Staffing shortages in northern Manitoba nursing stations a ‘life or death’ matter, advocate says

A shortage of nurses across the country is hitting hard in remote and northern First Nations like Pimicikamak Cree Nation in Manitoba, where nursing stations are typically the only place people can access health care close to home.

Chief David Monias said the nursing station in Pimicikamak was only open to see people on an emergency basis as recently as last week due to nurse availability, which has him concerned about the kind of care community members are getting.

“The front line is very key in terms of how they’re receiving our people,” Monias said, noting the situation in his community has since improved. “We have to make sure that we have our people properly diagnosed.”

Indigenous Services Canada runs 21 of 22 nursing stations located in Manitoba. They are places where the majority of care is provided by nurses and they’re in short supply, ISC has said previously.

According to a recent response from the federal department to an order paper question filed by Niki Ashton, NDP MP for Manitoba’s Churchill-Keewatinook Aski riding, 223 nurses are needed each day in ISC-staffed nursing stations across the country.

ISC said on average in recent months, those shifts have been filled by 71 public servant nurses. Seventy-nine agency nurses and 30 auxiliary health workers were called on to help fill vacancies while 43 nursing positions were left unfilled.

Whole system has to change: advocate

Dr. Barry Lavallee, chief executive officer of a northern health and wellness advocacy agency called Keewatinohk Inniniw Minoayawin Inc., characterized the situation in some communities as “emergencies.”

“If you have no nurse, there’s nothing available,” Lavallee said. “In the communities it’s life or death in many cases, so we need somebody there.”

For that reason, Lavallee said nursing shortages in southern Manitoba communities can’t be compared to those located in the north.

“The whole system has to change,” Lavallee said.

“The nurses that we have, they’re doing a hell of a job in a poor situation to try and provide good care when I think the system is just a little bit backwards in trying to find ways to support them effectively.”

He said more needs to be done to attract nurses back to the public service, and mixed models of primary care need to be looked at to make it less dependent on nurses.

“We have all kinds of people, pharmacists, we have all kinds of people that could deliver care,” Lavallee said.

Jennifer Carr, president of the Professional Institute of the Public Service of Canada which represents nurses working in remote and isolated communities, said insufficient staffing levels are taking a toll on front-line providers and communities.

“Their primary role is to provide primary care to these locations,” Carr said.

“With the staffing levels that we have right now, that is in jeopardy … so much so that a lot of these communities are on emergency care only, which is not delivering the needed health care that these communities need and are promised on behalf of the federal government.”

Ripple effects of nursing shortages

ISC told CBC last week it contracts agency nurses to help fill vacancies when required and calls on other health-care workers, such as paramedics, to help provide care.

“As there are critical nursing shortages that are having an effect on health care across the country, this is also affecting nursing staffing levels at ISC-run nursing stations in remote and isolated Indigenous communities in Manitoba,” ISC said in an email.

Carr said some may find agency work more appealing because people have more choice over when and where they work. She suggested the government needs to do more to bolster staffing levels among publicly-employed nurses.

“It’s not just about pay,” Carr said, who added fixing up nursing stations, adding security and making sure nurses aren’t required to deal with other tasks — such as dealing with information technology or maintenance work — are also key concerns.

Carr said her members typically work rotational shifts of two weeks on, two weeks off in the same community, which allows them to build stronger relationships.

Darlene Jackson, president of the Manitoba Nurses Union, said while her members don’t typically work in nursing stations, she knows the work can be difficult.

“You have to have a lot of skills and experience to work in those nursing stations,” Jackson said. “You’re basically on your own.”

ISC announced in August 2022 it would triple recruitment and retention bonuses through 2025 to help address critical nursing shortages, and said it has a longer-term strategy to increase staffing levels in remote and isolated First Nations.

Since September the department has hired 111 full-time community health nurses and two full-time general duty nurses.

Monias said Pimicikamak, which has an on-reserve population of nearly 5,000 people, is trying to take matters into its own hands. A new health centre is expected to open soon and the community wants a bigger role in staffing it.

“We know what we want. We know what we need. We know how to take care of our people,” Monias said.

“If you give us a chance to take care of our people, we’ll make it happen.”