Charting the OT overload leading many nurses to quit their jobs

After months without a break, Linda Boutillier, an emergency room nurse in Dartmouth, Nova Scotia, took a well-deserved vacation earlier this summer.

But she got a call almost every day to come back and help. Shortly after her return, she worked a 19-hour shift.

Boutillier had been on the schedule for 1 p.m., but given the lack of staff, he stayed six hours longer.

« I feel guilty when I can’t do it – because I know my team and I know the burden that patients have, » she said.

« I love my colleagues and I also care about my community. So when I can’t be here, I feel like I’m letting the system down and letting my colleagues down. »

Nova Scotia, in particular, has seen one of the largest increases in the proportion of nurses working overtime during the pandemic, according to Statistics Canada data compiled by CBC News.

As emergency rooms in parts of Canada reduce their hours due to staff shortages and analysts warn the system is buckling under the strain, nurse representatives say signs of unrest were evident before the pandemic.

Linda Silas, president of the Canadian Federation of Nurses (CNF), said the reliance on overtime to fill staffing shortages has had a detrimental effect on the profession.

She said the lack of work/life balance pushes many to quit full-time positions.

« It’s a vicious circle, but we have to stop it, » she said. « We’ve been talking about working conditions, bad working conditions for nurses, for 10, 15 years. »

As in Nova Scotia, the number of overtime hours required was particularly high in New Brunswick, Saskatchewan and British Columbia, according to the data, compared to the national average.

September 2021 appears to have been a particularly difficult month for Nova Scotia’s health care system, with 47% of its nurses working overtime that month, marking the highest reliance on occupational therapy of any province over the past of all months of the pandemic.

Other data indicate that nurses who work overtime accumulate more hours. In July, the average overtime nurse worked nine overtime hours, the highest figure since the early months of the pandemic.

A staff shortage has led to the closure of emergency rooms in parts of the country, including Ontario and Quebec.

Silas said a shortage of nurses was apparent before the pandemic and now the need is even more acute.

Already, in 2019, a third of registered nurses – who make up the majority of the nursing workforce – were over 50, with several close to retirement, according to the CFN.

« Fixing the Workplace »

A recent survey of federation members found that 94% of respondents suffered from burnout. Younger nurses said they were more likely to leave the profession.

Silas said many are tempted to leave full-time positions to work for agencies where they have better hours and better pay.

« What we need to do is fix the workplace, » she said. « We need to make sure there is flexibility so they can get the day off and that we have a safe nurse-patient ratio. »

While occupational therapy work among all healthcare workers increased sharply after March 2020, the rate has since plateaued among non-nursing healthcare workers. However, the proportion of nurses working overtime continues to increase.

« It is important to recognize that we have a problem and that we must fix it immediately, » said Sylvain Brousseau, president of the Canadian Nurses Association.

Brousseau is also a professor at the University of Quebec in Outaouais and studies the working conditions of nurses.

He said the increase in overtime is a symptom of a problem in the system – OT is now integrated into the management structure of many hospitals.

« When you don’t fix the problem, people leave the healthcare system, » he said.

Ms. Boutillier, for her part, wants to see the nurses still in post rewarded, with a better salary and holidays when they ask for it.

« It’s the work-life balance that we don’t have. And that’s not being respected, » she said. « I feel like lately we’ve been just a cog in a wheel, filling in a flooded system. »