For many nurses, working on the holidays comes with the territory. But this year is different: nurses in Canada are at their breaking point after 2 years spent battling the pandemic with little reprieve.
Continued short staffing with an Omicron surge in sight means some hospital systems are repeatedly asking nurses to give up what little time off they have -- or worse, they may compel nurses to work on holidays that were already approved if too few volunteer for shifts.
One nurse, Nancy Halupa, has had enough. A nurse for 23 years, she runs the Instagram and Twitter accounts , where she is outspoken about the issues facing Canadian nurses today: understaffing, unsafe working conditions, and policies that hamper nurses' ability to demand better pay.
Recently, Halupa a screenshot from an email, submitted anonymously, from the HR department at the University Health Network in Toronto, Ontario. The email begins with an appeal to staff, addressing an expected rise in cases because of Omicron and acknowledging the "immense pressure" on nurses over the past 2 years during "this most profound health crisis."
The email then asks nurses to "consider the following request": delay holiday vacation they've had approved. They add, "individuals who are recalled from their scheduled vacation will receive payment for their vacation time along with time and a half for all worked shifts."
"We would like this to be our first approach before we consider vacation cancellation," it states. "Cancelling vacations may still be considered, on a shift-by-shift basis, to ensure safe patient care."
In other words, the hospital system will cancel scheduled holidays if nurses aren't voluntarily "recalled" from their time off.
ľֱ reached out to University Health Network, and to the Ontario Hospital Association, neither of which responded by press time.
Halupa said while extended time off between Christmas and New Years wasn't common pre-pandemic, "The vacations they're talking about are for the people that have asked for, like, one day off to go and do a family thing," she said.
"I don't think a lot of people truly understand how difficult the work is. I think people think that we go and we wipe bums and give people food, but it's a lot more than that," said Amie Archibald-Varley, RN, BN, MN, who specializes in maternal newborn care and works in ER quality improvement. "It's very technical. Nursing is a STEM [profession], and just for people to realize that -- we're at a kind of a critical impact, where nurses are leaving the profession because of how difficult [the job is] and how poorly we've been treated."
Halupa, who says she has more flexibility to set her own schedule as a "casual" nurse, said she's still cancelled Christmas plans the last 2 years. (According to a sample from the Ontario Federation of Health Care Workers, a casual nurse is "a nurse who works on an interim basis, as required by the Employer, and is paid an hourly rate.")
"You're bleeding your nurses dry. And you're sending these emails telling us how grateful you are," Halupa said, referring to hospital CEOs. "'But if you could consider canceling your plans for Christmas and working instead, that'd be great.' Holy s***. Like are you kidding me right now?"
University Health Network isn't the only hospital system to threaten cancelling holidays. Halupa got another submission of an email from Southlake Regional Center, also in Ontario. The email has a plea to give up vacation plans too, followed by, "As an absolute last resort, we may have to cancel previously approved vacation days at the individual staff level over the holiday period."
Archibald-Varley and Sara Fung, RN, BM, MN, who specializes in maternal-child health, co-host a that addresses many of the issues that they see in the profession, especially an environment they say is silencing.
"There's a lot of fear of speaking out on things that we might consider concerning for healthcare outcomes," said Archibald-Varley. There's a "fear of retribution, fear of our organizations coming after us or firing us." They've also been vocal about workplace conditions throughout the pandemic.
"Just the lack of control you have over your life and the lack of planning, if you think that you're going to go on vacation... the fact that your employer could take it away in a moment's notice is mentally very stressful," said Fung. "You kind of wonder, what else can they take away? Because there's so much already. You're dedicating your life to helping others and putting yourself at risk and this is the thanks that you get? It's very disheartening."
Even where healthcare systems aren't explicitly cancelling holidays, they've been urging nurses to work over the Christmas holiday in texts, emails, and handwritten signs posted on staff-room boards, many of which Halupa has also been re-posting. "Our phones don't stop ringing all day with text messages begging us to come into work. 'Come in whenever you can come in, for four hours, if you can come in for 2 hours, just come in.'"
Halupa, Archibald-Varley, and Fung say conditions for nurses have been unacceptable throughout the pandemic, with nurses asked to work long shifts, taking on more patients because of short-staffing, no breaks or mental health support -- all of which contribute to an unsafe work environment in a pandemic.
More recently, Halupa pointed to at Guelph General Hospital that states nurses can come into work if they are asymptomatic and have a family member or close contact with COVID-19, as long as they "self-isolate" at work.
"The rules for nurses and the rules for the public are completely different," Halupa said. "You want me to go to work, even asymptomatic, to deal with people that are immune compromised, knowing that I could have COVID."
The holiday cancellation warnings come at a policy juncture that gives Canadian nurses little room to advocate for themselves. For one, nurses' unions in Ontario were already limited in their ability to strike based on their status as essential workers, on par with firefighters and police. In the U.S., nurse strikes are used as a last resort, but give them some bargaining power.
But an emergency bill weakened them further. Bill 124 put a wage cap on a group of workers including nurses, limiting raises to no more than 1% a year, which with inflation could actually decrease their real pay. The reported that Greg Simpson of Ontario's Treasury Board Secretariat said nurses could still get raises based on merit, seniority, and increased qualifications.
What they want, nurses say, is fair pay for their time and protections in the workplace. This would also prevent a mass exodus of nurses from hospitals to staffing agencies, which pay much higher hourly rates and provide scheduling flexibility.
Doris Grinspun, RN, PhD, the CEO of the professional group Registered Nurses Association of Ontario (RNAO) and a leader in advocating for the repeal of Bill 124, said of nurses, "They are at a breaking point. They have canceled vacations for 23 months already," she said. "So what they will do is they will quit and they will go and work for an agency and make double the money." This, she said, ultimately hurts patients.
Nurses unions and professional organizations in Canada have echoed their members' frustration, with the Ontario Nurses Association and the RNAO (not a union) campaigning on social media and writing letters to policy makers like Doug Ford, the premier of Ontario, and Anthony Dale, the head of the Ontario Hospital Association, for their support in repealing Bill 124.
Meanwhile, platitudes about being heroes, or holiday gifts from hospitals like mugs and chocolates, nurses say, do little in the way of showing real appreciation for nurses.
"Instead of just giving us the token stupid Christmas gifts that they've been handing out, why don't you wear a shirt that says 'I stand with nurses, repeal Bill 124'? Because that will mean more to the nurses, I can guarantee you, than, you know, a coffee mug or a lanyard."
Halupa says she loves her job, and that ultimately, nurses she knows want to keep caring for patients. "Nobody does it for the glory, or the money. They do it because they have a calling to do it," said Halupa. "But we're not martyrs either. We still want to be paid what we're worth. And I think during this past year ... nurses have proven what we're worth to healthcare."