A new peer-reviewed study warns that Ontario’s hospital workers, most of whom are women and many racialized, are in deep turmoil as they labour through an intensifying staffing crisis that is harming their well-being and compromising patient care.
Running on Empty, published in New Solutions: A Journal of Environmental and Occupational Health Policy, is co-authored by Dr. Margaret Keith and Dr. James Brophy, who since 2017 have spearheaded three previous studies on working conditions in Ontario’s health care sector. Dr. Craig Slatin, a U.S. health researcher, is a co-investigator.
“Health care workers are warning us about the future of our public system,” said Dr. Keith. “They expressed a profound sense of dissatisfaction, despair, sorrow, anger, and frustration about their working conditions and the quality of patient care. There was an overarching sense of being unsupported, overworked, and disrespected, which is being driven by chronic underfunding and understaffing.”
Ontario ranks at or near the bottom of the country in key healthcare funding measures and has the lowest per-person hospital spending of any province, with 18 per cent less hospital staff compared to the rest of Canada, noted Dr. Keith.
The study says that although staffing concerns predate the pandemic, working conditions have worsened since 2020 as patient volumes have surged without a sufficient increase in staffing. Consequently, workers are perpetually asked to take care of more patients and work overtime, causing exhaustion and burnout.
A worker quoted in the study said, “Our phones never stop ringing being asked if we can come in and cover a shift. You can be leaving work and get a call before you even get to the parking lot asking, ‘Can you stay?’ You can do that once in a while, but it’s literally every day.’”
As staffing shortages cause unprecedented emergency room closures, long wait-times, and higher number of patients per staff, workers witness a marked decline in quality of care. An operating room nurse told the researchers:
“We see individuals who have been sitting in their beds for a day or two, sometimes three or four, because the operating rooms get so clogged. And when that individual gets to us they’re so filthy, they reek of their own feces. The beds haven’t been changed or the individual has not been properly turned and positioned. They’re getting pressure ulcers, which a patient should never get in the hospital.”
The research was done in collaboration with the Ontario Council of Hospital Unions-Canadian Union of Public Employees, OCHU-CUPE, based on extensive interviews with 26 hospital workers including nurses, personal support workers, housekeepers and clerical staff.
The findings of the qualitative study complemented recent polling of 775 OCHU-CUPE members, 62% of whom said they were dealing with exhaustion and high stress levels; 41% reporting they dread going to work; and 44% saying they had trouble sleeping.
“The sharp decline in their working conditions is harming their mental and physical well-being. But what is particularly jarring is the feeling of being abandoned by the government and often their own employers,” said Dr. Brophy. “It’s like your house is on fire, and everyone can see it, but no one’s coming to help. It makes you lose faith in the system.”
The sense of hopelessness and despair among workers is captured in numerous quotes peppered throughout the study. A trauma department nurse said, “You think it can’t get any worse - and it just got worse. I was going through increasing panic attacks before work, crying before I got out of the car. I loved going to work when I first started. Now I dread it.”
Michael Hurley, co-author and president of OCHU-CUPE, said that he was “stricken by the government’s relaxed attitude towards the staffing crisis”, noting that a leaked document from earlier this year showed Ontario would face a shortfall of 20,700 nurses and nearly 50,000 personal support workers by 2027.
‘The impact of the staffing shortages is felt every day by hospital patients and their families and these problems will only get worse if they remain unaddressed,” Hurley said. “You’d think that the government would be acting on a war footing and taking bold steps to ramp up recruitment and retention. That they would legislate nurse-to-patient ratios to protect morale and give nurses confidence that they can provide quality care; that they would ensure wages keep up with inflation, rather than continue real cuts to income and that they would offer free tuition, pay while training and a massive expansion in nursing and allied training programs.”
Instead, he said, Ontario continues to “witness real dollar funding cuts that are strangling the health care system” and causing staff to leave in despair, by the thousands”.
“We have seen some tinkering from the province, but nothing commensurate with the severity of the crisis. We had an astounding 870 emergency room closures last year, and we cannot allow that to become acceptable,” he said. “The government must act now.”