Frightened, frazzled and fed up

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This article was published 11/03/2024 (546 days ago), so information in it may no longer be current.

Walking through the Health Sciences Centre emergency department during a day shift last year, nurse Jaime Manness found herself suddenly in the middle of unfolding violence.

Police were using a Taser device to shock a patient right in front of her. The memory of it, seeing the electrodes fired into the patient and the resulting trauma, stays with her.

“I remember thinking, ‘I don’t need to do this anymore.’”

After 14 years working as an ER nurse in Manitoba’s largest hospital and designated trauma centre, Manness left HSC and joined a private agency. She became a travel nurse working in B.C. and Alberta, leaving behind the benefits, vacation time, sick pay and pension plan she enjoyed as a unionized nurse in Manitoba.

It wasn’t the promise of higher pay in the private sector that drove her out.

“The money up front might look better, but there’s a lot of risk involved,” Manness said.

The bigger question, she said, the one health leaders in Manitoba need to be asking themselves, is: “Why are people so willing to assume that level of risk?”

As one of an unknown number of Manitoba nurses who work for private agencies out of province, Manness has heard all the criticisms of travel nurses. Namely, that relying on private agencies to fill staffing gaps in the provincial health-care system is too expensive and doesn’t contribute to good continuity of care for patients. Manitoba is on track to spend more than $60 million this year on private nurses to fill chronic staff shortages.

Manness’s experience suggests nurses who are leaving the public system in search of better working conditions out of province aren’t doing so precipitously, and there are still lessons Manitoba could learn from other provinces’ nurse-retention efforts.

Nine months after witnessing the Taser incident, Manness is in northwestern Alberta. She negotiates her own contracts and chooses her work schedule. Her travel and accommodation costs are covered, and she earns a higher wage than she did in Manitoba. She’s made friends and has been welcomed in by the community of Grande Prairie. Working night shifts in the ER, she has time to talk to patients, explain treatment plans and make sure they’re getting the best care.

“It’s been like night and day, the change. I look forward to going to work. I feel safe… that’s the No. 1 reason that I’ve stayed in Grande Prairie so long. Because I’ve always loved being a nurse. My love for my career has never, ever been a question. But I feel safe, and I truly enjoy going back to work.”

Recently, a patient returned to the ER with his wife to thank her for her dedication. She’d had an eight-minute conversation with him explaining his treatment — a rarity in the too-often time-crunched, chaotic profession.

“I look forward to work because I am having those moments with patients,” she said.

“I have time,” Manness added. “And the care that I’m providing is making a difference again.”

Her decision to leave the public system came following two rounds of seeing criminal charges through court after she was assaulted by patients on the job. Over the course of several months, she was punched by a patient, had another’s vaginal blood clot thrown at her during triage and received verbal death threats, all while facing what she describes as a “constant threat” of violence at work.

Demoralized and dealing with the “moral distress” of feeling unable to properly care for patients amid staff shortages and ever-expanding workloads, she decided to make a change.

“That was the No. 1 thing that made me leave… that I just wasn’t able to provide the kind of care that I felt people needed, and I would go home every day… not really understanding what the point was.”

Seeking out-of-province work wasn’t an easy choice.

“I didn’t leave the job on a whim,” she said. Born and raised in Manitoba, Manness’s family and small business are still here.

“I love Manitoba and I believe in Manitoba. That’s the community I wanted to serve. I worked as a flight nurse. I worked as a critical-care nurse. Everything that I’ve done has been to serve the Manitoba population. And so, leaving was not easy,” she said.

“That’s the most important part, is that the folks who are choosing to leave bedside (nursing work) in Manitoba are not doing so (impulsively). It’s not an easy decision. And I honestly think that the situation’s just going to continue to snowball,” she added. “Until meaningful change is brought about.”

In addition to security guards in hospitals, Alberta Health Services employs “protective services officers” who are called upon to intervene when patients act out. Earlier this month as part of its nurse-retention plan, B.C. introduced mandatory minimum nurse-to-patient staffing ratios. The ratios vary by department, guaranteeing a nurse on a general medical or surgical ward won’t be responsible for more than four patients at a time.

In Manitoba, the first institutional safety officers will begin receiving training at HSC next week and are expected to be working on site soon afterward, following years of lobbying by the Manitoba Nurses Union and other advocates to bring in specialized armed guards.

Monday was the first day on the job for the new provincial lead for safety and security in hospitals, and Health Minister Uzoma Asagwara said they met last week. It was important to the government to set an “aggressive timeline” for hiring and training the institutional safety officers in response to safety concerns from health-care workers.

While no plans have been announced to follow in B.C.’s footsteps with mandatory staffing ratios, the minister said the province is “working proactively” to address nurses’ concerns and reduce their distress.

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“And to make health care in Manitoba a place where we’re able to welcome back those who left under the previous government. That’s work that is the top priority of our government,” Asagwara said.

For Manness, meaningful change will mean “listening to front-line health-care workers and understanding what they’re asking for, and appreciating why they’re asking for it.”

She said she is hopeful working conditions will improve in Manitoba.

“If my workplace could be safe, and if we could… provide the level of care that we signed up to provide, I would come back,” she said.

katie.may@freepress.mb.ca

Katie May
Multimedia producer

Katie May is a multimedia producer for the Free Press.

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