Stress and Deaths in Alberta Hospitals Due to Understaffing of Healthcare

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Stress and Death in Alberta Hospitals Due to Understaffing of Provincial Workplaces

Discriminatory WCB policy on chronic stress allows Alberta to understaff its hospitals and schools without having to deal with safety investigations. Is this by accident - or by design???

As corporations and provincial government employers cut back on staff during the 1990s, understaffing became a major contributor to workplace injuries, especially stress diseases.

Yet, during the 1990s discriminatory policies were put in place by provincial workers compensation boards that categorized "workload" as a "labour relations issue" so that those suffering workload-induced chronic stress diseases would no longer be compensated. They now only allow claims related to traumatic incidents.

This was done under pressure from corporate lobby groups. (Workers compensation is funded solely by corporations, not by taxpayers.)

This allowed the WCBs and provincial governments to ignore hazardously low staffing levels as a workplace hazard in provincial workplaces such as hospitals and schools. (Policies are worded differently in different provinces but have, essentially, the same effect. The Alberta policy manual actually uses the word "WORKLOAD".)

This is a CONFLICT OF INTEREST as politicians allow this discriminatory policy so that they can understaff their provincial workplaces without having to deal with safety investigations.

At the same time, understaffing has been proven to be a major factor in medical errors causing deaths of patients in hospitals and in stress diseases of workers. (The Institute of Medicine does extensive research in these areas. http://www.iom.edu/CMS/3718.aspx and more links can be found at the Center for Nursing Advocacy http://nursingadvocacy.org/faq/short-staffed.html ). In a national survey of health care workers in the US, where understaffing was identified, 85% of workers reported an adverse impact on quality of care, and 61% said patients have been placed at risk. A 2003 study of registered nurses in Massachusetts establishes that poor RN-to-patient ratios are resulting in significant harm and even death for patients. According to the survey, 87 percent of nurses report having too many patients to care for, and the results are devastating to patients: "One in Three Registered Nurses Report Patient Deaths that are Directly Attributable to RN Understaffing"

Alarmingly, nearly one in three nurses (29 percent) report patient deaths directly attributable to having too many patients to care for;
67 percent report an increase in medication errors due to understaffing;
64 percent report an increase in complications due to understaffing;
54 percent report readmission of patients due to understaffing;
52 percent report injury and harm to patients do to understaffing;
1 in 2 nurses report that poor staffing leads to longer stays for patients, which cost more;

Yet, even after several hospital deaths related to drug errors in Red Deer and Calgary, the Health Quality Council of Alberta did not even mention understaffing as an issue in their 2003 Report to Albertans on the quality of health care in Alberta, and since then they have downplayed any relation between patient deaths and understaffing even in their Patient Safety Report.

This is not surprising as the CEO of the Alberta Health Quality Council, John Cowell, is an ex-CEO of the Alberta Workers Compensation Board!!! (He is also on the CARF Canada Board of Directors - Commission on Accreditation of Rehabilitation Facilities).

Also, Doug Griffiths (later on the Alberta Legislative Review Committee) was on the Health Quality Council at the same time that he was also on the Progressive Conservative Party Board of Directors.

There is even rampant speculation that the Alberta government intentionally understaffed its hospitals during the 1990s to create an artificial 'crisis' in the public health care system to help justify their push for privatization of health care.

This Alberta example of conflict of interest illustrates how workplace safety accountability suffers at the hands of provincial political expediency.

While provincial employees (nurses, teachers, etc.) are being refused compensation and are enduring lengthy WCB appeals, they are going bankrupt, losing their homes and their children are going hungry.

As Alberta and other provinces congratulate themselves on wiping out their deficits, they fail to mention that it was on the backs of their own provincial workers, patients and citizens.

The Supreme Court ruled that the refusal of workers compensation boards to compensate workers for chronic PAIN was discriminatory, yet chronic STRESS sufferers have not yet had their day in court.

Back in 2001 the World Health Organization singled out Alberta in their document on international working conditions in the health sector, stating: "additional tasks, the presence of fewer standby staff and the need for supervision of less experienced and less qualified colleagues require more energy and staff care for the performance of inpatient services, a phenomenon that cannot be reflected by the term increased workload alone. In the Canadian province of Alberta, layoffs have resulted in heavier workload for the remaining staff, and the quality is reported to have reached crisis level" http://www.who.int/hrh/documents/en/PSI.pdf

Six years later, the crisis still remains. At the time of this writing (March 2007), a hospital in Vegreville is being shut down due to an MRSA superbug infection, a situation which has been linked to understaffing by researchers wordlwide. See BBC story and CBC story. Yet there were warnings on this at least as far back as 1999 when the Friends of Medicare wrote a Commission paper outlining many deficiencies in staffing and cleanliness and stating, "serious problems exist in Alberta's health care system".

Interestingly, the team looking into the superbug outbreak is the Health Quality Council under John Cowell (ex-CEO of the WCB!, mentioned above). The Health Quality Council report of July 25th 2007 (that led to the firing of the health region board) still underplays overall hospital staffing levels and only addresses staffing in infection control departments. Overall hospital staffing was not addressed by the Health Quality Council until September 2007 in the "Review of Emergency and Urgent Care Services in the Calgary Health Region" where they refer to staffing issues as "resources", "beds" and "capacity" and other buzz-words that avoid the use of the term "understaffing". And still, the issues of patient deaths, medical errors, excessive workload and employee stress are not mentioned at all.

For a discussion of the broader issues, read "Nursing Against the Odds" and "Safety in Numbers" by Suzanne Gordon

ALSO SEE:
Psychological Profiling And Mental Damage Of Claimants
and
DISCRIMINATION - Denying Compensation For Occupational Diseases)

Canada, by allowing WCB internal policies to discriminate against those who are psychologically injured in the workplace, is violating both the United Nations Convention on the Rights of Persons with Disabilities and the UN Principles for the protection of persons with mental illness and the improvement of mental health care

Canada is signatory to the United Nations Convention on the Rights of Persons with Disabilities and therefore has a responsibility to comply with Article 5 which states:
"Article 5 - Equality and non-discrimination 1. States Parties recognize that all persons are equal before and under the law and are entitled without any discrimination to the equal protection and equal benefit of the law. 2. States Parties shall prohibit all discrimination on the basis of disability and guarantee to persons with disabilities equal and effective legal protection against discrimination on all grounds. 3. In order to promote equality and eliminate discrimination, States Parties shall take all appropriate steps to ensure that reasonable accommodation is provided."

In particular, as a UN member, Canada has a further responsibility to uphold the Principles for the protection of persons with mental illness and the improvement of mental health care which was adopted by the United Nations General Assembly in 1991. It states:
"4. There shall be no discrimination on the grounds of mental illness. "Discrimination" means any distinction, exclusion or preference that has the effect of nullifying or impairing equal enjoyment of rights. . . . 5. Every person with a mental illness shall have the right to exercise all civil, political, economic, social and cultural rights as recognized in the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights, the International Covenant on Civil and Political Rights, and in other relevant instruments, such as the Declaration on the Rights of Disabled Persons and the Body of Principles for the Protection of All Persons under Any Form of Detention or Imprisonment."

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My personal story:

I was a health care worker in central Alberta who went through the staff cuts of the 1990s.

My workload increased (during the last few of the 12 years I worked there) to cover,
ALL AT ONCE:

sole employee in charge of ALL anaesthesia assistance to a 7-theatre operating suite (including attendance at high risk births)
supervisor and sole quality control operator of the Blood Gas Lab for an over-800-bed health region
assisting in bronchoscopies
assisting in the Intensive Care Unit with patients on ventilators
assisting in Emergency at intubations, etc.

I 'burned out'. I suffered diagnosed depression due to chronic stress that was PROVEN by an independent psychologist to be SOLELY related to work stressors. (There were no personal stressors). In fact, the psychologist stated in writing that,

"The work related events were excessive or unusual in comparison to the normal pressures and tensions experienced by the average worker in a similar occupation."
and
"Work related events or stressors were the predominant cause of the injury."

When I was refused compensation by the Alberta WCB, I lost my job, my home, and was forced into bankruptcy.

When I questioned why the CEO of the Health Region was not helping me attain either compensation or revised work duties (under their "Duty to Accommodate" an injured employee), he didn't help me at all.

When I sent a letter to the Chair of the Health Region Board outlining all the problems including:
- an unusually heavy workload over many years
- the ‘toxic’ psychosocial environment resulting from the supervisors’ callous disregard for employee stress factors (I was not the only one complaining. Most of my coworkers also wrote documented complaints. I have this documention.)
- the intolerable stress of being subjected to professional ethical conflicts imposed on me by management which repeatedly forced me into situations which endangered patients' lives,

. . . when I outlined to the Chair of the Health Region Board all of the above, she told me, in writing, that it is "inappropriate" to "challenge the authority" of the senior management and she threatened me with litigation saying that my allegations were "unfounded", "inaccurate" and "possibly defamatory", yet at no time did I see any evidence of her having investigated any of my allegations.

Well, I didn't say anything, but it did occur to me that when the so-called 'management' of a Health Region ignores allegations of wrongdoing, mismanagement and danger to patients . . . well . . . maybe their actions SHOULD be questioned.

So then I went to the government (Ralph Klein's Alberta PCs) and advised them that I was being ignored when I was advising the health region of possible danger to patients, etc.

Of course, Ralph Klein and his government just passed the buck and all I got was a few sentences from Clint Dunford (then Minister in charge of WCB) telling me to go back to WCB (Guy Kerr, WCB CEO) who had refused my compensation in the first place!

The Minister of Health at the time, Gary Mar, was impotent, saying he had "no jurisdiction over the employment issues described"

Well, by this time, my chronic stress disease was getting worse. I lost my job and my home and was forced into bankruptcy.

Alberta used me to wipe out their deficit through staffing cutbacks. They also used me in their pursuit of privatization of health care by causing an artificial 'crisis' in the public system by understaffing it.

Then, Alberta threw me away into the garbage.

J. Edgett

For more info, contact J. Edgett at:
edgett AT sasktel DOT net

ALSO SEE:
Psychological Profiling And Mental Damage Of Claimants
and
DISCRIMINATION - Denying Compensation For Occupational Diseases)

Keywords: understaffing alberta, under staffing, under staffing alberta hospital workers medical errors drug errors hospitals health care workers alberta health care staff staffing under staffing nursing recruitment retention nurses recruitment and retention alberta mrsa vegreville east central health region fired health quality council john cowell united nations un disabilities mental health commission

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