Hamilton, Norfolk hospitals grapple with nursing shortage

Amy Warren loves her job delivering babies at Norfolk General Hospital. But as one of 10 nurses currently doing the work of 27 in the Simcoe hospital's busy obstetrics unit, Warren could use a break.

For months, she and her colleagues have taken on extra shifts to make up for a shortage of nurses in their unit and throughout the hospital.

It's been a little bit stressful, to be honest," Warren said.

A lot of us have been picking up overtime to try to compensate. I think burnout rate's on the higher end right now. But we're doing the best that we can."

The need for reinforcements is particularly pronounced in Unit 3B, a combination delivery and medical-surgical ward where, on average, a baby is born almost every day.

But it never works out that way," director Amanda Sonnenberg said with a laugh. We had seven in 24 hours and then the next day we had none."

Sonnenberg hopes a $5,000 signing bonus for labour and delivery nurses will attract more applicants to her unit.

This is a high-risk area and we really need skilled people back here, so we need to invest in it. Because we're chasing our tails with the turnover," she said.

Exodus from the profession

Nursing vacancies are nothing new in Ontario, where almost every hospital is desperate to bring in fresh blood as veteran nurses reach retirement age. But the pandemic has sped up an exodus of health-care workers from the profession and Norfolk General has not been spared.

It's a supply and demand issue," said Sonnenberg, a resident of the hamlet of Pinegrove who was hired as an intensive-care nurse 10 years ago and became unit director in 2019.

We have had, unfortunately, burnout with the pandemic. We've seen nurses leave acute-care settings and go to clinics or the health unit or Monday-to-Friday jobs," she explained.

Hospitals have added vaccine clinics, assessment centres, all these things. We're still trying to cover our bases with the same number of nurses."

Add in declining enrolment at nursing schools and a pandemic-prompted hiring frenzy across the sector, and the result is a shortage that extends well beyond any one county.

It's across Canada," Sonnenberg said. We haven't had anybody leave for the States recently, because of the pandemic, but we have had people leave the province."

Ideally, she said, there would be 20 full-time and seven-part time nurses working in her unit. At the moment there are two part-timers and 16 full-time nurses, but half of them are on maternity leave.

That leaves 10 nurses to deliver between 300 and 350 babies a year, with parents coming to Simcoe from every corner of Haldimand-Norfolk since neither hospital in Haldimand County has a delivery ward.

Our front-line staff have been amazing," Sonnenberg said, adding that almost 800 people were admitted to the obstetrics unit for assessment last year.

With hospitals throughout Ontario vying for the same pool of talent, Sonnenberg said the $5,000 signing bonus is a way for Norfolk General to sweeten the pot. As further incentive, the province offers up to $20,000 in student loan forgiveness for nurses and nurse practitioners who work at rural hospitals.

We have found that people like to get their experience here and they take those skills elsewhere," Sonnenberg said. We're hopeful that the signing bonus will bring some skilled people in."

A few nurses have applied, but Sonnenberg said they did not have the necessary training to work on 3B, where nurses can deliver a baby in the morning and attend to surgical patients in the afternoon.

Those applicants are being considered for nearly three dozen other nursing positions currently advertised on the hospital's job board, along with postings for personal support workers and lab technicians.

We're here for our patients'

Hamilton hospitals are similarly scrambling to fill open nursing positions, with the shortage at St. Joseph's Healthcare Hamilton growing, said spokesperson Maria Hayes.

Hayes said some nurses have left St. Joseph's for health-care jobs with more regular hours, including virtual positions that allow for greater flexibility and more work-life balance" in the wake of the pandemic closing schools and keeping their children home.

In 2019, Hamilton Health Sciences offered a $30,000 bonus to attract surgical nurses due to a shortage that caused operating and delivery rooms in Grimsby to close on weekends, but uptake was low.

St. Joseph's has not actively considered" signing bonuses for new hires, with Hayes saying that approach does not bring workforce certainty."

We have focused on developing specialized skillset expertise through learning programs with our educational partners such as Mohawk College," she said.

Rural hospitals face disadvantage

Smaller hospital like Norfolk General are slightly disadvantaged" by not being attached to a regional care centre or medical school since they do not have a large pool of medical students and resident doctors who can fill in for exhausted nurses, Sonnenberg said.

Nurses are kind of the jack of all trades around here," she said. If nobody knows who does it, it's probably your nurse."

Attracting and retaining nurses is not an issue of pay, which is consistent for unionized nurses across Ontario, but of convincing applicants from outside Norfolk of the benefits of living in a rural area.

I love being a nurse here," said Warren, who was born in Port Dover and returned home to work at Norfolk General after graduating from McMaster University eight years ago.

Because we're a small hospital, you get a real sense of family," she said. Everyone knows everybody and everyone has a very high level of mutual respect."

Employees who live in Norfolk often run into past patients at the grocery store, which adds to what Sonnenberg called a sense of community pride."

A lot of our people are local, so this is our hospital," she said. We need this hospital to be the best it can be because it's where our families come."

Warren said she hopes to soon be welcoming new coworkers to her unit to relieve the pressure.

In the meantime, she focuses on her favourite part of the job - helping to bring new life into the world.

In labour and delivery it's a different kind of rewarding," she said.

You get to watch people get the greatest gift of their life, and that's moving, it really is."

J.P. Antonacci's reporting is funded by the Canadian government through its Local Journalism Initiative. The funding allows him to report on stories about the regions of Haldimand and Norfolk.