shaky ground, both Parsons and Byrne say they would do it all over again because of their passion for the job.

They hope with the right relief, incentives and planning will be the medicine it needs. 

Read more from CBC Newfoundland and Labrador

ABOUT THE AUTHOR

Ariana Kelland

Investigative reporter

Ariana Kelland is a reporter with the CBC Newfoundland and Labrador bureau in St. John's. She is working as a member of CBC's Atlantic Investigative Unit.

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