Stretching critical-care nurses to care for multiple COVID-19 patients at once doesn't work, nurses say

Critical-care nurses assigned to the sickest COVID-19 patients at Winnipeg's Health Sciences Centre say patient care is suffering becauseone-to-one care is no longer possible.

The traditional ratio is onecritical care nursefor each patientwho isunstable, sometimes multiple nurses if necessary,said a signed letter from 60-plus critical-carenurses demanding the provincereconsider its approach.

But withCOVID-19 hospitalizationsmounting, in Novemberthe province started stretched nursesinto taking care of multiple patients at once.

Under the new team-based approachquarterbacked by a nurse, with supportranging from respiratory therapists to physiotherapiststhe ratio is "significantly diluted" to one-to-two or one-to-three at HSC'smedical intensive care unit, the letter alleged.

"These patients require constant monitoring which we are unable to do," said the letter, which was presented Monday by the Manitoba NDP.

The memo went on to say that critical-care nursesasking to work additional shifts to lessen the load on their colleaguesare being deniedif the current two-nurse allotment is filled.

Thisnewarrangement also includes a "nurse extender" another health-care professionalto help. The letter said these staff members, while appreciated, have little or no critical-care training.

"We fear this new pod model is being implemented not only to stretch capacity temporarily, but also reduce nurse-to-patient ratios permanently as a cost-saving endeavour," the letter said.

'Patients will almost surely die'

The Dec. 18 letter follows someemailsfrom nurses, which alleged to upper management that"patients will almost surely die in this environment" and"patients are already suffering from neglect." The emails were publicized last week by the NDP.

UzomaAsagwara, the party'shealth critic, saidworking conditions have deteriorated to the point where thesenurses are filingworkload staffingreport forms and occurrence reports on every shift, as the letter indicates.

That decision shouldn't be taken lightly, they said at a news conference Monday.

"This is the nurses letting us know that on every single shift there are enough concerns, there are enough issues that are taking place that they're actually making occurrence reports on those matters," Asagwara said.

"That's their way of indicating very clearly to management, to administration and to people in general that what is happening at the unit level is not sustainable and it's not safe."

Shared Health chief nursing officer LanetteSiragusa said she wasn't aware at Monday's press briefing of the nurses' complaints.

The critical-care teams meet daily to discuss challenges and opportunities to do better, she said.

"We havebased it on what other jurisdictions have done, and it is absolutely not our intention to put any professional or patient in an unsafe situation," she said.

In a statement, Shared Health said the creation ofteams of staff will ensure patients receive support during a period of unprecedented strain on the health-care system. The move will not be permanent.

Manitoba Nurses Union' president Darlene Jackson said the critical-care nurses are bothered that consulting firm KPMGwas enlisted to expand hospital capacity.

"Every timea consultant is involved, we seem to go into an area where it's more of a cost-saving and it's more of a way to ensure that care is providedin the least expensive way," she said.

KPMG was previously hired to find efficiencies in Manitoba's health-care system.