Lily Cugliari-Kobayashi spent 39 years working in hospitals before exiting into community nursing in an ecumenical setting and volunteering at Toronto’s Holy Rosary Parish. Through the Faith Community Nursing Interest Group of the Registered Nurses’ Association of Ontario, she is hearing about a crisis that affects all areas of her profession and the entire health-care system.
“At this time, in general, I do not believe nurses are feeling supported due to the crisis — due to the extreme understaffing and a workload that’s an overwork load, that’s not being safe,” she said.
On the front lines at one of Canada’s largest hospitals, chaplain Brenda Stewart is experiencing the onslaught in her own workday and hearing about it from the nurses, doctors and others at Toronto’s Sunnybrook Hospital.
“The challenge with this is the fact that it keeps going on,” she said. “What you hear is ‘When is this ever going to be over?’ It’s the thing with wave after wave… It’s just the weight of it. The exhaustion is more palpable this time. You can really feel it.”
At Unity Health, the Catholic foundation that manages St. Michael’s, St. Joseph’s and Providence hospitals in Toronto, 200 to 300 staff and physicians are in isolation daily because they’ve been exposed to COVID. On Jan. 7, 230 staff and physicians out of 8,550 full- and part-time workers and 850 medical doctors tested positive.
Several hospitals in Ontario have declared themselves in “Code Orange.” Before COVID “Code Orange” meant a mass casualty event — a temporary influx of patients requiring immediate high levels of care. Now it just means too many patients and not enough people to care for them.
There’s no special exemption for Catholic health care.
“We have members that are struggling with staffing. It relates to where COVID’s at,” said Catholic Health Association of Ontario president and CEO Ron Noble.
Noble is hearing that up to 30 per cent of staff may be unable to go to work because they’re infected, will have been exposed, driven to exhaustion, or have to deal with family crises.
It isn’t just a crisis of hospitals.
“The home-care sector is currently experiencing a critical shortage of staff,” said St. Elizabeth Healthcare spokesperson Madonna Gallo.
Underinvestment and “uneven pandemic policies” are to blame, she wrote in an email.
“Thousands of visiting nurses and personal support workers have left the home-care sector for higher-paying jobs in hospitals, public health and long-term care facilities,” Gallo said.
Pre-pandemic St. Elizabeth and other home-care sector employers could supply a nurse for a home visit 95 per cent of the time. It’s down to 60 per cent across the province, according to Home Care Ontario. In the first week of the new year St. Elizabeth had 125 frontline staff with COVID-19, plus many more staff in isolation.
“Like so many essential workers, our staff are experiencing significant weariness as the pandemic rages on,” said Gallo. “A healthy and supportive work environment is extremely important.”
Based on Catholic social teaching that upholds community, solidarity and the dignity of workers, Catholic health care has always prided itself on being a good place to work. The Omicron crisis is a test of that Catholic difference, said Catholic Health Sponsors of Ontario president and CEO Beth Johnson.
“This is when we’re at our best,” she said. “It’s through these experiences that the esprit de corps, the camaraderie, really comes to life. Rather than draining people, it gives them energy they need to address whatever the next challenge will be.”
Several Catholic health-care providers in Ontario have signed up for programs offered by the Canadian Mental Health Commission, hoping to bolster the resilience of staff, Noble said.
Workers are the measure of how Catholic Catholic health care really is, said Francis Maza, vice president of mission, organizational development and ethics at Providence Healthcare in Vancouver.
“Part of our understanding of moral thinking is that we believe in the virtues of people who chose to be in health care. They’re there because they wanted to help,” he said.
This isn’t the first pandemic Catholic health care has faced and Maza believes that institutions founded in the midst of waves of cholera, diphtheria and Spanish flu will respond to COVID in the same spirit.
That doesn’t mean COVID doesn’t have lessons to teach Canada in how it manages health care, said Noble. Pre-COVID, Canadian hospitals aimed for a balance in which hospitals tried to operate at 80 to 85 per cent of their capacity, leaving 15-per-cent surge capacity.
“We can do better. If there’s a positive in COVID, it has shone the light on the inadequacies of our system,” Noble said.
For Noble the most obvious lesson is that we’ve underinvested in community and primary care. When hospitals start cannibalizing nursing and personal support staff from community care institutions they’re crippling exactly the kind of care that could keep people out of the hospitals — preventive care.
Hospitals should be “the service of last resort,” said Noble. “We’ve trained Canadians well, through the ‘60s and ‘70s, to look for the H on the roof to get their health care. Now we have to shift the model. We could add 1,000 beds and within six months they would be full. That’s not getting at the core issue.”
While many people say we’re all in this together, Cugliari-Kobayashi likes to sing it, straight from the second verse of one of her favourite hymns. “We are pilgrims on a journey/and companions on the road/We are here to help each other/walk the mile and bear the load” from “Brother, Sister, Let me Serve You” by Richard Gillard.
Cugliari-Kobayashi keeps close to her parish and her colleagues in the parish nursing program jointly offered by St. Peter’s Seminary and the University of Dayton.
“Spiritual support is defined by each of us in our own different way,” she said. “I’m a strong believer in prayer. I’m a strong believer in meditation and contemplation.”
“The most important thing I have is my colleagues. My colleagues are phenomenal,” said Stewart of Sunnybrook Hospital. “Sometimes we just tell jokes. We make ourselves laugh. Sometimes we have a very spiritual compassion corner where we pray or we meditate together. That is incredibly helpful.”