Overfilled emergency rooms and rising violence are threatening nurses in N.L., union says

A nurses' union rep says nurses in Newfoundland and Labrador are now dealing with a rise in violence in overfilled emergency departments, and is calling for mandated nurse-to-patient ratios to create safer workloads for members.

Yvette Coffey, president of the Registered Nurses' Union of Newfoundland and Labrador, says hospitals are running over capacity, with patients placed in beds in hallways due to overflowing emergency rooms.

Despite the surge in demand, the number of nurses taking care of those patients has stayed the same, Coffey said.

"They're getting burned out, and we need to have safe staffing," she said.

Coffey said she hears about health-care workers facing violence every day. Every other day, a registered nurse files a claim with WorkplaceNL, a government appointed organization that provides injury insurance. 

Data from WorkplaceNL show in 2023 there was about one claim every two days from nurses for all types of injuries, and about one claim every 13 days due to assaults and violence.

WorkplaceNL says the number of claims related to violence is declining, but the union says it's still a problem.

"The violence and the lack of staffing, the increased workload, all of these are occupational health and safety concerns that would never be tolerated in any other profession," said Coffey. "But it's being brushed under the rug."

At St. Clare's Mercy Hospital in St. John's, Coffey said the working conditions in one surgical unit resulted in 11 registered nurses leaving that unit.

To replace them, Newfoundland and Labrador Health Services called in five private agency nurses, she said.

The union is calling for mandated nurse-to-patient ratios to cut down on violence and reduce turnover. The ratios would determine the maximum number of patients an individual nurse in each unit can care for. 

Each patient added to a nurse's workload decreases health outcomes and increases mortality rates, said Coffey. 

Right now, those ratios can't be determined because the system is relying on 30-year-old staffing data, she said, adding the outdated data is not based on acuity — in other words, the severity of a patient's condition —  it's only based on the number of beds, said Coffey.

The acuity of patients in hospitals has also increased significantly, she said, noting hospital beds would previously hold patients with less severe health problems, like someone recovering from a knee surgery. These days, that's an outpatient procedure, and all the beds are filled with the sickest of the sick, she said.