Alberta’s reliance on contract nurses may additional erode health-care system, critics say

Alberta’s reliance on contract nurses may additional erode health-care system, critics say

Alberta hospitals and health-care centres have change into more and more depending on contract nurses and different staff to remain practical — a pattern that critics say should cease earlier than it erodes an already beleaguered public workforce.

Contract knowledge publicly posted by Alberta Well being Providers exhibits the province’s largest health-care supplier has elevated its spending on staffing businesses greater than tenfold over the last seven years.

“That is indicative of simply how unhealthy issues actually are,” Heather Smith, president of the United Nurses of Alberta, mentioned in an interview. “There is no short-term aid. There is no magic bullet to show it round in a single day.”

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Heather Smith, president of the United Nurses of Alberta, mentioned she’s anxious concerning the state of nursing workforce. (Peter Evans/CBC)

Smith mentioned Alberta’s 30,000 registered and registered psychiatric nurses (RNs and RPNs) are more and more being advised to work obligatory extra time and fielding determined calls to return in on their days off.

These nurses are additionally getting textual content messages from recruiters, providing them work with non-public businesses, Smith mentioned.

The perks will be substantial, she mentioned. Larger pay. Higher work-life stability. Trip time that will not be cancelled.

“We’re getting an increasing number of requests [from nurses] on a regular basis,” mentioned Heather Pringle, proprietor of staffing company Nurse Reduction, Inc. “Folks wanting out of the common place and with the ability to take cost of their very own profession and be their very own boss.”

Nurse Reduction gives RNs, licensed sensible nurses (LPNs) and health-care aides to services in a number of provinces. For 2 years, the corporate has been one of many main contractors supplying AHS with aid workers.

In 2015-16, AHS spent lower than $400,000 on two 12-month contracts with two staffing businesses to offer urgently wanted staff.

By 2021-22, AHS had 15 contracts signed with 10 businesses that had been prepared to offer RNs, LPNs and health-care aides when needed. AHS spent almost $5.2 million on these contracts.

AHS contracts don’t embody services operated by Covenant Well being, which runs Alberta’s Catholic hospitals and health-care centres.

CBC made 4 data requests to Covenant Well being in three months. On Friday, Covenant Well being offered aggregated knowledge on its staffing company bills courting again to November 2020.

Within the 2021-22 fiscal 12 months, Covenant Well being paid greater than $259,000 to 5 staffing businesses.

Within the nine-month interval from April to December 2022, that spending jumped to $2.2 million with seven businesses.

As of Jan. 6, Covenant Well being had 35 private-agency RNs and LPNs working in rural hospitals and continuing-care services, which was about one per cent of their nursing workforce, mentioned communications adviser Carla Howatt in an electronic mail.

The worldwide competitors for staff has pushed Covenant to make use of extra businesses than up to now, she mentioned. 

AHS’s reliance on businesses escalated when COVID-19 arrived in Alberta in spring 2020, a spokesperson mentioned.

A report ready for the Alberta authorities a 12 months in the past by EY Canada on the sustainability of the well being system exhibits health-care staff within the province are quitting, working extra time and calling in sick at dramatically greater charges than just a few years earlier.

Emptiness charges for RNs, LPNs and different well being professionals jumped up between 2019 and 2021.

Company homeowners and teachers say the pattern is comparable throughout Canada and in another developed international locations.

Smith, the UNA president, mentioned that in earlier years, company workers — typically referred to as journey nurses — had been dispatched primarily to rural and distant hospitals in need of workers.

When nurses began seeing them in Edmonton and Calgary emergency rooms and intensive care models in 2022, the union started asking AHS for routine studies on the place company nurses had been working.

A compilation of these studies from July to December 2022 exhibits as many as 41 company nurses positioned at Grande Prairie Regional Hospital, 39 at Edmonton’s College of Alberta Hospital and as much as 20 at Purple Deer Regional Hospital.

The variety of contract nurses fluctuates.

In Could 2022, AHS tallied 220 whole company staff on the job. That jumped to 341 in October. As of Jan. 5, it dipped all the way down to 231. AHS didn’t maintain observe of contract nurses throughout all websites earlier than Could 2022.

AHS spokesperson Kerry Williamson mentioned the rise within the fall was virtually totally exterior of Edmonton and Calgary, the place it is tougher to recruit staff.

But, even with contractors filling the gaps, hospitals and well being centres are nonetheless closing beds and quickly shutting their doorways, mentioned Chris Gallaway, govt director of the advocacy group Pals of Medicare.

As of Jan. 31, AHS listed 31 “short-term service disruptions” in services throughout the province.

“We’re in a staffing disaster,” Gallaway mentioned. “And we’re not seeing a response that is treating it like a disaster.”

Flexibility and pay are large attracts

UNA’s collective settlement has a pay scale of $38 to $51 an hour for RNs with out administration duties.

CBC Information discovered journey nurse commercials for placements in rural and distant Alberta areas paying as much as $85 an hour.

For the reason that workers come from throughout the nation, businesses additionally pay for staff’ journey and lodging.

AHS would not launch particulars about its contracts, together with what number of hours of labor they included or the charges businesses cost.

Melanie Olsen owns Burnaby, B.C.-based Choose Medical Connections — one of many businesses supplying staff to AHS. She has round 400 staff dispatched to all however three Canadian provinces and territories.

Olsen mentioned demand for nurses, LPNs and health-care aides has been rising for about 15 years. It accelerated throughout the pandemic.

Deciding how a lot to cost is determined by market forces and the situation, she mentioned. She mentioned charges in some locations have shot up due to the demand.

“We’ve got stored some nurses within the career that had been in any other case contemplating their choices,” Olsen mentioned.

Her company doesn’t headhunt working nurses to lure them from the general public system, she mentioned.

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Heather Pringle owns the staffing company Nurse Reduction Inc., which has been supplying staff to AHS for the final two years. (Submitted by Heather Pringle)

Pringle, the proprietor of Nurse Reduction, based her Edmonton-based company in 2008 after working seven years as a contract nurse herself. She mentioned she was drawn to contracting as a result of it allowed her to maintain extra of her earnings.

Company staff want greater charges of pay to purchase non-public medical insurance coverage, and to cowl employment insurance coverage and pension contributions, she mentioned.

Pringle units her charges by asking with the nurse what pay they would want to think about accepting a posting.

“It is simpler to seek out nurses when you are going to supply them precisely what they’re value,” she mentioned.

Quebec’s cautionary story

Jason Sutherland, a professor of public well being on the College of British Columbia, mentioned using full-time staff is mostly more cost effective than counting on contract nurses from staffing businesses.

Though the rising demand may result in a proliferation of well being staffing businesses, it may additionally give health-care staff extra leverage to demand higher working circumstances and compensation, Sutherland mentioned.

“The stability of energy has shifted away from the bigger employer into the fingers of the nurses proper now.”

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Damien Contandriopoulos is a nursing professor on the College of Victoria. (Submitted by Damien Contandriopoulos)

Damien Contandriopoulos, a College of Victoria nursing professor who’s from Quebec, says that province’s expertise with company nurses ought to be a cautionary story for the remainder of the nation.

No guidelines prevented pissed off nurses in Quebec’s public system from taking non-public company jobs with greater pay and higher working circumstances — then returning to work in the identical hospitals, he mentioned.

The hemorrhaging of nurses to the non-public sector led to dearer well being care, a decline in high quality of care and main Montreal emergency rooms so bereft of workers, they’ve had short-term closures, he mentioned.

“This could actually be alarm bells ringing for residents and authorities,” Contandriopoulos mentioned. “They tried. It failed miserably. Do not do it.”

Quebec politicians have promised to introduce laws limiting using well being staffing businesses within the province.

However in December, the Quebec authorities posted tenders for firms to offer the equal service of 4,600 full-time health-care staff.

“As soon as the toothpaste is out of the tube, it’s extremely very exhausting to place it again in,” Contandriopoulos mentioned.

Alberta desires to curtail company use

Each AHS and Covenant Well being say they’re emphasizing workers recruitment and retention so they don’t seem to be so reliant on businesses. As of Feb. 1, AHS had almost 2,300 jobs posted — 78 per cent of them in front-line care.

Williamson mentioned workers of AHS (or its subsidiaries and companions) who resign or retire after which go to work for a staffing company can’t work in any AHS facility inside six months of leaving the group.

Steve Buick, press secretary to Well being Minister Jason Copping, mentioned Alberta’s reliance on businesses ought to lower as the federal government pushes to coach and import extra health-care staff.

The federal government is funding 2,500 extra post-secondary seats in health-care fields, to be added over three years. It is also funding a bridging program for internationally educated nurses.

Since 2019, AHS has elevated its numbers of completely employed RNs, LPNs and health-care aides, Buick mentioned.

AHS mentioned company staff make up a tiny fraction of its front-line workforce.

As of November, AHS had 341 agency-supplied RNs, LPNs and health-care aides working throughout the province, out of a complete of about 50,000 workers in these professions. The company workers included 232 RNs — beneath one per cent of the overall AHS workforce of greater than 30,000 RNs, Williamson mentioned.

UNA president Smith mentioned that response dismisses the seriousness of the understaffing scenario.

With no provincial well being human assets plan ready since 2008, hospitals are left scrambling for unsustainable options like businesses, she mentioned.

“It is a Band-Help on a gaping wound.”