Doctors fill in for departed forensic nurses

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This article was published 24/03/2023 (1185 days ago), so information in it may no longer be current.

WINNIPEG — Manitoba’s largest hospital is turning to doctors and nurse practitioners to perform forensic exams after more than half of its nurses trained to examine sex assault survivors quit this week amid a program overhaul.

Seven casual nurses have now resigned from the Sexual Assault Nurse Examiner program at Health Sciences Centre, leaving only six, plus one who works full-time, to provide around-the-clock coverage.

The specially trained nurses collect criminal evidence when sexual and intimate partner violence survivors arrive at HSC.

Acute health services executive director Jennifer Cumpsty said “a significant number” of doctors and nurse practitioners will fill the gaps until summer, when nurses hired for permanent, full-time positions complete their training.

“Effective today, we have a group of physicians and some nurse practitioners that have come forward and are willing to cover those gaps so that we will be able to continue to provide care for survivors that present for care,” Cumpsty said.

The doctors will be using RCMP forensic evidence collection kits in the interim and training will be provided. Exams can take up to three hours to complete.

“We will be able to commit to filling those gaps as best we can,” she said.

As part of a program expansion announced last April, six nurses were hired for permanent, part-time jobs within the program. Until recently, it was staffed with one full-time and a dozen casual nurses who picked up shifts in addition to their other health-system responsibilities.

However, just one person was hired from the pool of trained, casual nurses who have supported the program over the past three decades.

The five others must complete training and won’t be ready to work independently on the unit until June at the earliest, officials said. In the interim, the hospital had intended to rely on the casual nurses to provide coverage.

On Thursday, Cumpsty and Shared Health, the authority responsible for HSC, defended hiring permanent nurses into the program who were not already trained to do the complex work.

Cumpsty said permanent positions were offered to “all the casual nurses that applied,” and there were several, but only one accepted.

Manitoba Nurses Union spokesperson Brandi Johnson said only a “few” of the casual nurses were offered permanent positions, under a Nurse 2 classification, which was not what the program was funded for by the province.

According to Shared Health, positions were briefly posted as Nurse 3 jobs, but revised following a mandatory compensation review. A Nurse 2 post has a lower hourly wage.

Johnson explained the skill set for a Nurse 2 position is not representative of a forensic nurse examiner and casual nurses flagged their concerns with the classification to system leaders.

“They shared that if the positions were posted as funded (Nurse 3), they would have all stepped into the permanent part-time positions and the program would have been without interruption,” Johnson said.

“After the downgrade of the positions, and a long gap before training began with the new Nurse 2s, there were countless shifts unfilled — not because the nurses who quit chose not to support the program — but because they continued to around their other, full-time jobs,” she said.

“Had contingency been put into place about what happens when a SANE nurse is not on shift, that would have helped retain nurses.”

Shared Health said hiring was done in accordance with the MNU collective agreement.

Health Minister Audrey Gordon, who faced calls to step down from the Opposition NDP Wednesday over the resignations, said the plan to have physicians and nurse practitioners fill gaps is a “good workaround.”

“It’s a good plan. The individuals will be seen by physicians, and we are working as a team to ensure that Manitobans who experience this horrible trauma — survivors of sexual assault — that our government takes so very seriously, receive the care they need here at the Health Sciences Centre,” she said Thursday.

Gordon said she’ll be satisfied with the program once it’s fully up and running with a complete complement of staff. The Tories had committed to having the expanded program and around-the-clock coverage in place early this year.

Cumpsty said management is reaching out to nurses who have resigned to see if they will reconsider.

Casual nurses have told the Winnipeg Free Press that nurse shortages, sinking morale and communication breakdowns between management and staff have all contributed to the staffing crisis.

Service gaps have led to survivors being sent home with instructions not to shower or wipe themselves after using the washroom until they can return when a forensic examiner is available.

The situation left casual staff distraught with the level of care, prompting their resignations.

“They have expressed their own moral distress, I think that they have communicated that… of what they feel their ability to provide care is,” Cumpsty said. “That’s what they have shared with all of us.”

More data analysis is needed to determine whether people have been told to wait in emergency, or go home and return when a nurse is available, since the first resignations Tuesday, she said.

The program has experienced service gaps in the past, she said.

“We have had periods of time where we have had those gaps, and it’s because nurses weren’t available to pick up those shifts,” she said. “Our new model is going to allow us to have the 24 hour coverage, so that we don’t have those gaps going forward.”

» Winnipeg Free Press