'We have to be focused on 'training; our own, to build capacity in the North.'

Nunavut can't immediately reduce its dependency on agency nurses who may fill as many as two in three nursing jobs across the territory, says Health Minister Leona Aglukkaq.

"I'm not going to shut nursing stations down because a community does not want agency nurses," she said. "That would be irresponsible."

Aglukkaq acknowledged that non-union agency nurses get a better deal than nurses who are permanent employees of the GN, but she said finding more permanent nurses will continue to be a challenge, "until GN can become more competitive" – and presumably offer its nurses similar pay and benefits.

Aglukkaq said she will reveal a new plan to address Nunavut's critical nursing shortage after the legislature comes back into session on Oct. 23.

The nursing and recruitment strategy contains measures that will go a long way towards giving nurses more reasons to work for the GN on a permanent or "indeterminate" basis, she said.

The new plan will also involve other GN departments in an effort to train more resident nurses.

"We cannot just be focused on hiring. We have to be focused on training our own, to build capacity in the North," Aglukaaq said.

Aglukkaq called the new strategy "a big positive step," praising it as the most comprehensive recruitment and retention strategy the territorial government has produced since 1999.

Aglukkaq said the plan will likely cost about $1.5 million.

At the legislature's last sitting in June, Aglukkaq asked for this amount as a supplementary appropriation to pay for the plan, which was not finished at the time. Members of the legislative committee who examined her request told Aglukkaq they wanted to see the final plan before voting any money.

Aglukkaq suggested the increasing unhappiness of GN nurses could have been avoided if the extra money had been approved in June.

Action on training and recruiting nurses can't happen too soon for Nunavut's community health nurses, who are increasingly upset by the better working conditions, pay and benefits that agency nurses receive.

Community health nurses also continue to grumble that agency nurses disrupt community health centre operations and cause patients to suffer because they never see the same nurse from one visit to the next.

"I am constantly being interrupted by phone calls from patients who want to speak with me because I'm the only familiar face and also know their story," said a community health nurse who did not want to be identified. "They are often reluctant to speak with strangers about personal problems and who can really blame them?"

Delays in diagnoses and breakdowns in communication also result from frequent nurse changeovers, community health nurses allege. And they allege some patients who could be easily managed in a community are sent out for treatment because temporary nurses don't know the patients' history.

Community health nurses also allege some agency nurses don't know how to do x-rays or certain lab tests and regular staff have to assist and provide extensive orientation every time an agency nurse arrives.

"It's not simply a walk around the building. Each time I do a basic orientation it can take about four hours. Do that a few times in a week, and that is a lot of hours taken from my regular work," the nurse said.

In communities without taxis, resident nurses also complain they serve as the "health centre express," shuttling temporary nurses to and from the airport and taking up time on off-duty evenings and weekends, when most of the agency nurses leave and arrive.

Like nurses at the Baffin Regional Hospital in Iqaluit, community health nurses also say they have major concerns about their safety, because they are often called back to their health centres late at night and usually return home alone.

In newer health centres, alarm systems are supposed to ring at the RCMP detachment, but nurses say many times these systems are broken or don't work as they should.

Aglukkaq said the new nursing plan won't specifically address workplace safety because all health centres and the Baffin Regional Hospital already have a zero tolerance policy on violence and abuse. This policy just needs to be enforced, she said.

But Aglukkaq will host a meeting with representatives from all community health committees later this month to see how these committees can support nursing stations and better health in the communities.