WHAT NURSE SHORTAGE? IT’S NURSING WE NEED

We've got nurses — they just seem scarce because they're burdened with menial jobs — carrying bedpans, serving meals, making beds — when they should be free to do what they're trained for: nursing

ALAN EDMONDS April 1 1967

WHAT NURSE SHORTAGE? IT’S NURSING WE NEED

We've got nurses — they just seem scarce because they're burdened with menial jobs — carrying bedpans, serving meals, making beds — when they should be free to do what they're trained for: nursing

ALAN EDMONDS April 1 1967

WHAT NURSE SHORTAGE? IT’S NURSING WE NEED

We've got nurses — they just seem scarce because they're burdened with menial jobs — carrying bedpans, serving meals, making beds — when they should be free to do what they're trained for: nursing

THERE’S SOMETHING odd about that nurse shortage people are constantly talking and writing about: it may not exist.

Canada has one nurse to every 260 people, and that’s a healthier ratio than anywhere else in the world, excepting New Zealand and Sweden. We lose a lot of nurses to the United States every year — but nursing is a very mobile occupation and young girls like to travel and see the world, which means we get about as many nurses as we lose, from Britain, Australia, New Zealand and elsewhere.

So where’s the shortage?

“[ suspect it lies in the way our hospitals use their nurses,” says Dr. Bernard Brousseau, executive-director of the Canadian Hospital Association. Nurses’ leaders are blunter. “Training girls as vital members of the health team, then not utilizing them properly is the sort of lunacy Canada can’t afford,” says Dr. Helen Mussallem, executive-director of the Canadian Nurses’ Association. “By the time we’ve finished playing housemaid, the patients are lucky to get any half-decent care, and sometimes, if you’re short of aides, night duty gets to be a sort of Russian roulette — for the patients,” says one staff nurse.

Commonly, the 45,000 or so nurses on general duty in Canadian hospitals tend their patients only part of the time. For the rest, they fetch and carry bedpans, make beds, serve meals, tidy rooms, provide patient room service, stack the laundry, wash surgical equipment, answer the telephone and do the work a full-time ward clerk could, and should, do better. You’d have a hard time proving it, but patients have died or suffered needless agonies for lack of attention from a nurse, who was busy doing something an aide should be doing.

Now the nurses are in the midst of what one could call a bedpan rebellion.

Their first target is the traditional training system. Historically, nurses have always been trained in hospitals during a three-year unpaid course, a year of which they spend working on wards as what some have described as “slave labor.” Some bigger hospitals have begun to abandon this system, but there is increasing pressure to have nurses’ education taken out of hospitals’ hands and placed in independent schools, such as the Nightingale School of Nursing in Toronto (where the picture on page 19 was taken). There the girls become registered nurses in two years, spending around half the time in various hospitals doing jobs designed to teach them, not the odd jobs that “slave laborers” complain about.

In some provinces — notably Saskatchewan and Ontario — provincial health authorities are giving way to this pressure: in Ontario a two-year course will, it is planned, be standard by 1975. But hospitals generally oppose such schemes, partly because they’d be even more short-staffed if deprived of students' services.

Poor salaries as well as working conditions make nursing in Canada unattractive when compared to those in the U.S.,

where salaries are often 30 percent higher. But collective bargaining for nurses, already a reality in British Columbia and parts of Quebec, is spreading slowly across Canada. Another nurses’ beef, perhaps the biggest, is harder to pin down. The bedside nurse,

the girl with a nursing-school diploma, is trapped at the bottom of the nursing ladder by her lack of university training. Most administrative, supervisory and teaching jobs go to girls with BA degrees in nursing. And university nurses stand a better chance of getting into specialized nursing — neurosurgical or obstetrical nursing, for instance.

The nursing establishment — federal and provincial associations and colleges — are always fighting for a new deal for nurses. But the young nurses are growing impatient. In the meantime, the nurses’

dilemma is inextricably locked in with the problems that beset doctors and hospitals. And that all sounds like a Chinese conundrum: We need new-style doctors and a new team approach to medical care, but what kind of doctors and what kind of care? Doctors must hand over more responsibilities to nurses — but they don’t want to. Nurses want the job. but say they’re too busy washing bedpans and making beds to do it.

It seems that Canada isn’t particularly short of nurses, but it is short of nursing. ALAN EDMONDS

ALAN EDMONDS