Alberta hospitals and health-care centres have turn out to be more and more depending on contract nurses and different staff to remain useful — a pattern that critics say should cease earlier than it erodes an already beleaguered public workforce.
Contract information 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, stated in an interview. “There is no short-term aid. There is no magic bullet to show it round in a single day.”
Smith stated Alberta’s 30,000 registered and registered psychiatric nurses (RNs and RPNs) are more and more being instructed to work obligatory time beyond regulation 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 stated.
The perks will be substantial, she stated. Increased pay. Higher work-life stability. Trip time that will not be cancelled.
“We’re getting increasingly more requests [from nurses] on a regular basis,” stated Heather Pringle, proprietor of staffing company Nurse Aid, Inc. “Folks wanting out of the common place and having the ability to take cost of their very own profession and be their very own boss.”
Nurse Aid supplies RNs, licensed sensible nurses (LPNs) and health-care aides to amenities in a number of provinces. For 2 years, the corporate has been one of many main contractors supplying AHS with aid employees.
In 2015-16, AHS spent lower than $400,000 on two 12-month contracts with two staffing businesses to supply urgently wanted staff.
By 2021-22, AHS had 15 contracts signed with 10 businesses that have been prepared to supply RNs, LPNs and health-care aides when essential. AHS spent almost $5.2 million on these contracts.
AHS contracts don’t embrace amenities operated by Covenant Well being, which runs Alberta’s Catholic hospitals and health-care centres.
CBC made 4 info requests to Covenant Well being in three months. On Friday, Covenant Well being offered aggregated information 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 amenities, which was about one per cent of their nursing workforce, stated communications adviser Carla Howatt in an e-mail.
The worldwide competitors for staff has pushed Covenant to make use of extra businesses than up to now, she stated.
AHS’s reliance on businesses escalated when COVID-19 arrived in Alberta in spring 2020, a spokesperson stated.
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 time beyond regulation and calling in sick at dramatically larger charges than a couple of years earlier.
Emptiness charges for RNs, LPNs and different well being professionals jumped up between 2019 and 2021.
Company homeowners and lecturers say the pattern is analogous throughout Canada and in another developed international locations.
Smith, the UNA president, stated that in earlier years, company workers — generally known as journey nurses — have been dispatched primarily to rural and distant hospitals wanting employees.
When nurses began seeing them in Edmonton and Calgary emergency rooms and intensive care items in 2022, the union started asking AHS for routine studies on the place company nurses have 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 Pink Deer Regional Hospital.
The variety of contract nurses fluctuates.
In Might 2022, AHS tallied 220 complete 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 hold observe of contract nurses throughout all websites earlier than Might 2022.
AHS spokesperson Kerry Williamson stated the rise within the fall was virtually fully exterior of Edmonton and Calgary, the place it is more durable to recruit staff.
But, even with contractors filling the gaps, hospitals and well being centres are nonetheless closing beds and briefly shutting their doorways, stated Chris Gallaway, government director of the advocacy group Associates of Medicare.
As of Jan. 31, AHS listed 31 “momentary service disruptions” in amenities throughout the province.
“We’re in a staffing disaster,” Gallaway stated. “And we’re not seeing a response that is treating it like a disaster.”
Flexibility and pay are huge attracts
UNA’s collective settlement has a pay scale of $38 to $51 an hour for RNs with out administration obligations.
CBC Information discovered journey nurse ads 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 stated 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 placement, she stated. She stated charges in some locations have shot up due to the demand.
“Now we have saved some nurses within the career that have been in any other case contemplating their choices,” Olsen stated.
Her company doesn’t headhunt working nurses to lure them from the general public system, she stated.
Pringle, the proprietor of Nurse Aid, based her Edmonton-based company in 2008 after working seven years as a contract nurse herself. She stated she was drawn to contracting as a result of it allowed her to maintain extra of her earnings.
Company staff want larger charges of pay to purchase non-public medical insurance coverage, and to cowl employment insurance coverage and pension contributions, she stated.
Pringle units her charges by asking with the nurse what pay they would want to think about accepting a posting.
“It is simpler to search out nurses when you are going to provide them precisely what they’re value,” she stated.
Quebec’s cautionary story
Jason Sutherland, a professor of public well being on the College of British Columbia, stated using full-time staff is usually 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 stated.
“The stability of energy has shifted away from the bigger employer into the palms of the nurses proper now.”
Damien Contandriopoulos, a College of Victoria nursing professor who’s from Quebec, says that province’s expertise with company nurses must be a cautionary story for the remainder of the nation.
No guidelines prevented annoyed nurses in Quebec’s public system from taking non-public company jobs with larger pay and higher working circumstances — then returning to work in the identical hospitals, he stated.
The hemorrhaging of nurses to the non-public sector led to costlier well being care, a decline in high quality of care and main Montreal emergency rooms so bereft of employees, they’ve had momentary closures, he stated.
“This could actually be alarm bells ringing for residents and authorities,” Contandriopoulos stated. “They tried. It failed miserably. Do not do it.”
Quebec politicians have promised to introduce laws limiting the usage of well being staffing businesses within the province.
However in December, the Quebec authorities posted tenders for corporations to supply the equal service of 4,600 full-time health-care staff.
“As soon as the toothpaste is out of the tube, it’s totally very laborious to place it again in,” Contandriopoulos stated.
Alberta needs to curtail company use
Each AHS and Covenant Well being say they’re emphasizing employees recruitment and retention so they aren’t 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 stated workers of AHS (or its subsidiaries and companions) who resign or retire after which go to work for a staffing company can not work in any AHS facility inside six months of leaving the group.
Steve Buick, press secretary to Well being Minister Jason Copping, stated 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 stated.
AHS stated 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 employees in these professions. The company employees included 232 RNs — below one per cent of the full AHS workforce of greater than 30,000 RNs, Williamson stated.
UNA president Smith stated that response dismisses the seriousness of the understaffing state of affairs.
With no provincial well being human sources plan ready since 2008, hospitals are left scrambling for unsustainable options like businesses, she stated.
“It is a Band-Support on a gaping wound.”