The NWT’s health authority promised an “open forum” for staff as managers try to solve a crisis of morale that has been building in the territory’s health workforce for years.
Staff will also receive extra cash to cover certain childcare costs, backdated to April 2021. Talks over the provision of “additional compensation” to front-line health workers are ongoing, the territorial government said.
Workers have for months maintained that working conditions and managerial approaches in the NWT, particularly at Yellowknife’s hospital, are compounding what is already a nationwide shortage of staff.
The obstetrics unit at the city’s Stanton Territorial Hospital has suspended most services over a lack of nurses, forcing expecting families to head south to Alberta until at least February, a move costing the health authority hundreds of thousands of dollars.
On Tuesday, Green said she had heard “complex and wide-ranging” concerns from healthcare workers that “require action across the system.”
The minister said fatigue, burnout, and “lagging morale” were all clearly serious issues that had in many cases “been building over time.”
“Each concern raised is important. Some will take longer to deal with than others, but I want to assure staff that they are being heard and I will continue to listen to their feedback,” Green said in a news release.
“Culture change is something that everyone owns, and everyone must participate in. There are fundamental pieces that need to be in place to support this change, including adequate staffing levels. As we approach the new year, this work will be undertaken with the highest priority.”
One of the more tangible developments announced on Tuesday came within the obstetrics unit at Stanton, where only an emergency service is currently being offered.
Last month, as the unit suspended regular labour and delivery services, people with direct experience described to Cabin Radio an environment where inadequate staffing routinely placed patients and nurses in stressful, dangerous situations.
“I’ve been in the most terrifying situations of my life there,” one person said, asking not to be named for fear of reprisals from management.
In particular, people interviewed by Cabin Radio said Stanton’s practice of scheduling three nurses per shift left employees trying to supervise multiple labours at once.
“We’ve been asking since I started to staff four nurses there. The ability to provide safe and appropriate care at the current level is basically impossible,” the same person said.
On Tuesday, Green said her government would not yet change staffing per shift but would increase the overall number of positions on the unit. The exact increase was not given.
“This will not change the current staffing level on each shift but should allow for more stability and increase the flexibility of staffing options, including the addition of part-time positions,” employees were told in an update by email on December 17.
“Of course, the impact of this change will depend on the successful recruitment of staff.”
A perception of inflexibility regarding part-time work – seen as a way for shift workers to balance their commitments when they have young children – was another concern raised to Cabin Radio by nurses.
A broader review will now take place in which managers “look at workload and staffing models,” staff were told in the same email, meaning a switch to four nurses per obstetrics shift may yet occur.
The hospital’s leave policy is also being reviewed. Nurses have for years complained bitterly that even the simplest leave request can be cancelled because of “operational requirements,” even when no stress on a particular unit is immediately apparent, and some staff wait many months to finally be allowed time off.
“Management just keeps using ‘operational requirements.’ When they use those words, there’s not a damned thing anyone can do, even the union,” the spouse of a worker at an NWT health clinic wrote to Cabin Radio by email on Monday.
‘What is so appealing?’
Last week, a nurse who had not previously contacted Cabin Radio did so to say they intended to leave Stanton as they could no longer bear what they characterized as “incompetent management.”
“This hospital has done nothing but suck out the love I’ve had for my profession,” the nurse wrote.
“I’ve had to apply in another province to get a job that would allow me to have a healthy work-life balance and actually afford to live.
“They charge us $80 a month to plug our cars in during the winter months. We can’t even make our own schedules, a strategy used by many hospitals to attract and retain nurses. What exactly is so appealing about working for Stanton?”
The health authority insists it is trying to change that perception. Writing to staff, health authority boss Kim Riles said management would “deliver a series of face-to-face opportunities for staff across the organization to meet with leadership in an open forum.”
Front-line workers who had to be at work but faced extra childcare costs because of school or daycare closures will now be offered a reimbursement backdated to April 1, 2021.
And Riles said she had “advanced a series of recommendations that advocate for some form of additional compensation for health and social services staff, specifically those on the front line, to enhance recruitment and retention efforts.”
Discussion of whether that compensation is offered now rests with the departments of health and finance.
“I want to thank the staff working on the front lines. I want them to know I recognize and appreciate their efforts; we are all committed to making change,” said Green.
“We recognize that not all the issues brought forward have been fully addressed, and this work will take time. We are working hard to build a health and social services system in which staff feel valued and heard.”