Work is underway to remedy the root causes of critical care staff shortages at Stanton Territorial Hospital, a spokesperson for the NWT Health and Social Services Authority (NTHSSA) said on Aug. 19.
The staffing issues have left Stanton with only two critical care beds and two lower acuity (moderate case) beds, from the regular four critical care beds, a situation that could last until the end of September, Health Minister Julie Green said on Aug. 10.
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As a result, more critical care patients than usual might be transferred to the south.
“This is being driven by a combination of difficulties in recruitment, a highly competitive job market for healthcare professionals and vacancies caused by departures or retirements,” Green said.
But NTHSSA spokesperson David Maguire that said even before the shortages were announced on Aug. 10, staff numbers were boosted to cope with potential higher pressure on emergency departments from the reduced ICU capacity.
“Specifically at Stanton, emergency department staffing levels were increased at the beginning of the pandemic and maintained at a higher than usual level throughout to maintain preparedness for pandemic response activities,” he said.
Surveys to gauge morale
In an effort to address issues causing departures of healthcare staff, Maguire said the the GNWT is working on formalized exit and engagement surveys to glean information for “broader system-level responses to this issue.”
The surveys will seek to identify specific circumstances affecting the morale of nursing staff across the NWT.
“To complete this work we have partnered with the Registered Nurses Association of the NWT and Nunavut and will be conducting engagement surveys with all nursing staff and licensed practical nurse (LPN)’s across the territory over the coming weeks,” Maguire explained. “In addition to the engagement surveys we will be working to conduct exit interviews with registered nurses, nurse practitioners and LPN’s who have exited the system as early as January 2021 with a goal of determining what factors may contribute to health staff departures. Letters are being sent out now to seek participants for the exit survey.”
Improving recruitment
Turning to the issue of difficulties in recruitment in a highly competitive job market, Maguire said the NTHSSA is promoting through hiring campaigns the quality of work-life balance in the NWT, and its unique features such as access to nature and culture.
In partnership with the University of Alberta, the NWT runs its Northern Family Medicine residency program training doctors in the territory with the aim that they will stay and work here. The program currently has four residents, with two new spots open each year.
“Over the longer term we hope this will be a way to train and retain physicians that are either from the NWT or who are passionate about living and working here,” Maguire said.
Casual and locum healthcare staff are brought in at times of recruitment gaps.
“The health authorities work hard to monitor staffing and shift staff resources within the system where possible. For example, it is not uncommon for a doctor from Yellowknife to cover shifts in Hay River, or a nurse from Fort Simpson to travel to a smaller community to provide coverage when needed,” Maguire said.
‘Premature’ short-term hiring bid
A recent job advertisement that was sent out in an email from Travel Nurse Canada appears to show the NTHSSA is seeking to close ICU staffing gaps in August.
The posting lists ICU nursing roles in the NWT for the periods of Aug. 16 to Sept. 8 and Aug. 18 to Sept. 5.
The positions pay $72 to $75 per hour and accommodations are provided. The posting states that NTHSSA employees aren’t eligible for the roles.
Maguire said no agency nurses have been hired yet and that the posting was “put out prematurely” and has been withdrawn.
Under a memorandum of understanding between the GNWT and the Union of Northern Workers (UNW), positions advertised on sites like Travel Nurse Canada - known as agency jobs – can be hired only in specific circumstances.
When there aren’t enough qualified staff to manage a surge of COVID-19 cases, and when insufficient staffing or staff resignations with less than two weeks notice leads to possible service reductions or health unit closures, hiring agency workers is permitted, the memorandum says.
NWT still has higher wages than south
UNW President Todd Parsons said the union has seen the advertisement and was informed it has been pulled.
Parsons added that the the union is aware of the NTHSSA staff shortages and said its position is that “any steps taken by (the) employer to address them must see similar compensation as work performed by our members, and it must be in consultation with the Union.”
The wage rates in the Travel Nurse Canada email are significantly higher than the base rates for NTHSSA nurses.
A full-time UNW nurse for the 2020-2021 fiscal year working at least 1,600 hours in the year earns between $47.68 and $59.96 per hour. Factoring in other earnings such as Northern Allowance and paid leave adds $9.96 to $11.90; and pension, health/dental and disability benefits add another $10.57 to $12.63, for a total hourly rate of $68.21 to $81.49.
“The listed hourly rate – whatever it may be - for the agency nurse may be higher on the surface but those roles are temporary contracts that don’t often include other benefits (dental, paid leave, pension, etc),” Maguire pointed out.
Base rates in the southern provinces are all lower than in the NWT by a sizable range, according to a November 2020 report from the Canadian Federation of Nurses Unions.
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The lowest wage for registered nurses is in Quebec, which goes from $24.08 to $39 an hour. The highest is in Alta, where the range $36.86 to $48.37 an hour.