The unwavering impact workplace culture has on the Canadian healthcare system.

Author: Antoinette

Without a doubt, the public healthcare sector is crumbling before Canadians eyes. Once believed to be a secure and stable system supporting most Canadians, now, has been deduced to longer wait times and thousands of Canadians unable to find a Family Doctor.

What is going on behind the scenes that is impacting staffing ratios?

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COVID and INFLATION

Behind the scenes Nurses and Doctors are working tirelessly but also suffering burnout in the process. Covid and inflation definitely had a large part to play in the growing struggle to keep our Hospitals in Ontario Canada Fully Staffed. There were several key issues that shifted culture and took an already toxic workplace to the pits of hell.

1. MANDATORY VACCINATION:

As Organizations grappled with the decision to mandate policy surrounding covid-19 vaccinations, staff already had a commitment under their professional designation to continue to work regardless of whether there were treatment available for Covid-19 infections or not.

This created chaos in terms of keeping the hospitals staffed. Strong Public opinions and misinformation surrounding the Covid-19 virus only amped up the stress towards healthcare workers. Not only were healthcare workers dealing with the uncertainty surrounding infection prevention protocols but also the strong public opinions on whether healthcare workers should be vaccinated or not. Nurses working the frontline were conflicted with their own human rights, values, and privacy surrounding their personal health information. The icing on the cake was pressure from management and patients regarding their vaccination status. A nursing staffs health and overall immunization status was never a discussion shared with the management but rather overseen by the Occupational Health departments in Heath organizations within the GTA.

The circus media surrounding COVID-19 created a hostile work environment in which management were calling staff into their office individually to ask about Covid-19 vaccines., creating additional stress and pressure when the focus should be on the care of patients. Healthcare workers were met with hostility in the workplace for not complying with the vaccine mandate if status was shared with coworkers or patients. The mandate created a divide where it never existed amongst staff in healthcare. People no longer felt comfortable discussing their vaccination status with coworkers as this further caused divide due to differing opinions.

I remember walking toward the staff vaccination clinic feeling hopeless when a coworker waved and yelled “DONT DO IT”… I could never forget the feeling I felt at the pit of my stomach walking into the clinic and signing a waver to receive my vaccine. The waver made it feel surreal as a waver was never required to receive any of my previous vaccination as a Canadian. It left me with a sense of insecurity I never used to have.

many healthcare workers were able to return to work immediately WITHOUT receiving the COVID-19 vaccine!! But HOW?

The news and government failed to inform the public that staff were able to obtain a religious exemption that would excluded them from the mandatory vaccination policies. Healthcare workers obtained legal documents through their religious faith, notarized and submitted this to their employers and were able to work alongside vaccinated nurses without ever revealing your vaccination status.

2. LOCKDOWN:

The mental impact covid-19 inflicted on thousands of Canadians had an overwhelming adverse effect on Healthcare workers. Many Healthcare workers that had to continue to work regardless of family or friends living with them were at risk or not.

Many healthcare workers were pressured to be at work but had no childcare due to lockdown. This significantly caused conflict between management and staff as everyone wanted to be accommodated with working hours as daycares reduced their hours or closed completely and former babysitters refused to care for children of healthcare workers due to fear of being infected.

3. IMMIGRATION AND REGISTRATION OF INTERNATIONAL NURSES:

Welcoming new international educated nurses to an already tired and overwhelmed healthcare system had its pros and cons

Pros

Extra Staff:

After losing many of our Canadian nurses to irrational policy, hiring nurses who are internationally educated and readily available to support the Canadian healthcare system could assist to close the gaps and lessen the strain on a very fragile system.

Diversity and Multilingualism, the ability to connect and communicate with the diverse population of Canadians receiving medical care in Canadian Hospitals.

Although we now have access to advanced interpretation tools within the healthcare system with interpreters available 24/7 via video call, Multilingual/bilingual nursing staff will always be an asset as they are readily available at the bedside and assist with closing the language barrier gap that can exist between patient and healthcare provider.

International nursing skills/experience/knowledge:

Some international nurses come with extensive nursing skills. This is truly an asset as their advanced skill level and knowledge is shared amongst our Canadian staff potentially contributing to a stronger healthcare system.

Cons

Fraud:

Unfortunately when opportunities are offered that allow anyone a guaranteed pathway into Canada, there will always be people who are not honest about previously acquired education. While attending orientation, it was obvious for some that some of the international educated nurses that were hired to work in the hospitals in Canada were not meet the standard of entry level nursing. While speaking to some, they had difficulty explaining what school and experience they had in order to qualify for the position. These conversations take place during the orientation and on the unit during unit orientation. When an internationally educated nurse is hired in a hospital but does not know how to use a basic assessment tool ex. “Stethoscope” it raises questions whether or not they were qualified to work in a Canadian hospital because these are basic skills taught while in nursing school. Some even stated that they returned back to their home country to gain the required experience for 3 months and then returned to Canada and got hired. It used to take months to get a job in a Canadian hospital for the average Canadian graduating nursing school unless you had solid references. Because of previous scam regarding staff using fake education to gain employment and teach in our colleges and universities, is it really that far-fetched that people used this very vulnerable time to gain employment they may not have qualified for to work within the canadian healthcare system? Questions to consider.

Unfortunately there is an unspoken negative impact because everyone talks about this but is afraid to talk about it.

Exclusion of Canadian nurses shifting workplace culture:

While we have welcomed our international nurses with open arms, some of the international staff outnumber the Canadian staff which really should not matter at all, only, in some units this appears have shifted culture on the unit.

International nursing staff not speaking English in the nursing stations and areas of care. Because they are the majority in many cases they will only speak their native language going against hospital policy. If you attempt to address the issue, you are then bullied out of your position in many cases. They try to make it hard for you to work with them, making complaints over small insignificant things and talking ill about you when they think you’re not around. Purposefully speaking in their native language when you’re around so that you can’t understand. These are passive aggressive ways they try to ostracize Canadian staff.

Often once obtaining a charge nursing position, international nurses were observed creating unfair assignments, assigning the most medically complex and heaviest patients to nurses that do not share the same cultural background instead of being fair and assigning patients to staff that were balanced amongst the team. There is an heir of bullying and selfishness further contributing to toxic work environments. This behaviour further results in sick calls due to stress and burnout.

You’ll often notice some staff running all shift while others spend the whole shift sitting in the nursing station the majority of the shift, scrolling through social media and online stores while speaking in their own native tongue if you dare speak up or protest they will make it difficult for you to work with the team.

They also were observed only working shifts with their own (same cultural background). If the unit was short staffed and you called one of the staff in this social group to come in for work to help out the unit they would ask you who was working, after they find out who’s working they will decline even if they are available just because they want to work with staff from that speak the same language although everyone working speaks English at work.

If someone calls in sick and the unit is short they will text the staff that at home speak the same language as them so that they will decline the shift knowing it’s short staffed and sometimes causing a cascade of absence calls because they pretty much warned the staff before their shift so they would also call in sick further leaving the unit in a staff deficit.

This kind of behaviour has been observed over the years and has severely fractured unit culture and safe staffing numbers.

If you do try to speak out against the behaviour you are then targeted and bullied. Although hospitals have strict harassment and bullying policies, they don’t appear to have much effect because you have to go through Fact finding and during that time staff will gossip, spread rumours to further create stress for the staff who reported the incident. You’re observing the behaviour in real time every shift and you are now the minority!

After speaking to a number of staff many have experienced this type of bullying from groups of IENs most commonly (Filipino) but in small Northern communities, where the majority Caucasian nurses have also bullied and isolated nursing staff of colour, this has been reported significantly and conversations take remain whispers out of fear of unemployment.

How can we resolve this issue and bring unity and positive work culture to the forefront in our community hospitals in Toronto, GTA specifically.

How can organizations better support diversity and positive unit culture? QTNA

The data in this opinionated article is based off real life experiences and witnesses from nurses previously working and currently working in the Canadian healthcare system for over 30 years.