Nurses are exhausted and struggling with moral injury, says RN who left bedside nursing

This letter was sent to New Brunswick Premier Blaine Higgs on July 9, 2022.

My name is Patricia Yu Howatt and I have been a Registered Nurse in New Brunswick since 2014. I have worked in oncology, ICU/ER, cardiology, and spent much of the last year floating between departments. I have assumed formal and informal teaching and mentorship roles. It is almost exactly eight years since I began working for the local health authority and today marks the end of my employment. I am now one of many experienced nurses who left bedside nursing.

Our health care system is in the midst of collapse. This is not news to anyone and health care workers have been sounding the alarm for years. We are continuously asked to do more and more with fewer resources — a situation that has only become worse with the pandemic. Our neglected healthcare requires that providers and support staff sacrifice their health, safety, mental well-being, and families in order to keep what is left afloat. Experienced nurses are straining and buckling under the accumulating pressure. Novice nurses are left to manage dangerously understaffed, high-acuity units. They are expected to fill the shoes of the expert nurses who would have mentored them in better times. Nurses are exhausted and struggling with moral injury due to the inability to provide basic care our patients deserve. There is no indication of any reprieve on the horizon.

Compensating for the years of divestment in our healthcare means addressing the systemic needs will be an expensive and drawn out endeavour. The crisis of our health care system is complex and a multifaceted, focused approach is imperative. This requires a committed collaboration among all parties at the provincial and federal level to ensure a consistent, long-term plan. On-the-ground stakeholders must be included at the table. Retention of experienced staff is paramount in order to support the recruitment process.  Recruitment of new and internationally-trained nurses and doctors must be accelerated. The role of support and auxiliary staff must also be considered, along with a shift in education programming. Major reinforcement to primary care, access to care in non-acute settings, and community health initiatives will aid in relieving the stress on our hospitals and ER/ICU departments. Relying on travel nursing and floating staff is not a solution.  The province must use innovation and action to halt the continuous loss of the very people needed to rebuild and strengthen our healthcare.

I never could have anticipated how much I would grow from the experiences, the friendships, and the challenges of nursing at the bedside. I also never would have anticipated leaving it under these conditions. The current situation is untenable. I cannot fully articulate how heartbroken I am for my colleagues and my patients.  Our current trajectory does not exude confidence. I made the difficult decision to put myself and my family first. I desperately hope that the health authorities and the Government of New Brunswick, in partnership with the Federal Government, will choose to put New Brunswickers/Canadians first. When that happens, people like me won’t have to choose between a profession they love and their own ability to function.