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Coronavirus: Exhausted nurses need support, experts say

As nurses experience high levels of stress amid rising COVID-19 hospitalizations across Canada due to the rapid spread of the Omicron variant, the latest challenge in a two-year fight against the virus , experts believe organizational changes can help frontline health-caregivers face burnout.

“Burnout is the end of a very long period of stress,” Nita Chhinzer, associate professor of leadership and organizational management at the University of Guelph, told in a telephone interview.

“This results in physical, mental, emotional and cognitive depletion of your resources.”

There are different methods healthcare facilities can use to help workers dealing with stress, Chhinzer says, and that responsibility shouldn’t be placed primarily on the individual.

“Instead, what we need to do is take a shared responsibility approach to recovery,” she said.

“We as a society, as government officials and policy makers, as leaders of organizations and employers, we need to come together collectively to provide a framework of support. “

Support can take the form of programs and protocols tailored to specific workplaces with resulting guidance and tools that are applicable to the job at hand. An example could be the development of escalation procedures, when workers feel high levels of risk, which prioritize the employee.

“Healthcare is one of those interesting spaces where it feels like you have clients and clients are at risk. We forget that nurses are also at risk,” Chhinzer said.

“Nurses, even before COVID, suffered from severe abuse in the workplace.”

The strain on nurses is a story all too familiar to Doris Grinspun, CEO of the Registered Nurses Association of Ontario (RNAO). A survey released by the organization this summer described an “alarming exodus” of nurses leaving the profession as well as high stress levels among peers.

This is a situation that does not look like it will end anytime soon, especially with the emergence of Omicron.

“This virus does not stop,” Grinspun told in a telephone interview. “Omicron is multiplying exponentially.”

She predicts that Ontario’s intensive care units will be full by February, and yet the province will continue to face nurse shortages, in part “because of burnout, because they are not. not treated the way they should, because their workload is double or triple what they need to be. “

Nurses have also reported being pushed beyond their limits, which they believe could compromise the quality of patient care and potentially lead to mistakes that could have devastating consequences.

The support of frontline workers is essential to the proper functioning of the health system.

Chhinzer points out that unlike many other industries, healthcare operates on a servant-leadership model.

In such a model, “frontline workers are the ones who need to be supported. Neither the manager nor the supervisor, ”she explained. “The job of the supervisor is to provide support to this front line leader.”

But these frontline leaders may now be fewer. One potential problem with nurses leaving the healthcare system in droves is that there may be fewer experienced workers available to mentor new hires, which can have a cascading effect.

The RNAO poll also identified the industry’s struggle to retain young nurses, some of whom have said they intend to leave when the pandemic is over. One of the keys to keeping young nurses on board, Grinspun says, is making sure there are seasoned colleagues available to coach them.

“We need [nurses to stay] because we need them to mentor the new ones, ”she said. “When you come out of school as a registered nurse you have a lot of fantastic knowledge about books, but you need mentors in the workplace to help you put that knowledge into practice. “

The loss of nurses early in their careers can have a lasting effect on health systems.

Finally, there is the issue of financial compensation. A lot of people come into nursing because they have to help the sick and injured, Grinspun says, but it’s also a business.

“I can tell you that we have this thing in our stomachs. It’s an urgent need,” she said. “I hear an ambulance coming, and you know what I want? Go over there and help.

“People call it a vocation. I don’t like to call it a vocation because it’s a profession and because it’s an occupation.”

Grinspun challenged Ontario’s Bill 124, which caps annual salary increases for nurses at one percent. The bill was introduced by the provincial government in 2019.

She believes actions such as repealing the bill and providing nurses with fair pay and necessary support might encourage some of those who have left to return.

Grinspun says that at the moment nurses feel “abandoned” by the province, adding that Premier Doug Ford and Health Minister Christine Elliot are no longer returning his calls.

Chhinzer says there is an opportunity for organizations to bring back nurses who may still feel drawn to the altruistic side of health care if they take initiative and build supportive infrastructure.

“While people may burn out and then choose to leave, they choose to leave because they feel trapped,” she said. “They feel like they have no other choice, but many of them still have this truth, giving nature within them.”

Trying to understand what drove workers to leave in the first place and come up with real solutions can be key to keeping them in the fold.

“We have to be sure that we are really going all the way and that it is not just lip service,” Chhinzer said.