When Premier Tim Houston announced in late January his government’s plan to improve emergency rooms around the province it was met with some trepidation, in particular from the Nova Scotia Nurses Union, and now the plans are facing more criticism from nurses who work at the QEII Emergency Department.

Nurses within the QEII ED penned a letter on January 23 that was originally sent privately to the Premier, Health and Wellness Minister Michelle Thompson, and CEO of Nova Scotia Health Karen Oldfield, but feeling their concerns were going unheard the letter was made public on February 7.

The letter outlined their primary concern as failing to improve ED’s abilities to retain and recruit RNs, “The QEII ED is a revolving door for RNs. As soon as our new hires complete their orientation, they realize their license to practice nursing is at risk by being forced to do the impossible with limited resources, and they leave the department,”.

Dear Premier Houston, Minister Thompson and Ms. Oldfield,

We are writing to you with grave and sincere concern for the citizens of Nova Scotia accessing care at the Charles V. Keating Emergency and Trauma Centre at the QEII in Halifax. We, the front-line Registered Nurses in the ED, have bore witness to the ongoing health care crisis with beginnings far outdating the pandemic. Now, as we stand on the other side of that pandemic, it’s in an unraveling and hazardous health care landscape that’s experiencing a “brain drain” of skilled RNs. The recent press conference on ED improvements instilled one last glimmer of hope in our RNs. We envisioned our calls for help were finally answered. To everyone’s bitter disappointment, it is now clear that the Nova Scotia government is completely blind to the needs of and issues facing RNs in our collapsing ED.

The measures announced do not address one of the major issues contributing to increased morbidity and mortality in the ED: retention and recruitment of skilled RNs. Our ED now operates RN staffing levels at an average of 50-60%. With patient to nurse ratios worsening, the burnout experienced by RNs has ballooned. This is affecting our ability to retain and recruit RNs. It is driving our existing RN staff to move to casual positions, sign lucrative travel nurse contracts or leave the profession altogether. Our daily operations are now totally dependent on casual staff and travel RNs, with our core staffing being begged to cancel their vacation, come in for overtime or extend their shifts. The QEII ED is a revolving door for RNs. As soon as our new hires complete their orientation, they realize their licence to practice nursing is at risk by being forced to do the impossible with limited resources, and they leave the department. Without immediate action and interventions focused on RN retention, we fear unnecessary suffering will continue in the ED. We simply cannot be expected to spread ourselves any thinner.

We implore you to save lives and our EDs: implement RN recruitment and retention strategies immediately. Every experienced RN that leaves the ED is taking invaluable experience and expertise with them. The suggested incentives include higher wages, retention bonuses, improved night/weekend shift premiums and work short premiums. These incentives in the ED will entice RNs who have left to return, and will help to retain the few skilled ED RNs who remain. Without these incentives, the “brain drain” will continue, and it will undoubtedly sink our community EDs.

Sincerely,
The Registered Nurse group, Charles V. Keating Emergency and Trauma Centre

Prior to this letter being written, the Nurses Union sent one on January 9th that included 59 recommendations for the province to implement, and although some of those recommendations have been adopted, the most important issue of improving retention and recruitment has not been addressed.