Why do good nurses leave Nunavut?
In Cape Dorset, a nurse we thought would stay for a long time is leaving. This came as a big surprise. She moved to Cape Dorset with her family after asking the community if they approved of her being assigned here (something few have ever done) and settled into community life. She was well liked by the community and she appeared to really like it here.
Why then is she leaving after a short 18 months? What was so intolerable in her job that she felt she had no recourse but to resign from a job she loves?
I have read the January 12, 2007 letter, “Why did Pangnirtung lose its best nurse” about the nurse in Pangnirtung, and I empathize with some of the angst in that letter.
Why do good nurses leave Nunavut communities?
* They are asked to do things that are counter to all the nursing values they hold dear: safe and competent practice, integrity, dignity, choice, justice, confidentiality and respect;
* The employer appears to condone unprofessional behaviour in others and does not take a stand when these behaviours are uncovered;
* Being a whistleblower has its own penalties and usually the whistleblower suffers, especially if it is about another nurse;
* Being a good nurse means you have to practice self-care and that involves being responsible for your own mental health and wellbeing. Nurses seem to be penalized for this;
* Good nurses know when to leave an intolerable employment environment that may include malicious and toxic defamation by other nurses;
* Nurses (and all workers) have a right to expect a respectful workplace and if the employer cannot ensure this then the nurse must leave;
* Contractual agencies do not adhere to a consistent standard of practice for their employees (agency nurses);
* The Department of Human Resources does not have a consistent and measurable level of competency for community health nurses, i.e. the employer does not ensure all nurses (agency or otherwise) hired meet the same standard levels of safe and competent practice;
* There is a glaring lack of support for middle management (nurses-in-charge, supervisors of community health programs) from the levels above them: (directors, executive directors of regions, deputy ministers);
* Policy and procedure manuals are inconsistent and not up to date, such as a pandemic plan, community disaster plans, policy and procedure manuals for community health centres and nurses, orientation manuals;
* Hiring practices are not equal from region to region: rent or no rent, the infamous $24K recruitment bonus; buying (yes, buying) international nurses (who themselves personally pay thousands of dollars to recruitment agencies like Trillium who place them in Nunavut);
* Many nurses do not realize the impact that living in a small remote Nunavut community will have on their personal and professional life;
* Punitive rents for accommodations;
* Irregularities with payroll processing and vacation travel allowances;
How can a good nurse stay when:
* They are asked to turn a blind eye to criminal and unethical activity, such as entering an office with no authorization, stealing documents from an office, breach of confidentiality, copying patient’s charts, copying narcotic records and another employee’s overtime files;
* They are asked to excuse unprofessional conduct with: “this is the first time it happened,” and “she said she didn’t know it was wrong;”
* They are told repeatedly to “trust the process” and that very process perpetuates and condones the harassment from another nurse;
* Defamation by another nurse is allowed to continue unabated;
* Nursing shortages dictate they work shorthanded and understaffed regularly and upper management tells them to make do. (Private inquiries to nursing agencies suggest there are nurses available yet the agencies have allegedly been told by the employer that nurses are not needed at this time).
* There have been six deputy ministers of health in the last seven years (and one of these stayed for almost three years) and each one has a brand new agenda that tries to sweep clean the “mistakes” of his or her predecessor.
Nurses leave Nunavut communities regularly. It is a sad fact. There is a nursing shortage globally. This is also a fact.
How can Nunavut attract good nurses with integrity and excellent competencies who are willing to stay and be a part of Nunavut communities?
Listen. Truly really listen and hear the stories and concerns of Nunavummiut and nurses alike. Both are crying out with good reason.
Act. Why is it that some nurses are “blackballed” by the employer? Report unprofessional activity to the appropriate person, body or agency. Speak out against malicious gossip and unprofessional dialogue. If you say nothing you are condoning that behaviour.
Be present and counted at community consultations. Be your own health care advocate. Vote. Your vote counts. Ask your elected representative to be a strong true voice on your behalf. On your children’s behalf. Your and their health care is in your hands.
Change. Dare to ask for and demand and receive the best nurses that Nunavummiut deserve. Nurses deliver 85 per cent of health care in Nunavut.
What do you have do lose? Your life.
(Name withheld by request)