RNs: Caring Workers going above and beyond
The Cycle of Sacrifice is a tool for understanding the nature of sacrifice endured by RNs on a systemic basis. Beginning the cycle is the reality of RN understaffing in the Ontario health system. The Ontario health system serves the largest population in Canada, some 13.4 million people today. Despite this, Ontario has the second-lowest RN-to-population ratio in the country: 699 RNs per 100,000 residents. This compares with an average of 994 to 100,000 residents in other provinces and territories of Canada. In order to catch up to the rest of Canada, the Ontario health system would need to employ 39,842 more RNs today. Instead of moving in this direction, 1,156 RN positions were cut from the Ontario health system between January 2012 and September 2013. The poor standing of Ontario in terms of RNs employed in the health system to serve the population is not new. As far back as 1999, Ontario was third last among Canadian provinces with 829 RNs per 100,000 population, as compared to the average of 892 RNs per 100,000 in the rest of Canada in 1999.
With the understaffing of RNs in the Ontario health system, RNs who are employed are overworked and overstretched. Combined with the fact that nurses’ work is physically and emotionally demanding, the overstretching of RNs makes for added physical and mental stress leading to relatively high rates of workplace-induced injury and illness. As injured RNs attempt to claim and take sick leave, they face disciplinary action and other controls leading to more stress or/and longer periods of leave. The cycle is then reset as RNs remaining on the job or being forced to return to work too early are yet more overworked and overstretched and face yet higher risk of physical and mental injury.