Manitoba should take pro sports approach to solve nursing problem

Opinion

Hey there, time traveller!
This article was published 24/01/2024 (595 days ago), so information in it may no longer be current.

Professional hockey teams — particularly ones located in cities such as Winnipeg — face a chronic dilemma when it comes to improving the overall quality and quantity of their players: should they try to lure experienced free agents or draft and develop a new generation of talent?

The very same dilemma faces Manitoba’s health-care system.

The combined impact of the pandemic and years of mismanagement and austerity by the former Progressive Conservative government has left this province’s public health-care system with huge talent shortage, particularly when it comes to nurses. The magnitude of the shortage is reaching astronomical proportions.

A Free Press story this week confirmed Manitoba’s regional health authorities are expected to spend more than $70 million this year on private-agency nurses to fill holes in the schedules at hospitals, clinics and long-term care facilities.

How can private agencies provide the extra bodies when health-care facilities are so short?

Most agencies are flush with experienced nurses, the vast majority of whom are frustrated refugees from the public system. After years of radical change in health-care delivery without consultation, threats of wage freezes, delayed contract talks and increasingly less control over their schedules, these nurses simply left the public system.

In a master stroke of irony, many of the agency refugees end up covering off shifts back in the public system, albeit for slightly higher pay and vastly enhanced control over when and where they work.

When it was elected last fall, the NDP government promised to recruit hundreds more nurses and lure back as many as possible from private agencies. The unrelenting increase in the use of private agencies is evidence the government’s efforts have fallen on deaf ears.

Now, Premier Wab Kinew and his government may have to face up to a rather daunting reality: the nurses who left the public system out of protest or necessity aren’t coming back. Not for more money, more control over their schedules or enhanced benefits.

If that is the new reality, what is the government to do?

In short, it’s time to focus on the draft-and-develop model. In other words, Manitoba has to train the nurses it needs and do it as quickly and effectively as possible. And then hope that it can retain existing nurse population and maybe lure a few free-agents back from private employers.

On this issue, time is of the essence.

A shortage of nurses, both in hospitals and in other facilities within the spectrum of publicly funded health care, leads to a lack of overall capacity. Fewer nurses in ERs means longer wait times. Fewer operating-room nurses means fewer surgeries. Fewer nurses in palliative units of hospitals means fewer open beds.

The nursing shortage is particularly problematic now, as Manitoba suffers through one of the worst non-pandemic respiratory virus seasons in memory.

It should be noted the previous government tried to ramp up nurse training.

Starting during the worst parts of the pandemic, the Tories announced increased funding for all manner of nursing-program spots. This included $20 million in 2021 for more than 250 new training seats and a flurry of additional, similar announcements in 2022.

In early 2023, the Tories also authored an ill-fated recruiting mission to the Philippines that failed to land any nurses.

As well-meaning as these efforts were, they have not managed to meet the need for nurses within the public system.

The province is now working with nursing unions on a new contract that will once again try to find a formula for recruiting former public-sector nurses working privately, and retaining those who have so far resisted the agencies’ siren call.

Although the Manitoba Nurses Union supports increased training investments, president Darlene Jackson has said retention must serve as the focus in contract talks this year. The union has said it may take four to five years for stepped-up training to have a real impact on staffing levels.

In the interim, there is an argument for increased investment in the provincial float pool, where nurses sign up for casual or part-time shifts in facilities outside of Winnipeg. The float pool was designed, in part, to entice nurses that have left the public system with the same flexibility and shift premiums as private-agency assignments.

A feature of the 2021 MNU contract, the number of nurses working in the float pool is now 113, up from 55 last summer. That is certainly a positive development. However, it alone won’t meet the crushing need for more nurses in larger facilities.

The draft-and-develop model is not without its risks. The cost to government of training a nurse is high and, once graduated, there is nothing to stop them from fleeing to private agencies or other jurisdictions.

And it’s going to take time to translate an open seat in a nursing program to a fully functioning nurse.

For all those reasons, we simply cannot afford delays in draft-and-development efforts. All available evidence suggests there isn’t enough money in provincial coffers to bring private agency nurses back into the public fold.

dan.lett@winnipegfreepress.com