With the deadly fourth wave of the COVID-19 pandemic well under way in Canada, the World Socialist Web Site spoke with a nurse in Ontario about the terrible working conditions she has confronted since the virus first emerged in 2020. A nurse with over 20 years of experience, Tammy explained how health care workers are suffering under the strain of punishing workloads and lengthy shifts and spoke of their mounting anger with the political establishment.
Asked how her working conditions have changed since the onset of COVID-19, Tammy said, “The first wave was not that bad. Shifts and workplace assignments were not altered. We worked our eight-hour shifts. I felt appreciated, people would come in and thank us. But the second and third waves were very different. Workers were called back from holidays. They shut down operating rooms, day surgeries, outpatient clinics and redeployed everyone.”
The demands placed upon nurses grew. “They would,” explained Tammy, “reassign people who worked in a clinic (i.e., diabetes) and put them on units like critical care. Some who had not done hands-on patient care in over 20 years were now put into a new role. Nurses were also transferred back to shiftwork. The 12 hour shifts really upset many nurses. This led to nurses having to request accommodations to remain on day shifts. It was very onerous. Lots of paperwork was created. Every nurse was affected by these changes. To this day nurses who were reassigned to areas like ICU or critical care are still there.”
For many nurses the second wave marked a turning point in their careers. Tammy recalls, “Many of the older experienced managers retired and some cashed out their pensions early. The new managers were more confrontational. They began micromanaging us and watching us with suspicion.” She continued, “We had incidents where managers would have nurses remove the bonnets off our heads, saying that we were wasting supplies. We were very short of supplies, of N95s. They would only allow you to wear one if you were going into a room where CPR was being administered. The supplies were removed from supply shelves and put on carts to be rationed. You had to sign out supplies and provide a reason why you were taking them.”
The chronic lack of supplies was just one expression of the failure of the ruling elite, in Canada and internationally, to prepare for a pandemic that was both foreseeable and foreseen. Health care systems around the world have been ravaged by decades of cuts and pro-business austerity programs. According to estimates, over 100,000 medical workers have lost their lives globally while battling COVID-19. Tammy touched on this, remarking, “They spent all this money on TV monitors that would tell us how low our supplies were. Did we forget we had SARS! They should have learned something!”
Tammy drew attention to the years of health care spending austerity imposed by federal Liberal and Conservative governments and Ontario governments headed by all three major parties, including the union-based New Democratic Party. She also explained her fear that the pandemic and its economic fallout could be used to justify further major cuts to health care provision. “Our hospital system is running out of room,” she said. “The hospitals we build, the extensions we put onto them are not keeping up with the demand when they are completed. We are always behind. It’s never enough. People are in makeshift rooms; they are in the hallways. There is no room for people who must stay overnight.”
“In Brampton for example they have one hospital for a population of almost one million people,” she added. “How is this possible? And if you decide that if you live in Brampton and you will go to Mississauga, those hospitals are overcrowded as well. So, you go to the hospital in Georgetown and that small hospital is overcrowded too. Same problem in Oakville, and St. Catherines. They are not investing in health care. The government talks about investing all this money, but I don’t see where it’s going to come from. The only thing I can see is a lot of cuts coming to clinics and outpatient care.”
Nurses are leaving the profession in droves. Mental health has become a huge issue. “When people are injured, or are high on drugs, or have cut their wrists, where do you think they go? They come to the hospital,” Tammy commented. “We are the front line. When the cop leaves, it’s just us in there with the patient.” COVID-19 has made all these social problems worse. Tammy added, “Nurses are taking leave, retiring early, or going back to school to pursue entirely different careers. Nurses are burnt out.”
The negative impact on patient care has been devastating. In a recent CBC interview, Dr. Raghu Venugopal, a Toronto emergency physician, said he’s seen three nurses care for up to 25 patients at a time. On a recent shift, he witnessed a man have a seizure without any privacy while other patients, including a small child, watched in shock. He explained, “The nursing shortage is absolutely brutal.”
Tammy’s personal experience underscores that these horrendous conditions are far from exceptional. “There should be no more than four patients per nurse,” she told the WSWS. “We are responsible for knowing the patient’s chart inside out. I have been on a shift where two nurses have had to care for up to fifteen patients. When one of us goes on break, the other nurse must take care of all fifteen patients. There is no way that I can possibly know who all my patients are. I only have two hands. It’s like I’m drowning in the ocean, and I can only save one child! Who do I choose to save first?”
The pressure produced by increased workloads, understaffing, and inadequate supplies has led to a drastic deterioration in workplace relations. Tammy stated, “When you walk into the department the tension is so high it feels like the air is thick and you can’t even breathe. Everyone is on edge; you don’t know how to act. You don’t know if you can say anything, or if you can crack a joke because everyone is just on edge. The reason morale is so low is because there is no respect anymore, no one knows what’s going on, we are never told anything, they just throw all these nurses into the lion’s den. They are not ready for the situation they are put in. They have burnt out all the nurses everywhere in every department. No one is happy.”
To add insult to injury, with its Bill 124, Ontario’s Doug Ford-led Conservative government has capped salary increases for nurses—and all provincial public sector workers—at just 1 percent per year. The trade unions, including those representing health care workers, refused to wage any struggle against this outrageous attack, which imposed an effective pay cut on over one million Ontario public sector workers. Meanwhile, Ford and Justin Trudeau’s federal Liberals have doled out hundreds of billions in pandemic subsidies and stimulus to big business and the financial elite with virtually no strings attached. “We appreciate the Tim Horton’s commercials of how ‘we are all in this together,’ but why do we always have to fight for raises?” asked Tammy. “Nursing is always underfunded and is dominated by women. A lot of nurses are single moms. Nursing is a dangerous occupation. We deal with violent people. Nurses get physically assaulted on the job.”
Under these conditions, Tammy is very concerned about what the fall and winter will look like as governments move to abolish all remaining anti-COVID-19 public health measures. “The case numbers will spike absolutely,” she said. “This time it will be worse. Many hospitals that were designated COVID hospitals are no longer available. And on top of all that, we have major staffing issues at many hospitals. There are simply not enough nurses to meet demand. New recruits cannot replace the nurses that are leaving.”
Tammy believes that the Ford government’s reckless reopening of schools will have a disastrous impact on the health care system. “We will be in a chaotic situation,” she explained. “In fall hospitals are going to be jam-packed again.”
She pointed to the responsibility of the corporate elite for the consequences of school reopenings. “I don’t think (parents) have a choice because people don’t know where to put their kids,” she said. “A lot of people don’t have daycare. A lot of people want to work from home, but corporations want the workers back in the office so they can micromanage them. The business community absolutely has a role in pushing people back to work—that is the big corporations like the banks, the insurance companies, not the little Joe Blows like convenience stores.”
Tammy’s experience provides a moving account of how the capitalist system and the ruling elite’s “profits before lives” strategy have transformed what was once a dream occupation for many altruistic young people into a living nightmare. “I knew from when I was seven-years-old, I wanted to help people,” she told us. “Nursing is god’s gift. You can’t describe the feeling of helping people. Giving them a drink of water. Getting to know who they are and listening to their life stories.”
But now, asked if she had a message for everyone, Tammy responded, “When you come to the hospital because your relatives are sick, and you push that button and nobody comes to help, it’s not because we are ignoring you. It’s not because I can’t hear you. Please don’t be mad at the nurses, we are trying our best. We just can’t physically help everyone.
“We can’t help you because of overwhelming demand on the hospitals. We are taking reports, doctor’s orders, mixing meds, taking out meds, or transferring a patient from unit to unit or to another hospital. Sometimes it takes 2-3 nurses just to transfer a patient from a bedside commode back to a bed. And not to mention if you are in an isolated room or in a COVID-positive room. All those nurses who are helping that one patient are all gowned up, and when we un-gown we do it very carefully in steps, so we don’t contaminate ourselves and others. When a nurse goes home after their shift, do you have any idea how much of a toll it takes on them to have to go through that? And on top of it all, you are trying to keep safe because you have loved ones to come home to and you don’t want to bring anything home to them.”
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The World Socialist Web Site is fighting to build health care workers’ rank-and-file safety committees in Canada. To get involved or share your story, email: cersc.csppb@gmail.com