By Marilou Gagnon
Vancouver nurses have been doing frontline harm-reduction work for close to 20 years. They know the community, they know what is needed, and they know how to care for people who use drugs.
They have developed an expertise that cannot be taught in the classroom or learned in a textbook. This expertise can only be developed through experience, humility, compassion, innovation, and a true commitment to meet people who use drugs where they are at and learn from them.
Yet, nothing could have prepared them for this opioid crisis.
We have seen the numbers of overdoses and overdose-related deaths increase over the past years—a 327 percent increase since 2008, to be exact. However, over the course of the past 3 months, these numbers have increased at even more alarming rates, reaching an unpreceded peak in the last three weeks.
As a nurse working at Insite, nothing prepares you to respond to 10, 20, and even close to 30 overdoses over the course of your shift with no additional staff, resources, or equipment. Nothing prepares you to see hundreds of your patients die in one year and so many others suffer from the loss of close friends.
As an ER nurse working at St. Paul’s Hospital, nothing prepares you to take care of more than 3,000 patients who present with respiratory depression and withdrawal with no additional staff, beds, monitors, or time to address their complex needs.
This begs the question: what are we doing to support nurses on the ground?
Since declaring a public health emergency in April 2016, the province of British Columbia has not allocated additional funding or hired new nursing staff despite increased pressure, demand, and complexity.
Overdoses have continued to increase, nurses have been working longer hours, and their working conditions have worsened.
They are not taking their required breaks, they are staying after their shift to complete unfinished tasks, and they are finding it more and more difficult to come to work. Many of them are experiencing stress that is comparable to nurses who are deployed in humanitarian crises, including post-traumatic stress. Faced with competing demands, they have to make difficult decisions every day which leads to moral distress—deciding between who to care for and what to prioritize, deciding what and when to chart due to lack of time, deciding to stay with a colleague and help instead of providing non-urgent care due to the risk of overdoses, and so forth.
Nurses on the frontline of the opioid crisis do not have time to tweet, write op-eds, send letters to elected officials, or talk to media. They barely have time to take care of themselves.
They are responding to this crisis to the best of their ability and with little support from decision-makers, organizations, or health authorities. In fact, nursing organizations have been rather silent and inactive up to this point.
Where is the British Columbia Nurses' Union? What is this organization doing to protect the health, working conditions, and safety of these nurses?
What about the Association of Registered Nurses of British Columbia? It has an important role to play in representing nurses and ensuring that their voice is being heard.
As for the Canadian Nurses Association, it also has a pivotal role in shaping the response to the deadliest overdose crisis ever recorded in Canada.
In light of the extent to which nurses are impacted by this crisis, these three organizations should work together to send a delegation on the ground in order to assess the situation, talk to nurses, and develop a plan.
I have spent the past four days gathering observations, information, and testimonials from nurses on the frontline here in Vancouver. Based on this short visit alone, there is no doubt that support is urgently needed. But the only way that nursing organizations can understand this is to see it with their own eyes.