Northern News Services
Published Monday, October 01, 2007
NUNAVUT - Nunavut is in danger of losing the few home-grown nurses the territory has fostered, according to a graduate of the Nunavut Nursing Program, one of the GN's much-lauded solutions to the health staffing crunch.
Iqaluit nurse Asenath Idlout said she is forced to work overtime shifts in order to make ends meet, even with a full time job at the local hospital. All the time spent at work puts stress on her family, she said. - Karen Mackenzie/NNSL photo
"The motive was to have more Inuit nurses, and at first I was gung-ho to recruit my people into nursing. But I don't want them to go through this. I want to stay here in the North but if I can't I'll just have to go. I can't even provide for my children," said Asenath Idlout, a nurse at the Baffin Regional Hospital.
Nunavut currently has eight Inuit nurses working in the territory. Out of the six nurses who graduated with Idlout from the four-year program in 2004, "two are going, one is on leave right now," she said.
Idlout, who works full time in the adult ward, said she recently had to apply for shelter assistance to pay her rent, and routinely works overtime just to make the ends meet.
"I truly wish I could take off (the time) I'm supposed to every once in a while. So many times I've had to disappoint my kids. It can get draining, especially on a shift when you just go, go, go," she said. "Plus we're expecting an increase of rent in January, and that's going to kill me. But I don't want to quit, because I'm working my dream job."
One of the major problems "is that they have no incentives for retention," said Cheryl Young, head of the nurses' union local.
The fact that Nunavummiut indeterminate and casual nurses regularly work side by side with agency nurses, who make significantly more money with bonuses like travel and living allowances, only compounds the problem, she said.
Currently 30 per cent of nursing positions in the HSS are filled by casual and agency nurses.
Nunavut, like other jurisdictions across the country, uses agency nurses through several southern firms to fill vacancies, relief times and nurse leaves. According to Young, one agency recently billed the GN more than $30,000 for a one-month nursing contract to Baffin Regional Hospital.
According to a similar one-month nursing contract from the fall of 2006, one agency billed the GN a flat rate of $750 a day, along with housing, travel and a $50 daily living rate, for a nursing placement in the Kitikmeot region.
It also listed a weekend flat rate of $350, a weekend daily rate of $750 - including stand-by - and $750 for travel days.
By contrast, a current posting for an indeterminate community health nurse position lists an annual salary of $73,398 to $83,285, with subsidized housing and no living allowance.
The manager of the aforementioned agency, who requested anonymity, said she believed her business' rates to be on the lower end of the scale.
She said she believes that a lack of a standardized structure for agency work and billing, which most other provinces and territories have now established, could be contributing to the soaring costs for agency nurses in Nunavut.
Some agencies bill on an hourly rate, while others charge by flat rate, she said.
"Right now some agencies are costing the government a lot of money, but not all the agencies. I think we all need to be on the same page, and right now we're not," she said. "The first step, they need to decide how they want the agencies to be structured ... if they continue the way they are, it's just going to be more costly for them."
The Department of Health and Social Services (HSS) will soon issue a request for proposals to address agency nursing services, according to a representative of HSS.
This should streamline and standardize the process, she said. The department will also introduce its long-awaited Nurse Recruitment and Retention Strategy at the next sitting of the legislature.
Previous drafts of the strategy were heavily criticized by members of the nurses' local and Nunavut Employees Union.
The current draft was updated to address those concerns over the past few months, according to the HSS spokesperson.
The issue of the high cost of agency nurses was also addressed at a recent MLA retreat in Kugluktuk, according to Premier Paul Okalik.
"The focus was on trying to find a way to retain our nurses. We're spending a lot of money on agency nurses and at the same time we're constantly juggling how we're going to retain our nurses, so we're trying to find a medium," he said. "For agency nurses who may be here for a very short period, it costs a lot more money for providing airfare and accommodation, so that's one obvious cost saver. Also, the longer a nurse stays in the community, the more information he or she has on the patient in terms of treatment."
The GN has directed its officials to begin investigating a number of ways to address the problem, including nurse retention packages, and by looking at what other jurisdictions do, Okalik said.
"One province has reduced the amount of training for nurses by one year," he said. "We have to view all our options and try and find ways that will work for now."