Veteran nurse leaves Pond Inlet

For every nurse who leaves Nunavut, Nunavut’s battered health care system suffers another blow.

This time it’s Steven Leck, who worked for 17 years in the Baffin region as a nurse. On Feb. 22, he left Pond Inlet, his home for the past nine years, for the Northwest Territories.

There, Leck will take a job in Yellowknife as executive director of the Registered Nurses Association of the Northwest Territories and Nunavut.

When Leck left Pond Inlet, his hard-to-replace familiarity with Pond Inlet’s 1,400 residents and their health histories left with him.

It’s a growing trend: seven nurses quit their jobs at Iqaluit’s Baffin Regional Hospital last fall and three more quit in January. Others have left health centre jobs in communities such as Cape Dorset and Pangnirtung.

Leck says he’s leaving Nunavut partly because he’s exhausted from working more than 120 days of overtime a year.

“I’ve had 17 years of being on call nearly every night. I just said that’s enough,” Leck said.

Add that grueling work routine to the $10,000-plus cost of flying his family to visit relatives in the South, and it’s easy to see why Leck is eager for a new, interesting job with little overtime or a need to buy expensive airline tickets.

Pond Inlet’s $7 million health centre opened two years ago. But this new facility is just “part of the puzzle” for improving health care delivery in the community, Leck said.

“It’s not a case of “build it and they will come,’ because we haven’t had an increase in staff, but we have had an increase somewhat in what the community expects from the new facility: more in-patient time, more people who don’t want to go to Iqaluit, more who want to have their babies in town.”

In Pond Inlet, one home care nurse has been the only recent addition to the health centre’s staff.

But the population it serves has also grown over the past few years by several hundred people – mainly newcomers with decentralized Government of Nunavut jobs and new babies.

This population growth has put a heavy load on nurses who spend time on acute care and paperwork, so there’s little time left over for prevention activities and health education.

Based on the overtime hours that the community’s five nurses must work, about 700 hours a year, at least three new full-time positions should be added to Pond Inlet’s health centre, Leck said.

“It’s just a big circle. If you don’t do the health prevention and public health education, then people just get sicker.”

A string of agency nurses will likely replace Leck.

Agency nurses are flown in and out of communities, generally on a monthly basis. They receive more pay than regular, full-time nurses, as well as housing, although they don’t qualify for some benefits, such as paid vacation time and a pension, which full-time nurses receive.

Leck isn’t the first experienced, full-time nurse to recently leave Pond Inlet. A year ago another nurse decided to return to school. Now that Leck is gone, this leaves only three nurses who have some history in the community. Two others will be agency nurses, working in rotation.

“You just get into a rotating door mentality,” Leck said. “I’ve probably worked with 1,000 nurses over the years, but very few of them are still here. It’s much better to have long-term employees.”

The perpetual cycle of hiring temporary nurses will continue as long as full-time nurses in Nunavut are over-worked and see few compelling reasons to stay, Leck said. This is particularly important in the communities, where nurses are older, he said.

A Nunavut nurse recruitment and retention survey in 2005 showed that more than 70 per cent of nurses in Nunavut are over 40.

“Should we really be expecting them to work 125 extra days a year?” Leck asked.

As a result, many nurses now prefer to work in Nunavut as agency nurses with higher pay and more free time. The nursing association has more than twice as many nurses registered than the number of nursing jobs available in the territory, noted the survey.

Leck, who was formerly the president of the Registered Nurses Association of Northwest Territories and Nunavut, commends the GN’s efforts to train and recruit nurses.

But he said retaining the territory’s existing nurses, particularly those in health centres outside of Iqaluit, should also be a priority concern.

Easing their workload would be a first step. Leck said the GN should carry out a workload study, to see where extra staff are needed.

Leck said nurses would also be encouraged to stay by receiving more on-the-job training. This would give Nunavut more highly trained nurses whose skills would then benefit the community. More professional development would be a “win-win” use of taxes, he suggested.

“We need to have a real hard look at what’s going on. Are people being used in the most efficient manner and how can we support them?” Leck said.

Because so few doctors reside in Nunavut, nurses are crucial to the provision of primary health care.

In 2004, the Canadian Centre for Health Infor­mation found that Nunavut has the poorest per capita supply of doctors in Canada: only 24 per 100,000, compared with 97 per 100,00 nation-wide.