Registered Nurses are essential to the health care system, the pandemic has revealed there were systemic issues present before COVID-19 these have been exacerbated by the increased stress, overwhelming fatigue, and a growing perception that the nursing profession is not respected or valued.
There is the current legislation Bill 124 (enacted November 2019) that caps wage increases, including grids, seniority scales, performance matrices, to 1% per year. At the height of the pandemic there was a pandemic pay bump for 16 weeks and funds invested of $400 million for recruitment and training to upgrade skills. Though the pay bump was perceived as inadequate as it did not recognize (initially) all health care workers i.e., respiratory therapists, managers, educators, and allied health aka social work, physiotherapists etc.
The public sectors i.e., health care agencies, universities & colleges, crown agencies, and organizations that received at least $1,000,000 in public funding were included in Bill 124, about one million workers. The 3 year moderation period in effect caps salaries depending on the sector and when collective agreements ended during the period. The austerity strategies are not new to these sectors; many of us will recall the pay freezes of the 1990’s and restructuring to reach a lean state of efficiency. Now almost 25 years later the Ontario government has not pivoted effectively to recognize in a meaningful way nurses’ services during the pandemic and let’s face it the effects of COVID-19 continue even now. Reality is money talks and what seemed reasonable (perhaps) in 2018-2019 is no longer the case.
The exodus of nurses from the various sectors hospital, long-term care, home care, and an unknown number who are off on indefinite periods for burnout, post-traumatic stress disorder, COVID-19. Now in Ontario the number of vacancies has increased 56% in the first half of 2021. Herein lies the root why the government may not have mandated compulsory vaccination; across Ontario, in the smaller, more rural locations the impact could have closed more services, when we know there is a mega backlog of services and surgeries to be cleared.
Recently there have been more rallies, petitions, discussions, and charter challenges are ongoing, as the Ontario Nurses Association has a challenge that will likely be heard in 2022. Ongoing they identified gender as a factor in the unfairness of the legislation, nursing continues to be female-dominated, and the disparity was raised when nurses’ salaries were compared to police and firefighters. The leadership of ONA is changing, so it will be interesting to see how they advance their members’ needs, as contract negotiations are not just about money in the pay cheques, but Bill 124 limits the union as they explore the members’ needs for increased mental health supports, paid sick time for part time nurses, as either one of these benefits would exceed the 1% compensation limit per year.
As grim as this post has been, another challenge nurses face is physical abuse and emotional trauma due to patients’ physiological and cognitive states, families whose expectations do not match the resources available i.e. no one has 24 hour care with one nurse at point of care–not even in critical care. Nurses are adamant that much of the shortages in nursing arose from a deep mistrust, as the workload and short staffing patterns grew over the pandemic period. Waning trust and unresolved issues translated into an exodus of nurses, in the RNAO Work and Well being Survey nurses in the 25-35 year old cohort are most vulnerable to leaving the profession.
The opposition parties in Ontario have expressed the following; NDP there needs to be an effective method to show respect and the value we have for the nurses who cared and showed up during the pandemic. Now they’re exhausted and stressed and it’s known that wage caps create challenges when collective bargaining is needed, and the financial losses are significant. The Liberals would repeal Bill 124 as one of its first acts after the election, a concrete acknowledgement to the people who kept us safe during the pandemic. The Green party identified that nurses due to inflation rates have had a wage cut, so pay raises are needed sooner than later.
So that’s my learnings about Bill 124, as someone who in the 1990’s had a 5 year pay freeze and unpaid days off (well two days as we were so short staffed the unit paid overtime and later double time to cover gaps) I don’t understand why the government has not reviewed the legislation. Of course there are many factors we could question with why? #RepealBill124 is one step and as we can see there’s a lot going on in the profession of nursing. Be the nurse you want to work with, ask and accept help prn. Namaste.
The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversyMartin Luther King Jr.
Registered Nurse Storyteller, Healer, Scribe, Transformational Leader
Thanks for your thoughts. I am a Professional Practice tutor and further to what you have already identified, I am experiencing challenges with my nursing students who are trying to develop as professionals in a practice environment where some of their role models may be experiencing the aforementioned burnout and chronic understaffing that is affecting all sectors. As we all know, mud slides down hill and these students may be the target of much of this frustration.
These students have experienced their own challenges during the pandemic such as moving to an online environment, modifications to their clinical practice schedule as COVID numbers have waxed and waned and social isolation from their peers. They should be seen as potential new hires and they will be looking to practice in areas where they are supported and their contribution is valued.
I ask my fellow nurses for their continued compassion and understanding as these young people try to navigate the current healthcare system.
Absolutely nursing students are the future of our profession and let’s hope they will find success and a more healing environment, to be the nurse we want to work with.