Health human resources challenges
Prior to the emergence of COVID-19, jurisdictions across Canada had undergone significant health-care transformations, leading to disruption in the nursing workforce, work environment and workload. Reports of unplanned closures of nursing units and emergency departments across the country, in part due to unsafe staffing levels, garnered public attention.6,7,8 COVID-19 is expected to significantly burden our health-care system, with estimates that 30-70% of the population could become infected. Maintaining the nursing workforce, the largest health-care profession in Canada, is critical to a robust pandemic response. With this goal in mind, the following represent challenges that is stressing the shortages thus far:
- Increasing population health needs — Canada’s cases are rapidly increasing, and health-care systems are implementing preparedness efforts to strengthen surge capacity. The significant aging population in Canada may increase the burden of illness from COVID-19. The expansion of health-care settings to triage and assess COVID-19 cases (i.e., assessment centres, telehealth) will challenges the health-care system to ensure all units are adequately staffed.
- Risk of exposure and illness acquired in practice — Nurses and health-care providers at the point-of-care are at higher risk of exposure to COVID-19. China has reported over 3,000 health-care providers were infected with COVID-19, and Italy reports that 9% of their cases are health-care providers.9 Canada is already experiencing worrisome trends with cases of nurses being infected or exposed to COVID-19 in Ontario and British Columbia10,11 In the immediate future, losing health-care providers due to exposure and/or illness for weeks can put a significant strain on the workforce and highlights the importance of protecting our health-care providers. Long-term, the lasting impact of COVID-19 on the health of individuals is unknown, and the potential for chronic or prolonged health concerns is possible, and may have impacts on the health of the nursing workforce.
- Work restrictions related to travel — All travelers returning from outside of Canada must self-isolate for a period of 14 days, however certain jurisdictions have exempted workers in essential services from this guidance, including nurses.12,13 Recognizing the increasing health-care needs of the population during a pandemic, the risk to patients and staff of nurses transmitting COVID-19 must be weighed against the critical service that would be limited.
- Family responsibilities — Nurses are impacted by closure of schools and daycares. Coordinating with partners, families and friends to ensure their children are cared for can be extremely challenging. As an essential service care provider, where working from home is not an option, nurses may experience increased pressure and stress to obtain childcare and meet their professional responsibility. Ensuring that nurses can meet their family obligations is needed to ensure they can remain part of the workforce.