Nurses given voice in COVID-19 response

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This article was published 25/03/2021 (1372 days ago), so information in it may no longer be current.

A year after the pandemic began, and as Manitoba approaches a third wave of COVID-19 cases, front-line nurses are finally being asked for their input.

A working group, which involves nurses who work in the medical intensive care unit at Health Sciences Centre, was established in the past month and recently started to meet, the Free Press has confirmed.

It was prompted by an outpouring of concerns that patients weren’t getting quality care because the nursing team was desperately under-staffed during a surge of hospitalizations in the fall, and patient-to-nurse ratios were tripled, without nurses being consulted.

Meanwhile, other nurses who were untrained in the critical-care specialty were sent to help out, but didn’t have the necessary skills and were traumatized by the high-pressure work of constantly monitoring extremely ill patients.

Previously, critical care nurses at HSC, which has the highest number of ICU beds in Manitoba, weren’t involved in pandemic planning and felt their concerns weren’t being heard, said a nurse who has decades of experience.

She, like many other nurses who’ve taken the rare step of speaking to reporters during the pandemic, is afraid she’ll face repercussions if her identity becomes known. Some of her colleagues have quit; others have threatened to leave.

“They acknowledged that we never really had a voice in any planning,” the nurse said.

“Our staffing, our ratios, things that affected us directly, and we were never included in that conversation.”

The committee was formed in the wake of news reports about the working conditions in intensive care, and followed months of nurses voicing their concerns privately and in open letters to their employers.

At the height of the second wave in the fall and early winter, non-specialized “extender” nurses were assigned to the ICU, and experienced nurses were expected to use their help to look after up to three patients at a time, instead of just one. A one-to-one ratio is standard in critical care, but even as hospitalizations have recently declined, nurses in the unit are regularly assigned to two patients at a time.

If front-line nurses had been able to weigh in on the plans ahead of time, they could have warned against them and found another way to cope with the surge of COVID-19 patients, the ICU nurse says, pointing out their daily work requires them to manage life-or-death situations.

“We need more critical care nurses. And we know it’s not going to be (a ratio of) one to one. Sit down with us. Ask us what we think, what’s the solution, and we’ll come up with one,” she said.

“They left us in a really bad situation, and it didn’t have to be this bad.”

She hopes the situation will start to improve, but she’s bracing for a third wave.

Management has received nurses’ feedback about the need to improve unit orientation for redeployed nurses, provide mental health support for new and existing staff, and make “strategic changes” to the assignments of patients and nurses, a Shared Health spokeswoman confirmed in a statement.

When asked whether nurses had been invited to take part in pandemic planning over the past year, Shared Health said planning was done by critical-care leadership.

“It’s important to emphasize that detailed planning and preparations in response to COVID-19 have been ongoing for more than a year. This has included representatives from various areas of the health system, as well as clinical leaders and experts in critical care units. The critical care leadership team continues to monitor the provincial situation through daily huddles, tracking issues as they emerge and identifying solutions across units to share progress and maintain transparency with staff,” the statement said.

“We know this past year has placed unprecedented pressure on our health-care providers. We are deeply committed to working collaboratively with them to ensure we learn from their lived experiences and build upon them as opportunities to improve our ability to provide hiqh-quality, safe patient care.”

The Manitoba Nurses Union said nurses should have been consulted months ago.

“The time for a working group was at the onset of the pandemic. MNU has repeatedly said that nurses should need to be a part of the discussions before the crisis hits — not months after. Burning out a precious resource such as ICU nurses should alarm everyone who cares about health care.”

NDP health critic Uzoma Asagwara, a former nurse, has been hearing from nurses for months that they are burnt out and patient safety is at risk.

“We must listen to these front-line service professionals, who are experts in what they do, and implement their recommendations,” Asagwara said.

On Thursday, there were 30 Manitobans in intensive care, roughly half of the patient volume ICUs had near the peak of the second wave.

katie.may@freepress.mb.ca

Twitter: @thatkatiemay