by Heidi Riley
It has never been a more challenging time to be a nurse, but there have also never been as many opportunities in the profession, says Barbara Brookins, President of the PEI Nurses’ Union, which represents Registered Nurses (RNs) and Nurse Practitioners on PEI.
There is currently a shortage of at least 200 Registered Nurses on the Island.
Barbara says heavy workloads made worse by COVID-19 are taking a toll on nurses as they struggle with long hours, sometimes including back-to-back 12-hour shifts, and scheduling that makes it difficult to take vacation time or access educational leave.
“When I started nursing, I was able to get time off to attend family activities,” says Barbara. “Now, to be assured you will get time off, RNs are pressured to trade shifts or take a part-time position.
“Between COVID-19 and not being granted the leave they are entitled to, more nurses are leaving the profession earlier than they had planned and quite a few others have dropped to part-time.”
The higher number of part-time nurses means it may now take two or three nurses to fill a full-time position. Barbara says the Nurses’ Union and provincial and federal governments are working to improve the staffing and workload situations, and that nursing continues to be an important and rewarding career.
“If you pick nursing as a career just for the money, those incentives will not be enough for you to stay,” she says. “But nursing is an amazing profession, and I am proud of the career I chose.” In fact, she says the reason people go into nursing has never changed – they want to be a part of preventing illness and supporting patients and their families through health challenges.
“Nurses have an important role in the healthcare system. It is so rewarding to help people through their worst times and at their most stressful moments to get through their health journey.”
Currently, the membership of the PEI Nurses Union includes about 1,350 Registered Nurses and 52 Nurse Practitioners. There are also a few hundred additional RNs working in management, as instructors at UPEI and Holland College, or in private long-term care facilities.
Many career paths as an RN
Barbara says it is an exciting time to be a nurse because of the growing number of roles available.
“It used to be you worked in one area for your entire career, but now there are so many opportunities and specialties to get into.
“You can work in acute care, long-term care, primary care, community care, home care, or mental health in long-term or acute care settings. Or you can further your education and work as a Nurse Practitioner, an educator, a clinical leader, or in research.
She says the mental health field will continue to expand. “The new mental health campus close to the Hillsborough Hospital will provide many more in-patient and out-patient services with a focus on keeping people out of the emergency room and will streamline access to mental health services. The new mobile response team, which is not quite fully staffed yet, is also part of that service.”
Another new role is employee health nurses. “They ensure their fellow nurses have all their vaccinations and immunizations up to date, follow through with a treatment plan for needle stick injuries, and promote overall employee health. They work with the infection control team to ensure that guidelines are being met and everyone knows what procedures to follow.”
Education opportunities on PEI
UPEI offers a four-year UPEI Bachelor of Science in Nursing program. In 2022, UPEI increased the number of seats in that program to 72 per year. Another 48 seats will be added in the next four years.
UPEI also offers an Accelerated Bachelor of Science in Nursing program which runs two full years without breaks. This program is only available to those who have a previous degree. The number of seats in that program has risen to 20.
The Master of Nursing program, which includes the Thesis Stream and the Nurse Practitioner stream, currently has 25 seats.
“You could start working in a medical or surgical unit, and as you progress in your skillset, you can move to a more acute or critical area such as Emergency, ICU, primary care, or public health,” says Barbara.
It can take up to two years of additional study to earn the certifications required in some areas of nursing.
“You are never done learning in any profession, especially nursing,” she says. “Everything keeps changing, and nursing has become so specialized. Traditional roles in medical and surgical units are now becoming specialized, with more training available for care of the elderly, palliative care, medication, and family dynamics.”
The nursing salary grid is based on four classifications. Examples of which class an RN would fit in would be that most Acute Care Nurses are RN 1. An RN 2 has more of a leadership or educator role such as in primary care or in a long-term care facility. An RN 3 usually has a provincial scope of position, such as in infection control. An RN 4 is a supervisory role, such as a Nurse Supervisor who coordinates staffing and scheduling. Nurse Practitioners have a separate classification.
Each classification has different steps. Usually, RNs start at Step 1 and increase to the next step after each full-time year of work, up to step 6. After 25 years of service, another monetary premium is paid.
According to the current contract, new RNs working in acute care on PEI earn $34.30 per hour, reaching the top step of $41.84 after five years. After working 25 years, RNs receive another pay boost to $43.07.
A nursing supervisor earns $39.07 to $48.89 an hour. Nurse Practitioners, who have earned a Master of Nursing, start at $51.08 and range up to $57.82 per hour. The contract expired in March 2021, and a new contract has not yet been signed. For up-to-date details, visit www.peinu.com
Nursing care requires shifts that cover 24 hours a day, seven days a week, 365 days a year. The PEINU contract stipulates that PEI RNs work every second weekend, and do not work more than three 12-hour shifts in a row.
“In addition to regular duties, nurses also look after the psychosocial well-being of patients and family members. You can be with a patient and their family at end of life, or a critical incident. If the outcome is negative, you have to be able to quickly change direction and walk into the next room and focus on the next patient with a smile on your face.”
The Nursing Student Summer Employment Program offers summer employment for nursing students to work in the public healthcare sector and in fully licensed private long-term care facilities. Students in a Bachelor Degree in Nursing program who have successfully completed three years of a four-year nursing program are eligible for summer positions within Health PEI and private long term care facilities. Third-year BN students earn $28.21 per hour.
The PEI Nursing Recruitment Incentive Program for Graduate Registered Nurses provides employment opportunities for recent graduates to fill vacant Registered Nurse positions at Health PEI. A one-time financial incentive of $5,000 is available in exchange for a commitment to work in the province for two years.
The Nurse Retention Incentive program is for Nurse Practitioners and Registered Nurses. Retention Incentives of $3,500 will be paid in exchange for a one-year return in service agreement for 2023.
Barbara says another incentive to be introduced in the near future will grant a $5,000 retention incentive to nurses who agree to stay working for an additional year.
“This may keep some nurses from retiring in the next year,” she says. “We are also trying to get a priority incentive rolled out to keep people from leaving critical shortage areas such as the ER.”
Hope for the future of nursing
“We are still hiring new nurses, and some internationally trained nurses are coming into the system as well. Nursing education programs are expanding, we are looking into more bridging programs (such as LPN to RN), but it is more challenging than we would like it to be.
“The system is broken right now. It is a Canada-wide and world-wide problem that was already happening before COVID-19, but now it is much worse. It will take years to rebuild the system, and the profession and the healthcare system needs to work together to put the resources in place to support nurses.
“We are pleased to note that there is finally provincial and national recognition that there really is a problem.
“I have met with Prime Minister Trudeau and the federal Health Minister, and I frequently talk with provincial health minister Hudson and Premier King. This is the first time we have seen all of them ready to act. They just need to decide on the most important course of action and look at the best use of funds to rebuild the system. It’s not just plugging the holes – it is creating a whole new bucket.”
Suggestions for change
“A lot of work is being done between the Department of Health and Health PEI and unions to find the best way to create that balance that has been lost and needs to be found again. We need to be able to ensure that nurses who agree to work full-time can take the leave they are entitled to, which does not happen right now.
“We are also trying to put systems in place to provide more support to new nurses, such as pairing them up with experienced nurses.
“It is so important for nursing students to continue receiving experience in their field during the four-month summer break. However, the program to hire students pays less than waitressing and earning tips. The employer needs to recognize that the value of paying these students a competitive salary is an investment into nurses being more prepared when they graduate. The Nurses’ Union is trying to address this issue on a provincial and national level.
“We would also like to see PEI adopt a three-year Bachelor of Nursing program like in Nova Scotia that offers the same number of hours for clinical and classroom, but does not take an extended break for the summer, which would get students into the workplace a year earlier.
“Also, we are trying to remove the regulatory barriers that keep internationally trained nurses from practicing in Canada and to offer modules that would recognize their nursing expertise and support their transition into the Canadian healthcare system.
“A two-year bridging program for Licensed Practical Nurses wishing to become RNs would also be very helpful.”
Barbara Brookins’ career path
Barbara worked for almost 30 years in the Emergency Department at the Prince County Hospital in Summerside. In May 2019, she switched into specializing in Infection Control, as part of a seven-member team that offered education around hygiene, hand washing, and masking.
“It was interesting to be in the thick of developing policies and protocols and trying to figure out impacts on staff and service delivery. When the pandemic hit, there was so much coordination required to ensure the health system was able to operate while protecting patients and healthcare workers.”
Barbara took on the role of President of the PEI Nurses Union for three years starting in 2007, and then returned in December 2020. She works to make nurses aware of the terms of their contract, their rights, and what they are entitled to.
“I also work to addresses work/life issues, such as scheduling, overtime, staffing, education, vacations, pension, and health benefits. I am excited to be part of the changes needed to make the system work, because right now it is not working.
“We can’t accept the fact that people are waiting in the ER for 10 to 24 hours, and patients are lying on stretchers for days. I am in a position to knock on the doors of the people making the decisions and say we need to fix this.”