N.W.T. gov't and union met to decide use of agency nurses, as health-care staff feel strain

The N.W.T. government and the Union of Northern Workers met last month to discuss the appropriate use of agency nurses. 

The meeting, which took place July 17, was to establish a joint working group that could decide on how agency nurses could be used in a way that doesn't violate a 20-year-old agreement between the union and the territorial government. It's the only meeting to have taken place so far and the working group has not yet communicated any decisions or new guidelines, according to a union representative.

Agency nurses — sometimes referred to as travel nurses — are typically employed on short-term contracts through a private hiring agency, and often come from elsewhere in Canada. They typically receive a higher salary than permanent staff, but also don't get things like benefits.

The meeting, which was required by an arbitrator, came as health-care services in the N.W.T. have been struggling to operate due to a limited pool of available workers, and as existing staff experience the strain of overwork. 

"People feel tired in general, frustrated and just sort of generally burnt out ... It's been dire at times. We're under pressure," said Andrew Gregory, the vice-president of Local 11 for the union, which represents members at Stanton Territorial Hospital.

Gregory works as an emergency critical care nurse at the hospital, but spoke with CBC News as a representative of the union.

"Certainly, staffing is a tremendous challenge and ... it's always more difficult in the summer."

Gregory wasn't the only person to say this. A nurse at Stanton, who spoke with CBC on the condition of confidentiality due to potential employment ramifications, said since the health authority has been forced to limit its use of agency nurses, the workload for other nurses at the hospital has increased significantly. 

Gregory, as a representative of the union at Stanton, took part in the working group with the N.W.T. government to determine how agency nurses can be used while respecting the agreement.

Why is there a working group?

The working group is a requirement from an arbitrator's decision back in April, which ruled that the way the N.W.T. is using agency nurses is in violation of a 2004 memorandum of understanding with the union. 

The 2004 memorandum said the N.W.T. should only use agency nurses "as a last resort" and must provide the union with a report explaining its decision to hire the external nurses. 

In 2022, the union filed a grievance over the territory's use of agency nurses. 

The union and territory had negotiated a separate memorandum of understanding to use agency nurses during COVID-19, between August 2021 and March 2022, but the Northwest Territories Health and Social Services Authority's use of agency nurses continued past the expiry date, leading to the grievance.

The arbitrator ruled that the two parties must establish a working group to help determine when agency nurses may be used.

Health care staff shortages

Staffing shortages have plagued many of the N.W.T.'s health centres for years and is still resulting in reduced services in some areas. For example, the health authority announced last week it was extending the shutdown of Inuvik's birthing services because there weren't enough nurses.

Krystal Pidborochynski, a spokesperson for the health authority, wrote in an email that the health authority is using a variety of tactics to continue offering services without the use of agency nurses.

"The [health authority] uses every available avenue to ensure operations continue — for example, offering hours to relief staff, overtime or securing casual short-term contracts," she wrote.

"As a last option, we look at service reductions in areas where we are unable to safely staff, i.e. closure of obstetrical services or reductions, combining services, moving patients to other facilities, etc."

Pidborochynski wrote on Aug. 9 that the N.W.T. was, at the time, using agency nurses in obstetrics at Stanton Territorial Hospital and Inuvik Regional Hospital.

"The NTHSSA is continually working to recruit ... [permanent] staff who are or will be residents of the N.W.T."

'These people are not being heard'

Kieron Testart, the MLA for Range Lake, said the health system is "very near a breaking point."

He and Robert Hawkins, MLA for Yellowknife Centre, are organizing a "town hall-style constituency meeting" on Thursday evening on the state of health care. He said it's open to all staff and patients in the territory, and will provide a space for people to voice complaints and concerns with the current state of the system.

Speaking with CBC News earlier this month, Testart said part of why he's holding this event is because he's heard concerns from his constituents who work in health care.

"My concern is that the health system is a closed circuit right now. They're not taking input from the people who are leaving the system, the people who are struggling with the system," he said.

"Whether that's patients, health-care workers — you know, doctors, nurses — these people are not being heard."