A heated debate erupted at an Island Health board meeting Wednesday in Sidney as nurses and directors clashed over a controversial new approach to managing nurses.
Under the new approach, which was rolled out at Nanaimo Regional General Hospital in September and is expected in Victoria hospitals in mid-January, Island Health has hired more care aides and licensed practical nurses. Registered nurses, who have more training, are being refocused on specialized and supervisory tasks.
The result, nurses say, is the replacement of 270,000 hours of professional nursing care with less-skilled workers — a move they say puts patient safety at risk.
“As nurses, we are alarmed with VIHA’s [Vancouver Island Health Authority] apparent indifference to patient safety,” said Adriane Gear, a B.C. Nurses’ Union south Island representative, in her address to the health authority board of directors.
The new approach, known as Care Delivery Model Redesign, has sparked a provincial campaign by nurses, who say it is an attempt to reduce overtime and job vacancies for the sole purpose of solving a budget shortfall.
Representatives of the nurses union presented the board with a petition — signed by 10,000 people — demanding the health authority stop replacing nurses with care aides.
Island Health CEO Dr. Brendan Carr sympathized with the concerns nurses voiced Wednesday.
But the new model, he said, is an efficient team approach that recognizes that patients don’t just have medical needs — they also have functional and social care needs that a care aide or LPN can tend to. It’s also reducing overtime, which contributes to nurse burnout and rising health-care costs, he said.
“We are trying to come up with a realistic and sustainable high-quality model, and the only thing we are certain of is that what we are doing today will not be what we’ll be doing two years or five years from now,” Carr said.
“We will need to continue to change this model over time and we need our nurses and other professionals to be our partners in that.”
Both sides say the issue has been clouded by misinformation.
In an interview after the meeting, Carr said the new approach for managing nurses’ time — adding care aides and licensed practical nurses to nursing teams — was not communicated well enough to nurses.
“I know that people are concerned about this, and I don’t think we’ve done as good a job as we need to do to hear their concerns. There’s so much misinformation about this,” Carr said. “We haven’t done ourselves any favours, to tell you the truth.”
Carr said the new model may not be perfect, but it’s also not producing the higher mortality and infection rates and adverse events nurses say it will.
“The intention is not to be taking people away, it’s to make a stronger team,” Carr said.
“What we are trying to do here is move into the future with a model that will provide good quality to patients and ensure we have a sustainable system.”
Island Health’s board says it is collecting data and monitoring the new care model in Nanaimo. It said its reports will be made public at upcoming board meetings.