Voices from the front
The nursing crisis in Ontario is real, and it’s having a direct and profound effect on the quality of patient care.
Nurses across this province are struggling in a critically understaffed and underfunded health-care system. As the union representing 68,000 nurses and health-care professionals across Ontario, we asked for personal stories from the front line. Their responses are urgent and heartfelt. They tell it like it is.
Here are some of their stories, told in their own words. Identifying details have been removed to protect anonymity.
“I graduated in 1984 and I have never seen things as bad as this. For the first time ever we have multiple children and infants being held in the ER because we have no beds and/or nurses.”
Kitchener
I am a pediatric nurse and love working with families, children, and the rest of the health care team. I'm also 61 years old and exhausted. I retired from my full-time position in July and have returned to the unit on a casual basis. I could no longer manage the night shifts, the extended shifts, the no-break shifts, being yelled at, not being able to do my job.
I graduated in 1984 and I have never seen things as bad as this. I want to keep working on a reduced basis but don't know if I can physically and mentally do this. For the first time ever we have multiple children and infants being held in the ER because we have no beds and/or nurses. With the turnover there are many new staff and most are brand new grads.
The experienced nurse has the sickest patients, but with the responsibility of being in charge is still expected to be a resource for the rest of the team. Additionally, we are routinely being told there are no Pediatric ICU beds available in the province (we are a community hospital) and as a result are holding on to children and infants who should be in a tertiary center. The stress of juggling all the balls and ensuring that we provide safe care is emotionally draining and near impossible to achieve.
Additionally, families who are frustrated or expecting hotel-like treatment or not liking COVID restrictions directed by the hospital (masks, limits on visitors, etc.) take it out on the front-line nurse. It seems that no one sticks up for the front-line nurse or appreciates how difficult the job is and it is always the family who "gets their way.” Many nurses have given up on asking family members to wear masks in their presence.
The best part of my job was building relationships and identifying with patients and families as individuals. Now we are just running around trying not to make a mistake, identifying and acting on critical situations, and placating upset individuals. I spent many years teaching nursing students clinically in pediatrics and I want to support the new grads coming through. But we are stretched to the point of breaking.
I have infant grandchildren and I'm terrified of them getting sick and not receiving the care that they need.
I don't know how long I will be able to hold on.
“I go to work and give 110% and still leave wishing I could have done more. Something needs to change. Not just for us as nurses – but for YOUR loved ones as our patients.”
Alberton
I am a proud labour and delivery/medical surgical nurse in a small rural northwestern community. I have a passion for what I do, and the care I provide. Over the past years, I have watched both my own and my co-workers’ positive attitudes and drive fade. We have worked in short staffed, unsafe positions, where patient care is compromised.
With everything I do I think to myself “how would I want my loved one to be treated?” and unfortunately, with short staffing I haven't been able to uphold my own standards in patient care. Mentally and physically I am exhausted. I go to work and give 110% and still leave wishing I could have done more. Something needs to change. Not just for us as nurses – but for YOUR loved ones as our patients.
“Sometimes I'm the only one on shift who can safely manage a patient on a ventilator, because the others don't have enough experience. And sometimes I'm the only one who knows how to use the equipment or where to find supplies because the others are agency nurses who have only worked one shift so far at my hospital.”
Bracebridge
You know, people say to me a lot, thank you for your service, when they hear I'm an ER nurse. It made me think about that phrasing, because usually that's what people say to those who have been at war, or in some sort of way given service to their country. And I suppose in the past few years we have, facing a global pandemic. We put ourselves out there, faced a new virus with no vaccine or real idea about treatment, transmissibility, or lethality, and we did it well. And then it feels like the wheels fell off.
I find myself heading into my work shifts now with a sense of trepidation and resentment. Wondering how angry people will be because of the wait times, wondering how many patients will sit in my small ER waiting for a bed upstairs because we are full again, wondering how many people will sit in chairs in the hall and stare at me while I try to get in enough water and a snack to keep my energy level up for the day.
Sometimes I'm the only one on shift who can safely manage a patient on a ventilator, because the others don't have enough experience. And sometimes I'm the only one who knows how to use the equipment or where to find supplies because the others are agency nurses who have only worked one shift so far at my hospital. They come to me with questions a lot, the junior staff and the travel nurses, good questions, but questions nonetheless that slow me down. I've got a full patient assignment as well as being the team lead and in charge. We don't have enough doctors either to fill all our shifts, so sometimes they're working for 16 or 18 hours at a time, or locum physicians come in who don't know our routines or policies either. More questions.
“Just hire more nurses” – that's what I keep hearing – but would you get a 16-year-old with a G1 license behind the wheel of a transport truck on the TransCanada highway in the winter? Not likely. And that's what it feels like. Knowing that they're not qualified for the places hit hardest by COVID – the ER and ICU.
You want to know my story? I'm tired. I'm tired of trying to oversee it all. I'm tired of the COVID deniers when I'm bagging up another dead body for the morgue. I'm tired of people being angry that they've had to wait so long for their non-urgent problem in the ER because they don't have a primary care provider.
And I'm tired that our government values us so little that we can't even negotiate a wage in line with the increase in cost of living. I'm a single-parent sole-support household with two teens who will be attending post-secondary education and I'm working at a wage that has seen minimal increase over multiple years and one that is far behind those of other public service employees. I'm tired that the public thinks I got a $5000 bonus when it was announced many months ago when in fact I've only seen half of it, and given some back because it was fully taxed.
But it's not really about the money. It's about value. Or being undervalued – because we've had enough. We are leaving, young and old, experienced and rookie, we are leaving. We put it all on the line for COVID, asked very little in return, and got less than that.
I want my job satisfaction back. I want to feel like what I do makes a difference. I don't want to have to prove my worth, or justify my job to collect silly statistics for the ministry so they can say we aren't doing things right or meeting wait-time benchmarks, when none of the people making those decisions have spent any time doing patient care since we saw COVID hit.
One thing I do know is this, when we go, we are gone, and we aren't coming back.
“The hospital is running 100% over capacity. So now this two-patient room is a three-patient room.”
Ingersoll
I have not even been a nurse for more than 3 years. I am stressed and burned out. I am unable to even get a full-time line but work full-time hours, benefiting the hospital more than me. My unit has been on overflow for going on 6 months now, when it was supposed to be a temporary solution or "helping the hospital."
The hospital is running 100% over capacity. So now this two-patient room is a three-patient room. These patients do not get access to their own oxygen or suctioning. Before they were using a bell as a call bell. How is this fair, safe, and even allowed? What happens to this third patient who comes to the floor unstable and we do not have the resources to help them? Until someone dies, things will not change.
Our floor only staffs one RN, the rest RPNs. This is stressful and 1 wish for more RN support. We have more unstable and complicated patients on the floor than before.
Bill 124 affects my ability to think about a future, I can't afford a home, food is getting more difficult to purchase. Who will help the “heroes,” as they once called us? I am a nurse and I am tired.
“Some of our seasoned nurses got injured or physically harassed by patients, which could’ve been prevented if we had more nurses and security personnel on the unit, but due to staffing and budget problems we are on our own.”
Vaughan
Most of my colleagues and myself are experiencing burnout from ongoing staffing challenges and high acuity of the unit, which has worsened due to the pandemic. Even if the management finds new hires, they tend to leave within months due to the high acuity of the unit. Some don’t even return after the orientation. Seasoned staff choose to retire or find non-bedside nursing jobs as they get burnt out from tirelessly working 16-hr shifts on a regular basis. Those who choose to stay are hanging by a thread as they have bills to pay.
Patients' families are frustrated and throw emotional tantrums at nurses because their loved ones are not getting the best care due to short staffing. (We just don’t have enough staff to look after ALC patients' every minor need, which is terribly sad). Some of our seasoned nurses got injured or physically harassed by patients, which could’ve been prevented if we had more nurses and security personnel on the unit, but due to staffing and budget problems we are on our own.
All of us, both RNs and RPNs, all feel underappreciated despite working 16-hr shifts in a row. No one cares if we get injured at work. Some of us often joke about changing our career to dental hygienists as they get better pay ($45/hr) and they have a safer work environment. We don’t have any negotiating power as we cannot go on strike. Most of us feel like being enslaved as our pay does not reflect the workloads we are burdened with. If the Ford government has millions of dollars for "Welcome to Ontario" signs, there's certainly a way to pay nurses what they deserve.
“I fight every day for my colleagues, patients, and for the future of health care for the next generation.”
Toronto
I feel so lied by my government; on one hand, I am called a hero for the sacrifice of my energy, care, and time I spend helping the most vulnerable during the worst pandemic to hit Earth, yet, during this pandemic, my government has used my weakness (caring, and female) against me, to make laws that discriminate against me because I am in a female-dominated profession, has undermined my ability to get paid fairly (Bill 124), and did not even protect me (lack of PPE for nurses and health-care workers, despite studies from SARS that showed PPE was essential).
Basically my government is showing me day after day (they have time to make law after law belittling nurses and my patients), despite the fact that the nursing shortage is not just impacting nurses and the entire health-care system, that they are moving to privatize a healthcare system that is what Canada is all about. It's literally like a slap in the face every day.
I have had to stop watching the news so much because of the lack of evidence-based practices my government is permitting. If the shoe were on the other foot, if I was to do anything that the government is allowing my country to accept as health care, I would be stripped of my license, because it is NOT SAFE.
I fight every day for my colleagues, patients, and for the future of health care for the next generation. I wonder why the Premier views saving a few dollars on cutting on essential health care as a sign of a victory, when so many are having to wait for beds, myself and my colleagues get denied time off due to the shortage, and I see the impact the lack of staff have from watching my own parents try to navigate the system that has just gotten worse since the pandemic.
“We often work short and have novice nurses training, with not enough time to truly give our clients and novices nurses the treatment and experiences they deserve. We are dangling in the wind with no one coming to help.”
St. Thomas
I wanted to share my story to enlighten the public about how challenging our work environment is and the difficulties we face as nurses serving the public. To begin with the nursing shortage and the lack of support we feel is overwhelming. We are discouraged from speaking out and saying how deplorable the working conditions truly are. We often work short and have novice nurses training, with not enough time to truly give our clients and novices nurses the treatment and experiences they deserve. We are dangling in the wind with no one coming to help.
We are currently working with RPNs taking RN positions and anticipating the same level of care will be provided. The safety issues surrounding the care provided is at an all-time low when you consider how many nurses have left our profession to pursue other easier, less abusive jobs. Sadly the ultimate sacrifice is the nurses who are still there trying to do our best to provide safe, quality care to the public. The wait times have increased significantly. The burnout from no time off, vacation, and/or working overtime because the hospitals are so grossly understaffed.
The abuse, name calling, bullying, physical violence have increased dramatically over the past 3 years. In the past few months I have personally had to call other floors in my hospital to come and assist in the emergency department because I have multiple codes happening at the same time and only three nurses in my department, and one of the three nurses is me. They could not come to help as they also had no staff to send.
We as nurses cannot continue on like this. I am awake all night prior to going to work and hoping everyone makes it through the day without breaking down. To be frank it’s about sustainable ideas that protect our nurses and our health care system. It's about allowing nurses time to be with their families and about providing a safe work environment every day. It's about feeling supported and being able to provide for ourselves and our families.
Just remember we have everyone's lives in our hands as nurses, and if you reflect on how many people nurses help every day then you can then begin to understand the importance of our profession.
“I did not go into nursing to nurse this way. I can't recall when I last formed a therapeutic nurse-patient relationship or promoted health.”
Huntsville
I am an emergency room nurse that had worked full time for 20 years. In May 2022 I walked away from full-time employment, with a heavy heart. I am now in a casual position. I had to choose my mental health or full time. I left the benefits and security of full-time employment after decades of emotional and physical abuse by patients, the unrealistic expectations of my employer, and finally the disrespect of Bill 124.
The conditions on the front line are so horrid, I fear for my nursing license every day. I did not go into nursing to nurse this way. I can't recall when I last formed a therapeutic nurse-patient relationship or promoted health.
“As a care coordinator working for HCCSS, I often waitlist nursing services due to nursing shortages. This leaves patients with no other alternative but to access ER for IV therapy, wound care, etc.”
Vaughan
As a care coordinator working for HCCSS, I often waitlist nursing services due to nursing shortages. This leaves patients with no other alternative but to access ER for IV therapy, wound care, etc. When my patients get accepted off the waitlist it is often too late. Patients state things like “I could have died waiting for nursing service to become available”; another patient stated “they tell us don't go to ER if it is not an emergency, but who will change my dressing and look after my wound, what if it gets infected?” Nursing shortages are causing a crisis in Ontario and it needs to be fixed NOW!
“It's only September and we are holding over 20 patients in our ER without enough inpatient beds for them to go to.”
Puslinch
Our eight-bed CCU has such a severe shortage that we have had to close the unit several times this summer. We run a STEMI program through it and service a large portion of Ontario. There have been shifts where there have been no CCU nurses and the unit has been staffed solely by agency nurses. The skill mix is poor and we lack the necessary critical care/cardiac experienced nurses required.
It's only September and we are holding over 20 patients in our ER without enough inpatient beds for them to go to. We have increased offload times, admitted patients in hallways, and had patients sitting in the waiting room for long periods of time. Sometimes triage can be backed up with a two-hour wait. I have deep concerns going into the winter season for what will happen with an already precarious staffing situation, lack of resources, and increased wait times for assessment and for inpatient beds.
I don't know how much more give the system has left due to a lack of investment and oversight from the government over the last decade+ and what has only worsened under the Ford government. I have thought about leaving nursing many times over the past few years. I do still find joy in caring for my patients when I feel like I've been able to do it properly and to CNO standards.
I also find joy in supporting my nurse colleagues and participating in activism to improve the current status quo in healthcare. I'm not going down without a fight!
“I worked at one of the hardest hit long-term care homes in Ottawa during the first wave of COVID. When I got there, the unit I was assigned to had already lost more than half of the residents to COVID”
Clarence-Rockland
I graduated from Nursing school in the summer of 2020. I had just completed my final practicum when the pandemic reached Canada, only missing the final week of class because the hospitals and school shut down in-person learning. The RN positions I had applied to were pausing hiring while dealing with the chaos, and so my first job in healthcare was for COVID-relief at a long-term care home as a PSW.
I worked at one of the hardest hit long-term care homes in Ottawa during the first wave of COVID. When I got there, the unit I was assigned to had already lost more than half of the residents to COVID. Only 3 regular staff (one RPN and two PSWs) remained as the others were off sick with COVID too. My training consisted of doing one round on the remaining residents (changing briefs, dressing them for the day) and then avoiding excessive time with them as they were all considered positive for COVID on that unit.
We didn't know how to protect ourselves, and I had gotten in trouble when I spent extra time trying to feed a resident who was a slow eater. I wanted him to eat as much food as he was willing to eat, but the RPN told me that if I stayed with him that long every meal, I would get COVID too. So she told me to leave him with his meal not even half-eaten. I still feel immense guilt to this day for not having stayed despite her protests.
We didn't have the right PPE to protect ourselves and the residents. I insisted on changing my gown and gloves when going from a COVID Positive room to a COVID Negative room on a different floor. I was told there wasn't enough PPE for me to change between each resident, so I did my best to try and protect the negative patients. One of the staff made a comment to me for changing my gown as often as I did, and I refused to back down this time. He told me that we should just assume they were all positive at this point, but I refused. We also didn't have enough masks. We were given one surgical mask for the entire shift. You'd take off the mask during your lunch break to eat, and immediately put on the same mask again after. I caught COVID within 2 weeks of having started working there.
Having COVID was awful, especially since this was in May 2020 when very little was known about it. My only experience with it was watching it take residents' lives and seeing the long-term care home have more and more empty beds. It was terrifying. I knew I had good chances of making it through with my age, but the knowledge that there was a chance of mortality was terrifying.
“Being expected to do a job with your hands tied behind your back. Being set up to fail. This is now the daily NORM, not just an isolated incident.”
Cherry Valley
Anger, fear, tears.
Start your shift angry when you learn there aren't enough staff to take care of the patient load.
Then fear for knowing this puts each patient at high risk for injury or even death. Tears as you finish a shift knowing you did all could physically do but you know it wasn't CARE.
Being expected to do a job with your hands tied behind your back.
Being set up to fail.
This is now the daily NORM, not just an isolated incident.
Dropping private agency personnel to fill in for staff is just a body or a number to say it's covered. It would be the same as if you placed the politicians in scrubs and called them nurses or caregivers. You think the patients are safe? Not to mention, cared for?
I live in fear every time I work, for the patients and my registration.
The anger and resentment toward a system that has been broken for years that now make me feel ill, lose sleep, cause me anxiety, and now I am ready to give up. I can't be a nurse, not like this. I became a nurse to take CARE of people, but the system has beaten me down so long that I've lost the energy to fight. I plan to get out of health care just as soon as I can.
“What I can't ‘handle’ is a government who doesn't see that our health system is INDEED in crisis and is crumbling around the front-line workers. Patient care is most certainly affected.”
Kingston
I have been a nurse for 32 years. I thought I could handle anything. I thought I could handle making your loved one look as “normal” as possible after they died. I thought I could handle the screams of a distraught family member after they were told “there is nothing more we can do.” I thought I could handle the look on the face of a patient when what should have been an eight-hour surgery is over in one because “the cancer is too advanced to do anything .“ I thought I could handle looking into the eyes of someone who was probably not going to survive but telling them I'm here with them as I hold their hand a little tighter.
For 32 years I have “handled” it! What I can't “handle” is trying to do the work of three nurses. What I can't “handle” is the look of the new nurse trying to cope with an unbelievably unsafe nursing assignment. What I can't “handle” is a government who doesn't see that our health system is INDEED in crisis and is crumbling around the front-line workers. Patient care is most certainly affected.
I am at the end of my career, so I will be there, working tirelessly on the front lines until I retire, but what about our new nurses and students going into the nursing program??? How are they going to “HANDLE” these working conditions for years to come???
“It is time for change. What would happen if there was another medical tragedy to hit our society now with an already crumbling and currently broken and burnt-out nursing profession just scrambling to make do at this point?”
Thunder Bay
I am a Registered Nurse and have been practicing for over ten years. Currently working full time in a perioperative services department, mostly in the operating room, in a fairly large hospital that covers most surgical disciplines. Our situation is dire. My colleagues and I are burnt out, exhausted, overworked, and under recognized.
During the COVID pandemic we were treated like pawns in a chess match, being shuffled around wherever the hospital deemed it was necessary for us to go. With non-essential surgeries being cancelled or postponed due to the risk of COVID with intubation for surgical procedures, I found myself coming to work and not knowing what to expect for the day as Premier Ford's legislature basically allowed the hospital administration to place us wherever they wanted.
Whether it was feeling useless on a unit I knew nothing about, or watching patients with COVID die in ICU while their families watched through glass doors not even allowed to go in and hug their loved ones due to COVID rules at the time. Furthermore, myself and my colleagues have been continually forced to stay late (regardless of obligations outside of work) with the overhanging threat of “patient abandonment” if there were simply no nurses to come in and relieve when our shifts were technically supposed to end.
We are dropping like flies. Overworked, underappreciated, and feeling abandoned by our workplaces and government. Not only do we suffer, but our patients do. Administration deciding which surgeries will now be performed based on what many of the staff believe to be financially driven motives, leaving others waiting and getting more unwell while they wait. Patients being held up in the recovery room for hours and days because there is simply nowhere for them to go because there are no nurses and no beds. Some being discharged pre-emptively, just so they CAN get their surgery completed.
It is time for change. One would think that after a global pandemic we would recognize just how essential nurses are, yet our government decided to treat us like garbage when it actually happened. Other professionals are receiving extended COVID pay incentives, while ours lasted mere months. Nurses are leaving the profession, leaving Canada, and young adults are choosing other career paths because of the poor reputation of nursing as a profession at this time.
What would happen if there was another medical tragedy to hit our society now with an already crumbling and currently broken and burnt-out nursing profession just scrambling to make do at this point? The government needs to step up, take care of, and acknowledge the critical importance of the nursing profession in Ontario, and nation wide. It's time for them to stand behind us, respect us, and compensate us in a fair manner that will encourage the recruitment of new nurses and the retention of the existing, burnt-out nurses that have so much to offer to both our patients, as well as the profession.
“The importance of post-op teaching, ambulation, and emotional support for our patients and families is being lost on an entire generation of nurses, as senior nurses just don't have the time to provide the mentorship. Not only that, but these aspects of post-op care also prevent readmission, decrease length of stay, and build confidence in the health-care team – so patients are missing a huge piece of their recovery.”
Sudbury
I've been an RN for 12 years, most of that time working inpatient surgical. Staffing has always been tight, but we always found the time in our day to take 20 minutes to eat and use the washroom. We were able to prioritize our time to include all required care - medication admin, dressings, charting, following up with lab work, post-op teaching, ambulation, and emotional support.
Unfortunately, with the staffing crisis there just isn't enough time in the day to complete all required tasks. Meds, dressings, and charting gets mostly done, but not much else. The importance of post-op teaching, ambulation, and emotional support for our patients and families is being lost on an entire generation of nurses, as senior nurses just don't have the time to provide the mentorship. Not only that, but these aspects of post-op care also prevent readmission, decrease length of stay, and build confidence in the health-care team – so patients are missing a huge piece of their recovery.
As well, nurses are regularly missing breaks or eating as they catch up on charting. Emotional and physical burnout is a real issue. New nurses are leaving within weeks of starting, intermediate and senior nurses are quitting because they just can't do it anymore and are disgusted about the care that they can't provide because they just don't have the staff support they need.
I genuinely love being an RN. But I won't be able to continue working in a profession I love for much longer if issues within our hospital are not remedied as soon as possible.
Show your support
These stories are just the tip of the iceberg. Ontario’s nurses and health-care professionals are hurting, and so are their patients. Show your support by sending the government a message.
