Forgotten, undervalued and unsupported

Opinion

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This article was published 17/03/2022 (917 days ago), so information in it may no longer be current.

MANITOBA and many other provinces are lifting COVID-19 restrictions, but debates continue about how to prevent increasing cases, severe outcomes, hospitalization and death. These decisions will have the greatest impact on health-care workers, yet somehow their voices have been forgotten.

Imagine you’re a new nurse. You did your final practicum mid-pandemic in a rural Manitoba hospital, and you were hired immediately. Orientation? No time. Suddenly, you’re in a leadership position you don’t feel prepared for. Will your lack of experience put patients at risk?

You’re staying away from family and friends so you don’t bring COVID-19 home to them. Frustrated patients are swearing and spitting at you. You try to understand where they’re coming from, and you keep providing care. There’s no time for breaks, and you stay late to sit with people who cannot see their families.

You’re frequently forced to work overtime because there aren’t enough staff. You’re anxious and depressed, but you can’t call in sick. There’s nobody to replace you. And now, you are bracing yourself for more uncertainty as restrictions lift again. There is no relief in sight.

You are not alone. This is just one of many real stories shared by health-care workers in rural Manitoba.

Over the past two years, together with a team of researchers at Brandon University’s Centre for Critical Studies of Rural Mental Health, we have been exploring the impact of the COVID-19 pandemic on rural health-care workers’ mental health.

We surveyed more than 200 rural health-care workers, many eager to vent their frustration, fear, anger, sadness and exhaustion. To better understand their stories, we sat for more than 30 in-depth interviews last summer, asking subjects what story they most needed to tell.

What we’ve learned is that the impact is overwhelming. Health-care workers’ working conditions and mental health are both getting worse. Seventy per cent told us that they had moderate or severe levels of anxiety, and 70 per cent also indicated significant symptoms of depression.

They don’t have time to take care of themselves; nearly 60 per cent said they don’t even have enough time for rest. And they don’t feel taken care of by their employers: more than half say the values of the organization they work for don’t align with their social values, and that they face feelings of betrayal and division in their communities.

They have borne the brunt of frustration against public-health mandates and have been the victims of verbal and physical violence.

Some health-care workers have had to take stress leave; some are seeking new work; and some have already left the field.

For a system that was already grappling with a lack of resources prior to the pandemic, this exodus will weaken it further. When we speak of a health-care system, these mistreated, overworked and exhausted people are who we’re talking about.

The problems we need to address pre-date COVID-19. Rural health care has been grappling with understaffing and a lack of resources for years.

Chronic underfunding has left a fragile health-care system that is struggling to cope with the strain of COVID-19 and will continue to struggle. Workplace burnout is a symptom of illness in our system. Successful treatment will necessarily involve organizational and systemic changes, which will require both commitment and cash.

Government and health-care employers must acknowledge the mental-health challenges and workplace burnout workers are experiencing, and begin actively demonstrating their explicit commitment to providing decent working conditions.

It must be easier for health-care workers to access such resources as counselling. Specialized and confidential counselling services are difficult to find in rural settings, and reciprocal agreements between smaller sites can help alleviate the burden while helping to preserve privacy.

Finally, health-care workers must be paid what they are worth. Alongside an increase in hourly pay, improved benefits, including support for services and mental-health days off, are essential. Among the most urgent needs of health-care workers right now is an assurance of adequate rest time between shifts and guaranteed hours free from work. To do these things, increased staffing is also critical.

It was brave for health-care workers to tell us these stories. Sharing them is our responsibility. As we cautiously move toward the end of COVID-19 restrictions in most provinces, we cannot abandon those who supported us through the worst of the pandemic.

Governments need to listen, and learn to better care for those who care for us.

Madeleine Kruth is a research facilitator at the Centre for Critical Studies of Rural Mental Health and project co-ordinator for safe places for aging and care at Brandon University. Rachel Herron is Canada Research Chair in rural and remote mental health at Brandon University.