ER closures and limited staffing

[Mad Mike]

We'll see what materializes, it isn't going smoothly in other provinces and I don't expect it to go any smoother here.

https://www.cbc.ca/news/canada/nova-scotia/ukrainian-medical-workers-jobcalls-1.6539617

It's complicated, particularly when the practitioner is coming from countries that have a low bar for training and licensure, or places that use Soviet era technology and practices. Standards are high in Canada, as is the bar for being licensed to practice. Perhaps the bar is too high although I doubt there is much support to lower it.

My feeling is there should be a national licensing body that uses capability and credentials as the only scope for licensure. Right now we have a mishmash of provinces and provincial colleges making up rules. A national body could establish easier-to-use equivalency tests and straightforward pathways for practitioners licensed in countries with similar standards to Canada.

 

[backmarkerducati]

Another large complication... Doctors and Nurses coming from countries where the government has full control over the professions get a rude awakening when they arrive. The Canadian Government goes out there and says we NEED Doctors and Nurses to come here. Then they come here thinking they are wanted.needed only to find out that the "local" licensing bodies do not recognize their education/training (maybe for good reason, maybe not). They figured if the federal government says something that is the way it is.... BTW this has been a problem for MANY decades.

It is not just these professions... friends and co-workers that have moved here based on the "points system" have hit this in one way or another. They were told by the Canadian Government the only educated profession not needed was lawyers, and this was due to the difference in law systems country to country. All others we need you, oh but.... Just medical seems to be the worse for this.

 

[crankcall]

Medical is a very tough one , and often it’s not that we are better , we often have not approved ( right or wrong) a procedure or medicine and Doctor XX causes all kinds of challenges for follow up because we don’t do here , what they do there .



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[woot]

I'd say any RN could make the jump - the question is why would they? Financially it's difficult, 2 years full-time study costs $200K in salary and $60K in tuition. NPs also need 4000 hours of on-the-job experience, which means work then return to school, another toughie unless you're wealthy.

NP narrows the scope of work by deepening the capabilities in a focused practice area, so if one really wants specialize that's the route. MScN goes wide vs deep, more on business, health care policy, and leadership -- this opens the door to more career options in teaching, management, health care administration, and a lot of the advanced clinical positions NPs can do. MScNs also see better comp and jobs that offer better work-life balance.

My wife applied to an NP program this year and didn't get in. So I guess not any RN. She has friends who also didn't get in.

-Better pay
-better hours
-less abuse
-open own private practice/take on own patients/no boss

 

[Mad Mike]

My wife applied to an NP program this year and didn't get in. So I guess not any RN. She has friends who also didn't get in.

-Better pay
-better hours
-less abuse
-open own private practice/take on own patients/no boss

It's competitive and the minimum qualifications are high. You also have to deal with the alumni factor in the top schools.

What schools did she try?

 

[Mad Mike]

Another large complication... Doctors and Nurses coming from countries where the government has full control over the professions get a rude awakening when they arrive. The Canadian Government goes out there and says we NEED Doctors and Nurses to come here. Then they come here thinking they are wanted.needed only to find out that the "local" licensing bodies do not recognize their education/training (maybe for good reason, maybe not). They figured if the federal government says something that is the way it is.... BTW this has been a problem for MANY decades.

It is not just these professions... friends and co-workers that have moved here based on the "points system" have hit this in one way or another. They were told by the Canadian Government the only educated profession not needed was lawyers, and this was due to the difference in law systems country to country. All others we need you, oh but.... Just medical seems to be the worse for this.

I don't buy the fact that any foreign doctor has a rude awakening -- not sure I'd want a doctor who showed up with a medical bag thinking he/she could get to work tomorrow.

They have to pass exams, have proficiency in English or french, and find a residency. Residencies are limited by other factors, and domestic graduating doctors get priority.

We do need doctors. We also need to be sure they are trained and capable of practicing medicine before we let them loose.

 

[woot]

It's competitive and the minimum qualifications are high. You also have to deal with the alumni factor in the top schools.

What schools did she try?

Not sure. My point was just that there were a couple folks saying that "any" RN that wants to be an NP can do so. As you put it "It's competitive and the minimum qualifications are high." My wife and her colleagues are all from the ICU, so they already have more education then many RNs.

 

[crankcall]

Not sure. My point was just that there were a couple folks saying that "any" RN that wants to be an NP can do so. As you put it "It's competitive and the minimum qualifications are high." My wife and her colleagues are all from the ICU, so they already have more education then many RNs.

It’s not that easy , couple gals that work with my wife have made the jump . Her best friend just graduated last yr at age 45 but she did her masters while working full time at 28 and did her RPN while working full time , ( 3 kids, 2 of which are gifted) .
Several more have not been successful for whatever reason.
Wife has just been asked to become a teacher , she’s 1.3yr off retirement, no friggin chance although I suspect she would be good , she’ll drift off to retirement.


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[backmarkerducati]

I don't buy the fact that any foreign doctor has a rude awakening -- not sure I'd want a doctor who showed up with a medical bag thinking he/she could get to work tomorrow.

They have to pass exams, have proficiency in English or french, and find a residency. Residencies are limited by other factors, and domestic graduating doctors get priority.

We do need doctors. We also need to be sure they are trained and capable of practicing medicine before we let them loose.

You are thinking like a local that knows the system....

They are not thinking they will just walk onto the job, but many do not expect they will be completely rejected once here by the licensing bodies. The government (ours) told them they are needed to come here and work. They come from a place where the government's word is final (and ours just gave the word) and where they come from the government completely controls the licensing bodies. They get here and find out it is not like that at all.

 

[Mad Mike]

Not sure. My point was just that there were a couple folks saying that "any" RN that wants to be an NP can do so. As you put it "It's competitive and the minimum qualifications are high." My wife and her colleagues are all from the ICU, so they already have more education then many RNs.

Just like the BScN, it's competitive and each school has different admission standards. For example, it appears UofT doesn't review applicants with a GPA below 3.8, BScN from a top 5 school (preferably UofT), 2+ years of recent experience in a leading hospital for the chosen specialization, recommendation letters from field leaders, and they want to see clear examples of leadership experience.

Hopefully she can get a spot in the program soon, we need more NPs!

 

[Mad Mike]

You are thinking like a local that knows the system....

They are not thinking they will just walk onto the job, but many do not expect they will be completely rejected once here by the licensing bodies. The government (ours) told them they are needed to come here and work. They come from a place where the government's word is final (and ours just gave the word) and where they come from the government completely controls the licensing bodies. They get here and find out it is not like that at all.

Buying the Canadian dream? Caveat Emptor.

 

[GreyGhost]

Buying the Canadian dream? Caveat Emptor.

They also listened to/believed a political program. Might as well start their education early that those are unicorns and rainbows funded by their grandkids.

 

[Georg3__]

Got a email about lack of staff for imaging something something. And poaching of IT staff from private companies continues…

There is a important meeting happening tomorrow in downtown, might be on the news…

 

[crankcall]

The staffing will get worse now , vacations which have been approved for nurses 4-6 months ago are being “unapproved “ ie cancelled. People have flights booked , family meets and resorts paid for.
The current mindset is ‘ I’m not going to be here that week, if I come back and I’m fired I don’t really care’
That’s a recipe for disaster, and the management group don’t seem to see the problem. Your already burnt, have waited 4-6 months for vacay and get denied. Umm nope .


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[mimico_polak]

The staffing will get worse now , vacations which have been approved for nurses 4-6 months ago are being “unapproved “ ie cancelled. People have flights booked , family meets and resorts paid for.
The current mindset is ‘ I’m not going to be here that week, if I come back and I’m fired I don’t really care’
That’s a recipe for disaster, and the management group don’t seem to see the problem. Your already burnt, have waited 4-6 months for vacay and get denied. Umm nope .


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Yup, the nurses know that finding a new gig won't be difficult...so why bother being treated like a POS due to management / government incompetence.

They need to have time to unwind, we all do. But they need it especially.

 

[nobbie48]

The staffing will get worse now , vacations which have been approved for nurses 4-6 months ago are being “unapproved “ ie cancelled. People have flights booked , family meets and resorts paid for.
The current mindset is ‘ I’m not going to be here that week, if I come back and I’m fired I don’t really care’
That’s a recipe for disaster, and the management group don’t seem to see the problem. Your already burnt, have waited 4-6 months for vacay and get denied. Umm nope .


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Nurses could have it worse. They have above average pay and benefits. SAYS THE FAT GUY FROM HIS COTTAGE EVERY WEEKEND.

Seriously, not everyone is in the same boat and sometimes the comparison to the more privileged hurts. The nurse risks life and disease at all hours getting insulted while someone else sells baubles and socializes with their followers over lattes, has a regular sleep schedule. It's time for everyone, politicians to patients, to stop treating nurses like cannon fodder.

FWIW I haven't seen my GP since Covid began. I called yesterday and he's still telephone consulting only. I was hoping for an annual because shoving my cell phone up my rectum isn't going to evaluate my prostate gland.

 

[mimico_polak]

Nurses could have it worse. They have above average pay and benefits. SAYS THE FAT GUY FROM HIS COTTAGE EVERY WEEKEND.

Seriously, not everyone is in the same boat and sometimes the comparison to the more privileged hurts. The nurse risks life and disease at all hours getting insulted while someone else sells baubles and socializes with their followers over lattes, has a regular sleep schedule. It's time for everyone, politicians to patients, to stop treating nurses like cannon fodder.

FWIW I haven't seen my GP since Covid began. I called yesterday and he's still telephone consulting only. I was hoping for an annual because shoving my cell phone up my rectum isn't going to evaluate my prostate gland.

I asked my doctor about that also....

'Oh we don't do the finger anymore...we just look for certain markers in your blood work as it's just as effective.'

I stressed out for months about getting the finger...all for nothing.

 

[nobbie48]

We do need doctors. We also need to be sure they are trained and capable of practicing medicine before we let them loose.

An Asian friend of my wife was going to a doctor of her own nationality and was given Rxs for a condition.

Other symptoms came up over the years and she had to see a different doctor who asked what Rxs she was on.

It turned out that one wasn't recommended for Asians.

 

[nobbie48]

I asked my doctor about that also....

'Oh we don't do the finger anymore...we just look for certain markers in your blood work as it's just as effective.'

I stressed out for months about getting the finger...all for nothing.

I don't have enough medical knowledge to argue what's best but "Effective"can be misleading.

A less accurate test that is less painful and / or more convenient might get used more and the overall benefit to the population in general is more beneficial. However the more difficult test might be more accurate per individual.

 

[nobbie48]

In a nutshell our medical services have been backsliding for decades due to patient abuses, budget restrictions and expectations.

It bothers me when a rider down post includes "Life altering injuries." That can't be cured with a pill.

The system presents us with more thrills than ever before but who calculates the future costs for the time things go wrong? We are pumped with more attitude to match the new thrills.

From a M/C perspective enter the helmet mandates and insurance medical coverage.

There is little focus on e-bikes, white water rafting, adventure travel.

On the treatment end, the government has been trying to squeeze a bit more juice from the orange into the glass. Covid broke the glass.