It’s time for a moratorium on cutting nurses’ jobs and replacing nurses with poorly trained and unregulated care workers in Canada, the president of the Canadian Federation of Nurses Unions told the Annual General Meeting of the United Nurses of Alberta today.
What’s more, it’s time for politicians, health care managers and nursing leaders to start listening to what front-line nurses tell them about staffing needs, instead of just saying they love nurses and then replacing them with unskilled workers, Linda Silas said.
“They just want to tell you, ‘Oh Nurses, we love you! If you get sick, there’s a warm body out there to replace you.’ They don’t want to look at the evidence,” Silas said. “That doesn’t make sense. It’s not safe.”
If Canadian health care system leaders have justified the need for an RN, then they need to replace that professional with an RN, Silas argued. If a patient’s acuity indicates that patient needs an LPN, then you need to fill that job with an LPN, not a personal care worker.
“We need personal care workers in our teams, but we can’t leave them solely liable for patient safety. It’s our responsibility as nurses,” said Silas.
Despite Canada’s steadily rising health-care costs, Silas noted, “the lifespan of Gen X and Gen Y is falling off, and they are likely to be the first generation in history to live shorter lives than their parents. … Why? Because of chronic disease.”
“It is imperative that we re-consider what health services we are investing in, and be clear about what return we are realizing for those investments,” she explained. “And who better to re-imagine health care than nurses?”
So there is a perfect alignment with nursing, Silas said, because so many of the needs related to chronic disease – and to healthy aging – are within the existing domain of what nurses do.
And yet, she stated, many health leaders are ignoring the advice these front-line professionals give them – and everywhere replacing skilled nurses with minimally trained and unregulated aides, plus squeezing unpaid overtime out of professional nurses.
“For years, ‘they’ told us we didn’t know what we were talking about when we protested against cuts,” she said. “‘They’ used to say, you unions are just worried about jobs.”
“Today, we have the evidence to add to our common sense that sick patients need educated and qualified nurses, not ‘10-Week Wonders,’” she stated. “We can never talk about the evidence enough, and in 2013 we have scientific evidence.”
So if the goal is to save money, Silas noted, cutting nurses is not the way to do it.
Consider hospital expenditures: Nursing salaries used to be 69 per cent of hospital budgets in 1976, 64 per cent in 1991, and today it’s below 59 per cent – while doctors’ compensation and cost of drugs have doubled! “So are the numbers justifying the nursing cuts?”
Health care decision makers also need to be reminded that “for every surgical patient added to a nurse’s workload, the odds of a patient dying under the nurse’s care increased by 7 per cent.”
That is why “it’s time for a moratorium on all ‘transformation,’ and on all nurse job reductions,” Silas said, arguing all 11,000 new Canadian nursing graduates should have full-time jobs.
Silas compared what’s happening in health care in Canada to the airline industry, observing: “Pilots get sick. And guess what, they do not replace them with the baggage handler!”
“We shouldn’t replace nurses with unskilled health workers either,” she said. “In health care, we do replace nurses with baggage handlers, and we have to stop it!”
“Frustration is high because we are putting patients lives in danger and we are risking nurses work life everyday,” Silas added. “The only way to change that is for nurses to speak up – don’t be ashamed … Yes, it is about jobs! Yes, it is about patient safety! Yes, it is about your safety and it is OK to speak up!”
“No doubt in my mind there is a masterplan to shut us out, to shut nurses out,” Silas warned, pointing to federal and provincial efforts by conservative politicians to limit union rights and subject unions to unreasonable restrictions on free speech and free association.
Nurses need to get their heads out of the sand, she said. “We may think austerity measures are only in Greece or Ireland, where we saw nurses and public servants losing their jobs by the thousands. In Ireland they lost 15 per cent of their salary immediately.”
But it can also happen here, she said. “Nurses: If you are not at the table, you are on the menu!”
“When nursing cuts happen it is a failure of nursing leadership, and shame on them,” Silas said. “And it’s up to us to change it, or shame on us!”
“There’s a Dixie Chicks song, ‘Not ready to make nice,’ and that’s what nurses have to start saying. And we have to stand our ground and start supporting those politicians who support us.”
“We have to say no to transformation that is not focused on our patients,” she said.
“What you allow is what will continue,” Silas concluded. “Safe staffing means saving lives.”