Focus on retention to encourage new nurses to come to FSJ
Nurses in Fort St. John rallied outside Fort St. John Hospital last Friday, to draw attention to the untenable and morally distressing conditions that are severely impacting health care in Northeastern BC.
From long-term care to acute care, nursing staffing levels are down approximately 50 percent at all times, according to information provided by front-line nursing staff to members of the BC Nurses Union.
“That means they’re pulling nurses from other areas, nurses from other floors to help cover wards that are shorter, more critical,” said Danette Thomsen of BCNUs northeast regional council.
Sometimes that means going on diversion, which is happening a lot in Tumbler Ridge, Chetwynd and Fort St. John, Thomsen said. The diversions at the FSJ Hospital have been in both the maternity ward and ER. The number of times these departments have been on diversion varies per week, said Thomsen, and happens more than people realize.
It’s not just nursing that creates conditions to make diversions necessary, sometimes it’s the lack of physicians.
“It’s been really worrisome for the nurses working in the maternity ward,” Thomsen said. “We all know how quickly things can go wrong with labouring moms so it’s a lot of moral distress.”
Over the past few decades, the communities in northeastern BC have grown, and much of that growth has been young families. The number of births in the area is up, and when Fort St. John is on diversion, labouring mothers are being sent to Dawson Creek, whose hospital is also short-staffed.
“It’s not like they’re being diverted across to another healthy hospital, you’re being diverted to another hospital that’s already struggling. Maybe they’re in the same situation but are being told they can’t go on diversion because there’s nowhere else.”
In addition, there is no maternity or obstetrical care at Fort Nelson Hospital, so maternity patients must travel to Fort St. John to give birth. The hope is that mothers will be out of Fort Nelson when they go into labour, but it’s not always possible to plan those babies’ arrival, Thomsen said.
In the community medical settings outside the hospital, patients are being deferred to a later time, and aren’t being seen because they are able to divert their clients to another day.
“The problem is that they’re never catching up and so then, the nurses are saying that those clients are ending up in the ER. Which is only a revolving door cycle,” she said.
If there was a walk-in clinic in Fort St. John, Thomsen says it could address a lot of the medical reasons that are sending residents to the ER, like ear infections. Due to the shortage of both nurses and physicians, a walk-in clinic just isn’t possible.
“We don’t want to discourage people from seeking treatment – that’s huge for our nursing staff. We’re all in nursing because we want to make a difference.”
Northern Health has been bringing in agency nurses to alleviate the shortage, but that brings its own problems. Although Thomsen says that local nurses are grateful for the agency nurses and the care they provide, it is a very expensive option.
Agency nurses are paid double the rate of local nurses, plus living expenses. Between 2019 and 2023, the BC government spent $146 million on agency nurses throughout the province, up from the $8.7 million spent in the 2018-2019 fiscal year.
Northern Health is looking into options to bring in more nurses and has started Go Health BC, which Thomsen describes as a travel nurse program.
“They actually belong to the health authority, so the hope is we’ll be able to attract some of the agency nurses to the Go Health program.” As employees of Northern Health, they will have collective agreement rights, be paid the same and would be more dedicated to the province of BC.
“I think it’s a great solution to that on-going issue.”
To effect any real change, Thomsen says that before decisions are made, we need to talk to the front lines, who are the ones doing the work. “They can give the solutions that they need. Each department is different, from the education to the equipment that they need.”
One thing that would help take the pressure off nursing staff, is to take away non-nursing duties, like making beds or answering the telephone. Bring in other people to assist, to do the non-nursing duties so that the nurses can focus on the care of the patients.
Retention of existing staff and keeping those new to the area are key to improving staffing levels in northeastern BC.
“Our focus needs to be on retention. Everybody always says recruitment and retention, but I have really been advocating to flip that – it’s about retention and recruitment,” she said. “If we cannot retain the nurses we have in our communities now, the new ones will just leave as well.”
Making healthcare a career people want to choose, and incentivizing young people who were born in the North to enter the program, would go a long way towards improving retention. Thomsen believes this is important because it’s the people from the North who are most likely to stay in northern communities.
Nursing students are finishing their educations with huge debt loads, up to $60,000 in debt depending on the program, said Thomsen. If nursing were a trade, students would be getting paid to complete their education like apprentices.
“Honestly, it’s time we looked at that stuff for nurses,” she said. “We need to be thinking about paying nurses to do an apprenticeship. We need to be making it more attractive – that’s a huge amount of debt load.”