Yellowknife nurses, at breaking point, complain to ministers

Nurses in Yellowknife have told NWT politicians they feel unsupported by senior management, morale is low, and they need “fair compensation” for their hazardous pandemic work environment.

Staff at Stanton Territorial Hospital have long complained of what they perceive to be poor management. Many have left their posts, a fact acknowledged by the NWT government when it backed a survey being launched to understand why people leave.

But the fall Covid-19 outbreak, in which dozens of people have been hospitalized, is understood to have pushed some nurses to the edge as operating hours lengthened and conditions worsened.

In a letter to ministers and MLAs, healthcare workers say southern provinces have provided extra compensation during the pandemic but the NWT’s health authority has not.

“During a time where most government employees were sent home to work, healthcare professionals did not have that option. When the pandemic began in March 2020, many healthcare professionals were recalled from their vacations. This lost vacation time was not returned to their leave banks,” the letter states.

“Existing vacations were cancelled and all new leave requests were denied due to ‘operational requirements.’ This caused great stress and exhaustion in healthcare professionals. The workplace was filled with frequent policy changes, shift changes, and redeployment. Staff members were left uncertain and worried about their ability to provide safe patient care.

“Staff members have also reported being required to use time from their personal sick leave bank when isolating due to becoming symptomatic after Covid-19 exposure at work. We propose that this should be considered ‘injury on duty’ and be paid as such.”

The five-page letter asks for the NWT government to:

• return lost vacation time;
• return personal sick time used for Covid-19;
• provide wage premiums when working in high-risk areas (e.g. intubating Covid-19 patients);
• institute a $4/hour wage increase retroactive to March 2020;
• provide retention bonuses to current staff;
• provide signing bonuses to recruit new staff; and
• clarify where federal Covid-19 funding has been allocated.

Staff signing the letter say they don’t know where federal funding designed to alleviate the pandemic’s effects on the healthcare system has gone.

“We have not received new equipment or compensation for the risk to our personal health,” they write.

The letter states Alberta, British Columbia, Ontario, Manitoba, Newfoundland and Labrador, Nova Scotia, Prince Edward Island, Quebec, and Saskatchewan have all agreed to lump-sum payments or hourly wage increases to act as hazard pay for front-line healthcare workers.

At least a dozen nurses said on Friday they were sending the letter to all 19 MLAs. Others were expected to follow suit.

The NWT’s health authority said in a statement it had no immediate comment.

“However, we take the concerns of our staff seriously and will review the issues raised in the letter,” spokesperson Jack Miltenberger wrote.

The nurses tell MLAs: “Staff morale is low and management has not adequately implemented solutions. Please advocate for the healthcare workers to receive fair compensation for the many hazardous working conditions we have been faced with during this pandemic.”

‘Every time I come in, I cry’

Nurses have described a stressful and unsustainable environment at Stanton Territorial Hospital for most of the year, even before the fall outbreak arrived.

In July, one nurse talked of being allowed two days’ vacation in early summer and then being told they could receive no further time off until at least October.

That nurse said staff were resigning their permanent positions and becoming relief nurses – meaning they can be hired back as needed but retain control of their schedule – in order to escape an environment where many staff are virtually never given the leave dates they request. At the time, there were no active Covid-19 cases in the NWT.

“People are taking stress leave,” the nurse said in July. “They are asking to take important time off – to take just one day off – and they’re not getting it. Then they’re going to a doctor and getting five weeks off, to say screw you.

“This is not good practice. People say they can’t even come near the building. They’ve worked more than 20 years, they’ve never taken a sick day, and they ask for one day off and they can’t get it. One nurse told me: ‘Every time I come in, I start to cry. So I’m just going home.'”

In recent months, the NWT’s registered nurses’ association has been planning a survey in part to understand why the territory struggles to retain nurses.

“Anecdotally, there’s this sense that people are planning to leave,” Denise Bowen, executive director of the Registered Nurses Association of the Northwest Territories and Nunavut, said in August.

“There are nurses who are feeling particularly disappointed, particularly upset about policies that have been implemented regarding Covid,” Bowen said, referring in part to earlier news reports.

The association’s survey was planned for September and October. After this report was first published, the association said it had chosen to delay the survey until later in the year. Once it is complete, the NWT government will receive a report with its findings.

It’s the first time such a survey has been carried out since 2005.

Stress ‘rained down’

In the past two months, the NWT’s Covid-19 situation has worsened significantly.

From the start of September to the end of October, the territory reported more than 1,400 Covid-19 cases. In the same period, 49 people with Covid-19 required hospital treatment.

Only now is the situation subsiding. As of Friday there were 47 active Covid-19 cases in the NWT, down from a daily high of 456 over Thanksgiving.

On Friday, a group of nurses signing the letter to ministers spoke with Cabin Radio. All asked for their identity and even their units to be suppressed as they fear retribution from hospital senior management. When staff raised concerns with reporters in the past, internal investigations attempted to unearth who had spoken.

“Any time someone makes a complaint, there’s an active investigation to discipline them,” one nurse said.

A second nurse told Cabin Radio: “This whole pandemic, we’ve been told how valued we are and how important we are. To know other provinces and territories have been given extra money for the work they’re doing and risk they’re taking, as a way to be thanked, and knowing the government here hasn’t done that, feels like a bit of a slap in the face.

“We’ve been really privileged in the North, not being super-exposed to Covid in the first few waves. But when this wave hit us we realized how small a hospital we are, how much of an area we service, and how things can quickly go wrong for us here.

“There was no backup. That was the straw that broke our backs. It was tiring and frustrating before, but we didn’t have it at that level. When the last wave hit, it showed us what’s expected of us and what’s not being given back.”

Nurses say they are expected to risk contracting Covid-19 daily and, more than that, must risk bringing the virus home to their loved ones.

Some say more than 18 months into the pandemic, provision of personal protective equipment remains inadequate with fresh masks not always readily available.

“It’s been a huge stress on all of us,” said a third nurse. “Just the risk.”

The first nurse said: “I didn’t see my family for six months because I was terrified I was going to bring Covid home and give it to them.

“I didn’t really see any attempts to help us and say yes, you deserve PPE. You should have it.

“The stress, it just rained down on our heads every day. Every day, they changed their policies and procedures. I know this is happening all across Canada, this is not new to us or specific to us. But everywhere else, they got reimbursed as a thank-you. What the nurses here got was a sign on the fence across from the hospital.

“And the sign is great. But it doesn’t feel like we’ve been appreciated by the government or by the hospital management.”

Minister has ‘questions’ about workplace environment

An NWT public health nurse earns between $94,380 and $112,730 annually, according to information published by the territorial government. In August, the CBC reported resident family doctors in the NWT received a base salary of $213,748 to $340,368 annually, “plus up to another $100,000 in recruitment and retention bonuses, plus other benefits.” Some specialists can earn between $7,045 and $9,790 per week to backfill in the territory.

In August, NWT health minister Julie Green told Cabin Radio the pay offered to northern healthcare workers was in line with that paid elsewhere in the country.

“Those are standard compensation rates,” said Green at the time. “So you could come to the NWT and earn that money, or you could get a job in another location and earn that money.

“We need to make ourselves different. What do we have to offer that no other jurisdiction has to offer, in order to attract both nurses and doctors? They’re in very high demand and there’s stiff competition. So you know, in addition to paying the standard rates for service, I think we need to promote that the NWT is a great place to live and practise your medical profession.”

Asked if the NWT was creating the good working environment she described, the minister acknowledged she was aware of concern among staff.

“We have questions about that,” Green said in August, pointing to the nurses’ association survey and other work being done to understand why people leave healthcare roles in the NWT.

“I do recognize that we ask a tremendous amount from our healthcare professionals,” the minister told Cabin Radio.

“Many of them have been with us since the move to the new hospital, which was very labour-intensive. And the startup was rough. I know people worked a lot of extra hours and didn’t get enough vacation time.

“And we rolled right from that into Covid and the same situation again. This business of being short-staffed means that it’s harder and harder to grant people their vacation requests and time-off requests. And it just ends up leading to more and more exhaustion and turnover.

“We seem to be caught in a vicious cycle where, if we could increase our workforce, we would have greater job satisfaction in terms of vacation time and time off to offer our existing staff. So my message to them is we’re making every effort to bring more nurses on, so that people who have worked straight through can take the time off that they need, that we want them to have.

“There’s no point in exhausting people to the point where they feel their only option is to quit in order to get relief.”

Bosses say they are listening

Kim Riles – the NWT health authority’s new chief executive and a former chief operating officer at Stanton – said a national nursing shortage had led to higher-than-normal vacancy rates at the hospital this year.

In August, Riles told Cabin Radio she had held meetings to understand the sources of staff frustration. “Access to leave is a key concern,” she acknowledged.

“In terms of how I sympathize with nurses who want access to leave, I have a huge amount of sympathy for that,” said Riles at the time, before the fall Covid-19 outbreak.

“There have been a number of factors that have impacted people’s ability to have time off, people’s ability to connect with their families, to just rest and recharge. So I think it’s immensely important for us to hear that and to be able to decide how that impacts our ability to be flexible as we move forward.

“We have to balance our obligations to the public – for continuity of services, access to care and programs that we provide – with needing to hear from our staff that they’re tired, that they need their time off. Hearing this feedback is important and I just want to assure people that we are listening.”

Two months later, the nurses’ letter to MLAs concludes: “We have brought our concerns up with multiple levels of management within the NTHSSA [the NWT’s health authority]. Our requests for the return of vacation and sick leave along with the introduction of hazard pay for Covid-19 have not been addressed. We have not been given clear reasons for the lack of these benefits.

“Healthcare workers have worked tirelessly throughout the Covid-19 pandemic and have not been adequately compensated for their sacrifices. Many staff members have put their personal health at risk and are burnt out.

“Healthcare workers are leaving their professions at an alarming rate, and every area in the NTHSSA has multiple vacancies. The NTHSSA is not supporting us.”

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Correction: November 6, 2021 – 12:23 MT. This report initially stated a survey of NWT healthcare workers had been taking place in September and October. After publication, the nurses’ association responsible for the survey said it had in fact chosen to delay the survey, which is now set to begin this month.