This post is a letter written by my sister, Michelle Johnson, a registered nurse. I have always appreciated her enormous insight and knowledge of the profession. – CJ

Michelle Johnson R.N.

If the Covid-19 crisis is a war, then nurses are the unseen army on the front lines.

“Nurse”

I think the word “Nurse” makes people uncomfortable – as if it reminds them that one day they might be in a situation where they desperately need one.

Hospitals exist to provide care, and yet, few seem willing to utter the word “nurse.” Reports refer to ‘beds available.’ When politicians talk about health care and avoid saying the word “Nurse,” it dilutes the pivotal and central role we play in providing care.

Michelle on the job in COVID-19 PPE (Personal Protective Equipment)

The crisis in hospitals today is not a lack of MD’s or Housekeepers; we know there’s no lack of hospital furniture. The crisis is a Nursing crisis. Although the odds are strong that the Covid crisis of the past two years will be resolved or at least be controlled through vaccination, therapeutics and the evolution of the virus itself, the nursing shortage will carry on. This crisis didn’t start with Covid: it is a crisis that was predicted several decades ago. Thirty years of defunding this profession has brought us to this point.

I have been a nurse in a downtown Toronto teaching Hospital since 1990. In the early 90’s in Ontario, the nursing professions saw a pay freeze and layoffs, thanks to the NDP government cuts to healthcare. The profession slid further when Mike Harris took power in 1995. Laid off nurses were compared to obsolete hula hoop makers: we were told to retrain in relevant and useful jobs. Those cuts were deep and reshaped our nursing workload and the quality of care provided, to this day. The Liberals who followed were quiet when they made their cuts; our workloads increased, and the quality of care dropped yet again. At one point, our healthcare leaders brought in MBA’s and promised the new business model would fix things: “Patient Care” got rebranded as “Client Services.”

Nursing is a female-dominated profession, and notoriously underpaid. The typical nurse in Canada makes $71,565/year gross, a pittance when you consider the education, skills and responsibilities demanded of the profession. In the early 1990s, the Pay Equity law was passed to address systemic sex-based wage discrimination in the workplace. Rather than likening us to doctors, we were compared to male pastry chefs and compensated accordingly. This pay gap has not been redressed in the intervening years.

In Ontario, nurses are now prevented from bargaining or striking under Bill 124 enacted by the Doug Ford government. We can protest on our days off, and we have. Even so, our union and professional association have been unable to effect meaningful change. There is some cause for optimism: nurses are finding each other on social media and new leaders are emerging. What remains true; we are in a deep crisis. We need those in power not just to legislate us as essential workers. We need those in power to recognize and compensate us as a profession that is essential to a well-functioning health care system.

On TV, medical shows are always about doctors, not nurses. In real-world discussions about healthcare, the focus centers on doctors and hospitaIs. Nurses seem to be left out. When we are included in stories about shortages or crises, we are reduced to “staff.” Our place in the healthcare system is diminished and our role in providing medical care is overlooked.

My reality is that as front-line medical workers, our training, our hands-on interventions, our critical thinking and specialization save endless lives. Our empathy shapes the patient’s experience in situations that are often painful and frightening. We are on the front line. We use our senses to assess the situation, our eyes and ears always on alert. We touch the body, we smell the foul odors. Nurses witness tragedies first-hand and carry the burden of those events long afterwards. With little support to process the emotional impact, the rise in nurses suffering from PTSD is leading concern.

The decades of defunding and devaluing nurses must end. Our health care system depends on the retention of experienced nurses. Valuing and compensating nurses for our vital role is essential to stop the exodus of excellent nurses and to build a system that is strong and resilient.