Ruminations: That Classic Catch-22

Nurses close the curtains of a COVID-19 patient's room at an ICU in Surrey, B.C. (Jonathan Hayward/The Canadian Press)

"A shortage of workers can mean people's health and well being. It's scary."
"We're in an ethical situation where it's also scary not to ensure that all health workers are vaccinated."
"So it's a bit of a Catch-22."
Devon Greyson, assistant professor, public health, University of British Columbia

"I have a hard time understanding how there are nurses, with scientific training, who refuse to get vaccinated."
"If I were a nurse, in the field, in a clinic with unvaccinated colleagues, I would feel uncomfortable for our patients, for myself, for our loved ones."
"Starting Wednesday, we will reach [out] to them to make a last verification on their vaccination status and if they are not adequately vaccinated, they will be suspended."
Luc Mathieu, president, Ordre des infirmieres et infirmiers du Quebec

"I feel like a terrible nurse. I bust my ass 60 hours a week for what? To hear the pandemic's over, the vaccines are a poison, COVID is a conspiracy. I'm not putting that in my body; and on and on. I work consistently short-staffed and I mean dangerously short staffed."
"Nursing was a calling for me. I always wanted to be in the medical field. Today I want to go off the grid and say f--- this. We've suffered an overwhelming trauma that I'm not so sure we are going to recover [from]."
"...Now I'm tired, I cry before my shifts, I have severe anxiety, but I still give the best care I can."
Season Foremsky, Calgary nurse, suicide

"Our front-line physicians and nurses are under extreme stress and pressure. The pandemic is impacting individuals and our teams both physically and mentally."
"Our people have been working tirelessly to care for Albertans throughout this long and exhausting pandemic."
Dr.Verna Yiu, president, CEO, Alberta Health Services

"Season's death is a red flag for every individual healthcare worker to take a pause and reflect, to say, 'I need to take care of myself."
"A lot of politicians are saying, 'Oh, just hang on, just hang on. It's the pandemic, we have no control'."
"Sorry -- we were saying the same thing before the pandemic."
Linda Silas, president, Canadian Federation of Nurses Unions

Nurses on the front line of the COVID-19 pandemic say they’ve seen many of their colleagues quit or transfer jobs because they’re burnt out after months of abuse from some patients and exhaustion from staff shortages. CBC

Hospitals across Canada, already short-staffed with medical personnel, many of whom under constant pressure, have decided to leave the profession altogether, are now facing an impossible situation. A relatively small proportion of medical staff are adamantly against being vaccinated. And given that the majority see the need to be inoculated against the novel coronavirus, the presence of colleagues who are unvaccinated pose a contagion threat to themselves as well as to the patients entering hospital and trusting that they will be safe from the the highly communicable Delta strain now dominating case numbers.

The situation is such that provincial mandates as well as individual hospital and long term care homes have mandated the necessity for vaccinations for all staff to protect themselves and the vulnerable individuals in their care. Deadlines for vaccine mandates now on the near horizon, see the potential for greater staff shortages in a prevailing atmosphere of already-existing staff shortages, hugely exacerbating an already unsteady position of reliable care for patients. The overburdened workforce due to the pandemic is on track to become ever more burdened.

Health care personnel layoffs have begun, with employees being informed, due to their refusal to be inoculated against COVID, that they are being placed on unpaid leave. Employees at the Toronto Hospital network, reporting a 97 percent vaccination rate, have been informed they have until the 22nd of October to be vaccinated, or they will no longer be employees of the hospital system. British Columbia is set to place staff at long-term care and assisted living on unpaid administration leave should they fail to be vaccinated.

Quebec has offered $15,000 bonuses in hopes of attracting and retaining some 4,300 full-time nurses. In total 25,000 health-care workers not yet fully vaccinated with an October 15 deadline looming, risk being suspended without pay. In Edmonton, Louis Hugo Francescutti, an emergency room physician, worked with several hospital staff refusing vaccination, despite their employment being on the line; they are committed to reserving themselves from COVID inoculation.

In Calgary, nurse Season Foremsky wrote on social media of the toll the pandemic had taken on her mental and physical resources; the trauma of seeing people die, the abuse she suffered from anti-vaccination protesters she faced, and the tediously strenuous long work hours and lack of support. As a mother of two young children hers was a delicate balancing act to keep her head above the stress that was suffocating her. She cared for COVID-19 patients as an emergency room and intensive-care unit nurse at the South Health Campus in Calgary.

And on September 27, the once-vibrant woman was gone, dead of a suspected drug overdose that occurred at home, a suicide. One in three nurses report thoughts of suicide, according to a recent poll conducted by the Canadian Federation of Nurses Unions. Of nurses surveyed, 98 percent reported symptoms consistent with a high-to-moderate risk of suicide. Among them, fewer than ten percent attempted to access mental health services.

That same survey noted a study of Alberta nurses saw similar or slightly elevated rates of alcohol and substance use disorders, comparable to numbers in the general population. Linda Silas, president of CFNU, speaks of nurses working "in a pressure cooker"; work shortages, worsening physical and mental health, and workplace violence are not new in their workplace, caused by the stressors surrounding the SARS-CoV-2 virus causing COVID. They were present long before the pandemic and since then, have boiled over.