Covid-19: Ontario hospitals close wards as nursing shortage bites
BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1917 (Published 01 August 2022) Cite this as: BMJ 2022;378:o1917
At least 14 hospitals in Canada’s most populous province are operating without key services this weekend as exhausted and depleted nursing staff struggle to cope with a surge in patients with covid-19.
The closures include the intensive care unit at Bowmanville’s hospital and emergency departments at Wingham and Listowel. Hospitals in Alexandria, Brampton, Clinton, and Perth have also shut their emergency departments at times in recent weeks.
“This decision was not made lightly,” a spokeswoman for the Bowmanville hospital told CTV News, explaining that intensive care patients would be transferred to Ajax Pickering and Oshawa hospitals. “We recognise the impact of this temporary relocation on patients and their families.”
Toronto’s University Health Network revealed this week that the emergency department of Toronto Western Hospital was so understaffed last weekend that nursing students were called in.
The network, which also runs the city’s largest hospital, Toronto General, has put out an “urgent” call for overtime volunteers this long weekend, offering at least CAN$50 an hour. “We will not be safely able to operate the Toronto Western Hospital emergency department if we are unable to fill nursing shifts this weekend,” said a memo sent to University Health Network staff. “I am aware it is an extra burden to ask for volunteers once again. In the last wave of covid our physicians, residents, and fellows stepped up several times to do so.”
A new peak
Ontario is at the peak of its seventh wave of the pandemic, according to public health authorities. Many health workers are sick or isolating, while others have taken long deferred vacations.
But retaining nurses is also becoming a problem, as burnout and low pay have brought a crisis of morale. “The working environment in hospitals at the moment is terribly tense,” Michael Hurley, president of the Ontario Council of Hospital Unions, told Global News.
A survey released last month by Statistics Canada found that nurses were the health workers most likely to want to change jobs, with 24.4% saying they intended to leave the profession within three years.1
Toronto’s University Health Network said in a statement that beyond the current short term fixes, it is “focused on longer term solutions, including international recruitment, training and deployment of clinical supports, and digital health solutions.”
The provincial government has said it is considering offering lump sum bonuses for nurses who work in underserved areas. Unions are urging the government to speed the applications of about 14 000 foreign trained registered nurses who live in the province but cannot yet work there. They also seek the repeal of Bill 124, a 2019 law that caps public sector wage increases at 1% a year.2 Premier of Ontario Doug Ford has said he will take inflation into account in upcoming pay negotiations.
The shortages have been hitting rural hospitals for months, Ontario Nurses’ Association President Cathryn Hoy told Toronto CityNews.
“Long weekends always have increased visits to emergency rooms, so there’ll be further staffing problems, further burnout problems,” she said.
The retention problem is “terrible, it’s worse than ever,” said Hoy. “I hear they’re retiring. I hear they’re just waiting for their American licences to come through. I hear they’re quitting. I hear they’re applying for post-graduate programmes. They are leaving.”
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