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Amie Varley and Sara Fung are the hosts of The Gritty Nurse Podcast.

Hospitals have always been busy places. You often hear about emergency rooms being over capacity, or the term “hallway medicine.” We call this gridlock. It happens when patients have no access to an inpatient bed, sometimes for days on end. For nurses and other health care professionals, these circumstances are high stress, and can be difficult to manage. But they are part of the job.

Hospitals create contingency plans and policies for some of the most complex situations imaginable. We practise them in mock drills. We discuss them with colleagues. We always thought we would be ready for anything. Nurses, especially, knew about the consequences of an unknown virus. We knew the dangers.

Over the past year, no one in health care has been hit harder than nurses, personal support workers and housekeeping staff. A July, 2020, report by the Canadian Institute for Health Information indicated that 19 per cent of all of the COVID-19 cases in Canada at that time were health care workers.

In some cases, such as in long-term care homes, the situation was dire. Online, nurses shared pictures of themselves wearing garbage bags and goggles from home, since they were not provided appropriate personal protective equipment. Even in hospitals, nurses and allied health care workers had to fight for PPE. We begged and pleaded with our governments, organizations and peers, but our cries mostly fell on deaf ears. Our concerns were drowned out by the banging of pots and pans and the smokescreen of being hailed as “health care heroes.” No one cared, no one listened. The only hope was for a vaccine that couldn’t come soon enough.

And yet, now that the vaccine is here, nurses are still fighting to be heard. For instance, when the Ontario provincial vaccine distribution task force was created, nurses hoped that maybe we’d get a seat at the table. We administer the majority of vaccines, so why not listen to our input for how it would be rolled out? But it came as no surprise that, when the list of names was announced, there was no nursing representation. Our voices have been left out, noticeably silenced and absent from the decision-making process.

It all adds up. In a 2020 report conducted by the Canadian Federation of Nurses Unions, it was revealed that 60 per cent of nurses intend to leave their jobs within the next year. This was pre-COVID-19 data. Nurses were already suffering from high levels of post-traumatic stress disorder and depression prior to the pandemic and it is only going to get worse. One in three nurses reported having suicidal thoughts. The high prevalence rates of PTSD found in nursing were consistent with those found in large samples of public safety personnel (for example, correctional workers, firefighters, paramedics and police officers) who are also regularly exposed to potentially psychologically traumatic events, significant workplace stress and violence, and have high rates of burnout. We were already broken. We need more help.

Research shows that the high level of mental-health stress placed on nursing “has a direct impact on employers in terms of lost productivity, sick leave and both short- and long-term disability.” It also directly affects patients and patient care.

Despite the fact that we look after the sick 24/7, many nurses who work casual or part-time hours do not have paid sick days, and right now, some nurses aren’t even being given sick leave when they have to take time off to isolate while waiting for COVID-19 test results. Those who do have sick leave are sometimes paid a fraction of their regular salary while off. In many hospital organizations, an “Attendance Support Program” discourages nurses from calling in sick. Even if the program isn’t meant to be punitive in theory, in practise it often is: Those who are seen to take sick days too often can become ineligible for internal job transfers and, in extreme cases, terminated. No one should ever be forced to choose between putting food on the table and going to work while ill, potentially infecting patients and colleagues. Nurses in particular shouldn’t have to make that choice as increasingly contagious variants of COVID-19 start spreading in Canada.

No one wants to take responsibility for the nightmare that nurses have suffered over the past year. The federal government has blamed provincial governments and vice versa. Nurses have been left out of the decision-making process, our expertise and opinions ignored. However, more nurses are coming out and telling their stories. We have to, because if we don’t advocate for ourselves, who will? We can no longer deal with the crushing anxiety of our current situation. We must fight for radical change. We can longer wait for those who aren’t ready.

For many, nursing is a calling. The profession allows us to help members of the public at what is often their greatest moment of vulnerability or need. It is a great privilege to call yourself a nurse, and it is one we do not take for granted. We have spent the past year helping to protect Canadians across the country. But who protects the nurses?

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