FEATURE
T U E S D A Y, O C T O B E R 2 6 , 2 0 2 1
S A S K AT O O N S TA R P H O E N I X
B1
HEALTH CARE PROVIDERS WEEK Critical nursing shortage looms as many poised to leave amid crushing health system pressures
BY PAT REDIGER
Although nurses have been considered health care heroes in the fight against the COVID-19 pandemic, the rising number of cases, government decisions and anti-vax demonstrations are taking their toll. “They are demoralized, depressed, burnt out and are now often seeing patients who should be in the ICUs (intensive care units) on the medicine wards because there isn’t any room in intensive care. It’s causing so much stress and anxiety for nurses right now,” says Tracy Zambory, president of the Saskatchewan Union of Nurses (SUN). Just a few months ago the public were banging pots and pans in support of health care workers and placing signs of appreciation in windows. Nurses are now witnessing crowds of anti-vaxxers and COVID-deniers demonstrating outside hospitals, while tensions inside health facilities are also escalating as patients and families vent their frustrations with public health measures and decreasing access to the health care services they rely on. “This is the most detrimental thing that’s ever happened to the morale of registered nurses,” says Zambory. “For our members to go from heroes to zeroes when they are struggling to keep their patients safe at the expense of their own mental and physical health, is nothing that you can even put into words. It’s just caused such deep hurt.” Despite this growing pressure, Zambory said registered nurses will continue to answer the call for both vaccinated and unvaccinated patients. As soon as a patient comes through the doors looking for help, registered nurses and the rest of the health care team will provide the best level of care they can under extremely trying circumstances. As the COVID numbers have increased and the health care system is stretched to its limits, Zam-
bory questions the effectiveness of the provincial government’s solutions. For example, as beds in the ICU have been filled, some patients who need this level of care are now being placed on medical wards that have neither the equipment nor staffing for these situations.
(Nurses) are not unbreakable. There is a pandemic inside the pandemic. You are seeing more injuries and more mental health injuries, and there are many who are considering no longer practicing. - Trac y Zambory, SUN p r e S i d e N T
“ Fr o m a r e g i s t e r e d nurse’s point of view, this is very troubling and frightening because someone’s life is at stake. Nursing in intensive care requires a special skill set and for patients who need the ICU not to have access to this level of care is very dangerous. Our members are extremely worried, and it’s only going to get worse.” Although the premier has indicated that the province is managing, Zambory said the truth is that the rising number of new infections, ICU admissions and number of deaths indicate otherwise. “When we are leading the nation with record case numbers and hospitalizations, and surgeries, diagnostic testing, chronic disease management, and even organ transplants are on hold, it’s clear we are not coping.” Nurses have been shouldering most of this burden since the pandemic began in earnest in March 2020
and it’s exacting a toll on these people. “They are not unbreakable,” said Zambory. “There is a pandemic inside the pandemic. You are seeing more injuries and more mental health injuries, and there are many who are considering no longer practicing.” The latest numbers from Statistics Canada underscore the impact the pandemic is having on the nursing profession. Vacancies in health care and social assistance increased by 40,800 (+59.9%) from the second quarter of 2019 to the second quarter of 2021, the largest increase of any sector. This increase brought the number of vacancies in the sector to 108,800, representing one in seven job vacancies in Canada. Vacancies grew in all subsectors, led by hospitals and nursing and residential care facilities. Closer to home, the latest statistics from Saskatchewan indicated that there were 295 registered nurses and registered psychiatric nurse vacancies in the first quarter of this year, up from 95 vacancies a year before. “What we are seeing is that it’s just not the nurses who are in the mid-to-late stages of their careers, but many younger nurses who are saying that they didn’t sign up for this type of pressure. They cannot work under these circumstances any longer.” Even when the pandemic is over, there will be significant strain on the system. There is a backlog of surgeries that had to be cancelled and others whose health situations have been exacerbated as their chronic conditions have worsened or illnesses have spread since there was simply no opportunity to operate. As the health care system continues to struggle, Zambory said it will take the right leadership to address so many issues. Although vaccines are part of the solution, they are only one tool in the tool kit. Other measures include mandatory masking, limiting group
Just a few months ago the public were banging pots and pans in support of health care workers and placing signs of appreciation in windows. Nurses are now witnessing crowds of anti-vaxxers and COVID-deniers demonstrating outside hospitals, while tensions inside health facilities are also escalating. GET T Y IMAGES
Tracy Zambory, SUN president
size, and consistent policies and messaging around vaccine passports. She said that even without government mandates on these measures, the public can still take their own action and do these things to help stop the spread of
the virus and take pressure off the health care system. She also advises that people should contact their elected officials and express their concerns. “If people find themselves questioning why it is that we are having this
THIS SECTION WAS CREATED BY CONTENT WORKS, POSTMEDIA’S COMMERCIAL CONTENT DIVISION.
I am an ER nurse.. Right now, we are working short-staffed, with a dangerous and scary patient-to-nurse ratio. We do not have time to take care of our patients’ basic needs. I am demoralized, stressed out and I am sick before every shift. Something has to change so our nurses stay. - Catherine, RN BSN
THANK YOU to every single health care worker keeping Saskatchewan safe against all odds.
sun-nurses.sk.ca/answerthecall
SUP P LIED
type of COVID response, then we ask that they have a conversation with their Member of the Legislative Assembly (MLA) to find out what is happening and let them know how they feel. We need the public to have a voice.”
B2
T U E S D A Y, O C T O B E R 2 6 , 2 0 2 1
FEATURE
S A S K AT O O N S TA R P H O E N I X
HEALTH CARE PROVIDERS WEEK
Time to recognize our frontline heroes BY JENNY GABRUCH
It’s been trying times, to say the least, for Saskatchewan’s health care providers. Whe t her worki ng on the front line or behind the scenes, those in the field have been answering the call to serve and care for the public amid the ongoing challenges brought on by the global COVID-19 pandemic. “It’s been very stressful, very emotional,” says Tracey Sauer, president of the Saskatchewan Government and General Employees’ Union (SGEU). Indeed, the pandemic is pushing the provincial health care system to the brink, with extreme pressure on emergency rooms and intensive care units. There are too many patients and not enough beds or staff to care for them. Health care workers are dealing with burnout, stress and mental fatigue. “Our health care providers are working short, they are working overtime in the biggest crisis of our lives — so just imagine their mental health,” says Sauer. “They’ve covered each other not only with workloads, but they’ve covered each other emotionally.” ANSWERING THE CALL Sauer notes health care professionals have been providing dedicated care and services long before the pandemic began, and will continue to do so long after the crisis. “In my eyes, they’ve always been heroes,” she says. “If you ask any one of them if they are heroes, they will tell you, ‘We are just doing our job.’ But they are doing way more. They do what they do with their heart, with their soul and they do what they do with compassion and care. “I do believe they are heroes. I believe you couldn’t
find any stronger, dedicated people than our health care providers, and our health care workers in general.” That includes physicians, nurses, continuing care assistants, medical laboratory and diagnostic technologists and technicians, environment and laundry service workers, food service staff, office workers, therapy and recreation workers, maintenance staff – and the list continues. In Saskatchewan, there are around 43,000 unionized health care workers, along with those in the private sector. They work in public health, home care, long term care and acute care. ABOVE AND BEYOND During Health Care Providers Week, Sauer encourages everyone to recognize the contribution and efforts of those who play an indispensable role in patient care and the health care system, especially during this crisis. “They’ve gone over and above anything that they expected to be doing when they were hired for the job,” she says. Sauer knows first-hand. She began working in the health care field, in special care homes, when she was 18. “When a health care provider works in a nursing home, they become like family,” she says. “They become heroes to those residents in nursing homes, they become heroes for their home care clients and in the hospitals. Many become advocates for the people they are there to take care of.” Early in the pandemic, health care workers were hailed as heroes around the globe, but now some staff are encountering verbal abuse and hostility as frustrations mount. Sauer hopes people will work with health care workers, not against them. “If they have an issue,
Saskatchewan health care workers are dealing with stress, burnout and mental fatigue as they provide dedicated care and services during the biggest health crisis in decades. P HOT O:SGEU
They are doing their job.” To help address the issue, Sauer is calling for improved communication from the government. “The public is very frustrated. There aren’t always clear messages of what is being done and why it’s being done. I would like to see more consistent messaging from the government, and I would like to see more consultation with the government and the unions. “Health care unions have a vast amount of knowledge, and their voices need to be listened to.”
Tracey Sauer, SGEU president
they need to talk to their MLA, and not take it out on people that are trying to
S U PPL I E D
serve and protect them,” she says. “This will not be tolerated. Be kind, be respectful.
SHOWING SUPPORT Sauer says the public can recognize and support the province’s health care providers in several ways. She notes window signs thanking health care workers have been appreciated.
“I would like to see people continue that support,” she says. Another way to show support is by following public health orders and recommendations to ease the intense strain on the health care system due to COVID-19 hospitalizations. “ The most important thing right now is taking safety measures seriously. It’s the most helpful thing people can do right now. Wash your hands, wear your mask, social distance, get vaccinated … stay at home if you are sick. We need to alleviate the pressures on our health care system,” she says. “I do hope everyone will do their part to keep each other safe. And, by keeping each other safe, you will be supporting our health care workers.”
Five ways to better prepare for medical appointments It can sometimes feel like a health appointment flies by and that some questions are left unanswered. But there are some things you can do to feel more control and make the most of the limited time. “Preparation is key to the success of any appointment,” explains Trish Barbato, president and CEO of the Arthritis Society. “The best person to advocate for you is
yourself.” Here are five steps to make sure you’re ready for your next visit to your care provider, whether it’s in person or virtual. 1. Track your symptoms. Keeping track will help you effectively communicate the impact of your symptoms and understand what contributes to making them worse or better. 2. Come prepared with
any health care information. Keeping all your details in one place can help you stay on top of things. Consider a folder or a binder to stay organized. 3. Write down questions in advance. To avoid missing information, make sure to prepare a list of questions and write down the answers during your appointment. 4. Check to make sure you understand. Repeat
back what you are told and ask for confirmation. Don’t be afraid to ask your health care provider to repeat something. 5. Be honest. Share your concerns with your treatment team member if there are some aspects of your plan that make you uncomfortable. They may be able to suggest alternatives. Find more information at arthritis.ca. (News Canada)
Preparing in advance of your next medical appointment will help you make the most of the time you have with your health care professional and ensure that all of your concerns are discussed. (P HOT O: NEWS CANADA)
THANK YOU
The Saskatchewan Polytechnic Schools of Health Sciences and Nursing recognizes and thanks the Saskatchewan Health Authority, our many community partners and all of our preceptors for their unwavering commitment to our students’ success during these unprecedented times in our healthcare system. Through their dedication and support to health care education, our students will be able to safely finish their education and successfully graduate! We salute all health care workers in the province for their ongoing dedication and commitment to the profession and the people they care for.
saskpolytech
saskpolytech.ca
FEATURE
T U E S D A Y, O C T O B E R 2 6 , 2 0 2 1
S A S K AT O O N S TA R P H O E N I X
B3
HEALTH CARE PROVIDERS WEEK Saskatchewan residents embrace virtual health care during pandemic
BY ELIZABETH IRELAND
When was the last time you saw your family physician in person? For many people, seeing the doctor now means communicating health care concerns by telephone, videoconference, email, secure messaging or through the eHealth Saskatchewan patient portal. From March to December 2020, more than 1.7 million virtual health care appointments took place in the province, according to SaskHealth billing data. Saskatoon-based Dr. Myles Deutscher is president of the Saskatchewan College of Family Physicians (SCFP). His term with the SCFP is for two years and he currently practices clinical medicine, family medicine, obstetrics, transitional care and long-term care. The SCFP is under the umbrella of the College of Family Physicians of Canada (CFPC), which represents and advocates for more than 30,800 members across the country. Dr. Deutscher grew up in Meadow Lake, SK. He earned degrees in chemical engineering and medicine from the University of Saskatchewan and completed his family medicine residency in 2009. Since the COVID -19 pandemic began, Dr. Deutscher has experienced the shift to patient-centered virtual health care first-hand with his own patients. “Family physicians in Saskatchewan serve the full age
spectrum of patients — from delivering babies to following through an individual’s entire life to long-term care and palliative care. As family physicians, we view virtual care as another tool or service on top of what we are already doing. It is worth noting that the province has capped virtual health care visits to 3,000 per physician per year,” says Dr. Deutscher. Due to provincial caps, 2021 statistics for virtual health care will probably remain similar to the first year of the pandemic. However, Dr. Deutscher notes that during the early months of the pandemic the number of overall patient appointments dropped and “health problems built up.” A c c o r d i n g t o D r. Deutscher, some advantages of virtual health care include safety during a pandemic, shorter appointments (no sitting in a waiting room), and the ability for physicians to serve patients outside of typical clinic hours. Plus, there is less interruption to a patient’s day getting to and from the doctor’s office. The types of appointments that are appropriate for telephone, video calls or secure messaging include follow-ups on test results and responses to treatment. Common virtual care tools used by Saskatchewan physicians include pexip, doxy. me and Zoom. Patients should see their doctor in person when they are experiencing a new health concern, the patient
A virtual health care appointment is quick, convenient and limits exposure to others who may be ill, especially important during the pandemic. GET T Y IMAGES
has complex comorbidities, or their symptoms are potentially high-risk, such as severe chest or stomach pain. Anything that requires a physical exam, such as a skin complaint, requires an in-person appointment with a doctor. Challenges for virtual health care include privacy and technology issues. Dr. Deutscher hopes that a poor internet connection or lack of access to technology, particularly in rural and remote locations, does not risk fur-
ther marginalizing some Saskatchewan patients. For example, for a video-based virtual visit, the patient needs to have access to a webcam, microphone and speaker in a private setting. For physicians, it can be more difficult to make a diagnosis virtually and onus is on the physician to say that the patient needs to come into the office for an appointment. There are also the twin risks of overprescribing antibiotics and overusing diagnostic tests
(which increase costs to the province’s health care system). Dr. Deutscher is clear that while virtual health care can be equated to going to a walk-in clinic, it is not the same. He also wants Saskatchewan residents to be aware that “corporate virtual care is not the same as virtual care with your own family physician who knows you and your history. It is fragmented, episodic care with no communication between the corporate
vendors or shared access to your records. Corporate virtual care is also pulling physicians out of the public system.” Finally, is this mode of health care expected to last beyond the pandemic, because of the convenience and enhanced patient safety? “We hope virtual health care remains post-pandemic for family physicians to provide as an alternative option to in-person visits in the appropriate clinical setting,” concludes Dr. Deutscher.
B4
T U E S D A Y, O C T O B E R 2 6 , 2 0 2 1
FEATURE
S A S K AT O O N S TA R P H O E N I X
HEALTH CARE PROVIDERS WEEK
How to cope with fear during a contagion BY HILARY KLAS SEN
The current iteration of COVID is posing yet more dangers for health care professionals in the province. Stress, staff shortages, anxiety and burnout are rising. With that, new terminology is arising to help identify and explain what is happening. Additional fears now being documented by researchers include “coronaphobia,” the fear of developing the COVID-19 illness, according to Dr. Camelia Adams, associate professor in the Department of Psychiatry at the University of Saskatchewan. A more encompassing term recently developed — “Covid Stress Syndrome” — identifies a range of fears surrounding the pandemic. “It’s a fear of the socioeconomic consequences, fear of losing the job, or the traumatic stress of witnessing illness and death, or even xenophobia, prejudice against people from other countries believed to contribute to the spreading of the virus,” says Adams. Her colleagues in Regina, a team led by Gordon Asmundson, have been investigating the syndrome and have developed a scale to measure it. On the other end of the spectrum, “Covid Disregard Syndrome” is a constellation of attitudes and behavioral choices fueled by the belief that the threat of COVID-19 is fabricated or exaggerated. For those on the front lines of patient care, disregarding the virus is not an option. Adams’ survey of 118 Saskatchewan physicians released earlier this year regarded their wellbeing rather closely. Her group at the U of S found that while 95 per cent had effective coping strategies, they were far from asymptomatic. More than 70 per cent of physicians reported that their mental health was worse and 55 per cent said their physical health was worse. More than 40 per cent experienced sleep disruption. Adams’ group plans to re-send the survey shortly. “Now, almost a year later, I expect mental health problems to be even worse,” Adams says. In the data collected by Dr. Adams, it was obvious that physicians tried their
A survey conducted by Dr. Camelia Adams revealed that over 70 per cent of Saskatchewan physicians reported that their mental health was worse and 55 per cent said their physical health was worse as a result of the pandemic. GET T Y IMAGES
Dr. Camelia Adams SUPPLIED
best to cope with the situation. A huge majority reported healthy coping styles such as exercise, relaxation, yoga, interpersonal support, spiritual or cognitive strategies. They committed to their strong value systems and altruistic goals, such as professionalism, integrity and stoicism. They also felt mentally prepared for their roles, described simply in statements such as these: “I chose this job,” or “I was ready for something like this,” or “This is what I was prepared for, moments like this.” Perhaps this high level of commitment arises from the Hippocratic Oath, or the training physicians undergo.
Studies, including Adams’, have shown that in this and other epidemics, in the face of danger, physicians typically choose to remain professional even at the expense of their own health. But how sustainable is this resilience in the current environment? While physicians were initially trusted and praised when the pandemic started, they also experienced unnecessary blame and lack of appreciation along the way (even being attacked in some locations). To protect that resilience, Adams recommends health care workers be attentive to the adaptive strategies that work for them and prioritize them. These coping mechanisms may be different depending on the person. They may be behavioural, spiritual, cognitive or interpersonal. For some, it might be a blend of several styles. “It might seem small, but sometimes the simple intention of prioritizing healthy coping makes a difference. Our survey showed the top strategies that helped most of our physicians revolve around healthy routine and physical activity, (regular meals and sleep, exercise, walks); spiritual coping (meditation/prayer or other practices according to one’s spiritual practice); interperson-
al coping (connection with loved ones); and remembering the reasons that made us choose this profession in the first place (altruism, generosity). These might be enough to ground many of us. I also think that minimizing unnecessary stress (including too much exposure to stressful social media or news) and minimizing unhealthy coping (such as overeating and substance abuse) is important,” Adams says. In an environment of fear, a lot of time can be spent worrying. It’s important to identify unnecessary worrying and replace it with healthy planning, she says. “It is also important to
remember that when those steps fail, there are many of us willing to help.” Adams’ survey revealed that only one physician of the 118 respondents sought professional help. There may be some residual stigma in the profession about asking for help. “Physicians are seen as helpers and never as the helped ones. It would be hard to switch roles. Asking for help from professionals who can offer support, guidance and even treatment (e.g. medication) is a welcome choice. There is strength in admitting to one’s vulnerability and in voicing needs,” says Adams. “I do believe this is a ripe time to shift physicians’
thinking with respect to their threshold for needed support. We need to help each other to be able to help others.” Adams says there is evidence that empathy fights burnout in health care professionals. “Perhaps now more than ever it is important to reconnect with compassion for one’s patients, for one’s commitment to helping others and for each other. And maybe to remember that even when physicians’ efforts seem to go unnoticed by some, there are many people out there who see their tough journey during this pandemic and appreciate everything they do.”
Thank You
to all Saskatchewan health care providers for everything you have done and continue to do each day for our children, moms-to-be, and families. We stand with you today and every day.
pattisonchildrens.ca
FEATURE
T U E S D A Y, O C T O B E R 2 6 , 2 0 2 1
S A S K AT O O N S TA R P H O E N I X
B5
HEALTH CARE PROVIDERS WEEK Critical care in the air: STARS on a mission to save lives
BY RAY PENNER
It’s 3:15 a.m. and a young mother is driving through the night, hoping to get her and her three-year-old daughter home to Alberta before daylight. But the long day she has worked catches up with her, about 60 km northwest of Saskatoon. For just a few seconds she falls asleep, the small SUV veers off the highway, hits a culvert and rolls over. The mother manages to crawl out of her window, relatively unhurt but is frantic about her daughter, who is bleeding from her forehead and unresponsive. Desperate, the mother calls 911. As part of the 911 network, the STARS team in Saskatoon picks up the call, immediately assesses the situation, and within 10 minutes is in the air. With a top speed of 230 km/h, it takes little time for the two pilots to get the helicopter to the scene, using the coordinates issued by 911 dispatch. With the RCMP now waiting at the scene, the crew’s critical care nurse and paramedic get the child into the helicopter, along with her mother, and the helicopter takes off again. The crew radios ahead to alert Jim Pattison Children’s Hospital. Minutes later, they land at the hospital’s heli-pad, then transport the patient onto the elevator to the waiting pediatric emergency team. Thanks to a fast response, the child’s life is saved and she fully recovers. It’s a scenario that Tracey Steel, director of clinical operations for STARS — Shock Trauma Air Rescue Service — knows all too well. A critical care nurse herself, Tracey still flies on emergency response calls, along with directing clinical operations across Saskatchewan, Alberta and Manitoba. She actually met a grateful patient many years later after their STARS rescue from a rollover. “Working at STARS makes you feel like you’re making a real difference in people’s lives,” says Steel. In addition to the regular crew of four, STARS might also involve a transport physician who is on-call 24/7
and may travel with them, or advise them by phone. The transport physician also may make a triage decision, such as diverting a flight from one destination to another, to attend to an even more dire situation. Interestingly, when the 911 call comes in, the two helicopter pilots are not privy to the medical information, so that they can focus solely on fly-no fly factors such as weather conditions. “We do not want the medical information influencing their decision of whether or not it is safe to respond,” explains Steel. The other two members of the crew — the critical care nurse and critical care paramedic — are proven professionals. The paramedics have five to 10 years of critical care experience in an intense urban environment. Likewise, the nurses of STARS have years of experience in intensive care or emergency rooms. The rigorous hiring standards are “just the tip of the iceberg,” notes Steel. Recruits then undergo six months of further critical care training, followed by a transition period with a trainer. If they pass that test, they can then expect to undergo 100 hours of mandatory training annually, including monthly and quarterly mandatory training. Steel emphasizes that STARS works closely as part of “the chain of survival,” which involves police, air ambulance, ground ambulance and medical facilities throughout the region. Even if an emergency means the helicopter has to travel farther than its 250 km (oneway) radius, there are caches of fuel in rural areas that STARS can count on. Within the three Prairies provinces, there are six STARS bases including Saskatoon, Regina, Edmonton, Calgary, Grande Prairie and Winnipeg. The Saskatoon base has approximately 50 employees, some of whom, like Steel, are responsible for aspects of operations at all the sites. Each of the sites has one helicopter, with another four in the fleet to enable regular maintenance without disrupting service. In Saskatoon, one
The health care team aboard each STARS mission includes a critical care nurse, critical care paramedic and two pilots. A transport physician is in constant communication with the team and may also be aboard the flight. P HOT O: STAR S
heli-pad, at the Children’s Hospital, serves all incoming STARS flights. Currently, STARS is upgrading its fleet to new H145 helicopters, each with a price tag of $13 million when fully outfitted. Additionally, it costs, on average, $10 million per year, per base to operate STARS. “STARS is built for the community by the community,” says Steel. No wonder then, that fundraising is an ongoing and significant focus. The provincial government provides almost half the annual funding, with the remainder coming from corporations, small businesses, service clubs, and individual donors. STARS is also in the final phase of its major capital campaign to fund the new helicopters, which means raising an additional $6 million. A significant way for individuals to support STARS is through the STARS Calendar campaign, with Viterra as their principal corporate partner, and through the annual STARS Home Lottery. The calendar has raised $1 million annually, and last year’s home lottery set a new record at more than $5 million. More information on both campaigns can be found at STARS.ca.
STARS’ critical care teams stand ready around the clock to provide life-saving care across Saskatchewan, Alberta and Manitoba. P HOT O: STAR S
CELEBRATE NATIONAL NURSING WEEK
Thank you Medical and Support Teams at Royal University Hospital!
How can YOU support our Medical and Support Teams at RUH? Make a donation to help fund professional development, scholarships and continuing education.
Donate today. Charitable BN: 11927 9131 RR0001
ruhf.org
306.655.1984
CUPE LICENSED PRACTICAL NURSES AND CONTINUING CARE ASSISTANTS HAVE BEEN ON THE FRONT LINES SINCE THE START OF THE PANDEMIC. THANK YOU.