Workload crisis and its toll on mental health

Workplace mental health injuries aren't just an individual issue. Workload, staffing shortages and stress are becoming part of a new conversation.
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HEU member standing in front of ER

Content warning: Death and depression

Health care has the highest rate of work-related injuries in B.C.  Injury claims are twice the provincial average – and four times higher for those working in long-term care.

But there’s a growing number of mental health injury claims related to workplace trauma, violence, workload, anxiety or fatigue, especially since the COVID-19 pandemic hit.

The impact may not always be felt in the moment, but it can return days, weeks or years in the future.

In 2019, the WorkSafeBC mental disorder presumption was extended to care aides. This move means fewer barriers for care aides impacted by violence or work-related trauma.

HEU advocated for, and welcomed, this change. The next step is to extend this to all health care workers. It’s especially critical during and after our global health crisis.

Additional supports are needed for members, who are struggling with their mental health, such as addressing workload and staffing shortages.

The Guardian spoke to five HEU members around the province about some of the mental health hazards in their workplaces.  

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HEU member standing outside ER

Haunting memories

Understanding depression as a result of psychological injury at work resonates deeply for HEU member Trinity Smetaniuk, an outpatient booking clerk at Kelowna General Hospital.

“My job and how much of my heart I put into it really does go back to a lot of the mental health struggles that I’ve had recently,” she said.

In September, Smetaniuk had one of the worst depressive episodes she’s ever faced, leading her to feel suicidal and seek counselling. But it wasn’t just the stressors of understaffing at her current job. She is a former lab assistant, and her memories of working on the emergency room floor haunt her.

In one instance, while working the night shift, Smetaniuk and her colleagues tended to a baby in critical condition. A team of multiple doctors, more than a dozen nurses, and a handful of technicians had surrounded the baby, but they were having trouble withdrawing a blood sample from its tiny arm. Since collecting blood samples was one of Smetaniuk’s specialties, they asked her to try.

She remembers touching the baby’s arm, and that it was colder than it should have been. “I tried my absolute darndest to get even a little bit of blood,” she said.

Eventually, she had to give up and let someone else try. But the baby died before they could even get a sample.

“As soon as I left the room, I went into this little storage room, I leaned against the wall, and I just wept because it was the most heartbreaking thing to see everybody give their all and have so many people looking at me and saying, ‘You can get the blood, just try one more time.’”

After the incident, she attended the team’s debrief, where a hospital chaplain was there to offer support. But even though the incident happened five years ago, she remembers it like it was yesterday.

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HEU member outside relaxing with her dog in the snow

Pandemic stress

Tanya Halbert, a cook at Rotary Manor long-term care home in Dawson Creek, says the mental health impacts from the stress of working in health care have been exacerbated by the COVID-19 pandemic.

In addition to working on the frontlines of a care home, Halbert is the primary caregiver for her 72-year-old mother, who was immuno-compromised during the pandemic due to other health issues.

Throughout the pandemic, and especially at the beginning, protocols around sanitizing and PPE were frequently changing, sometimes even weekly.

New health orders and shortages of PPE made it hard for workers and managers to anticipate what would be needed, and implement new procedures and training.

“This pandemic really brought a lot of people’s moods down,” said Halbert. “You just felt like you’re going to get it for sure. You’re going to get it from work. We’re all going to get sick.”

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HEU member standing outside his workplace

Understaffing and a revolving door of managers

Perfecto Reclusado, a care aide at Willingdon Care Centre, says that caring for patients with dementia while short-staffed is extremely taxing.

“You always have to be physically and mentally prepared,” he said. “It’s rewarding too. You need to have love and compassion, especially for the seniors.”

While the Centre was frequently short-staffed before the pandemic, it’s been especially hard with the Single-Site Order. On days when a patient isn’t cooperating, it’s trying. “It affects us too, sometimes we carry it back to our home. We’re mad – at something – and our families notice,” said Reclusado.

Good managers make the job much easier, he said. But since he started at Willingdon in 2013, there have been at least three different managers cycle through.

“Sometimes, it’s really hard because they each have their own set of rules,” he said.

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HEU member outside hospital before her shift

Violent assaults

Laurie Simpkins, a mental health rehab worker at Vancouver General Hospital and HEU chief shop steward, says the demands of the job can overshadow the original reason why people chose to work in health care.

“Most of us went into this because we care about helping people,” she said. “I think that gets lost along the way, for some people. It’s not due to anyone’s fault, per se, it’s just doing a very, very demanding, mentally and emotionally taxing job over time.”

Chronic short-staffing issues have worsened during the pandemic. Fewer staff means fewer eyes on the floor, making it harder to see and respond to situations before they become behavioural emergencies.

“Most of us who have worked in [mental health and substance use] have been assaulted at least once,” she said.

Simpkins says there’s a maximum of only nine security guards in all of VGH. This means that if a patient is violent, nurses and mental health workers on the floor might not get help for 30 minutes or longer.

A patient who is psychotic or high can be unpredictable and aggressive. Without enough security support, Simpkins says, “staff may have to go hands-on – for the safety of patients and workers – to help restrain a patient and place them in seclusion. Doing that changes you as a person.

“There’s a lot of emphasis on the patient’s trauma – and that is absolutely important, we are acutely aware of that… but what about our trauma? Our trauma gets lost.”

After a violent incident, the team debriefs. But Simpkins admits many people are afraid to speak up and reach out for support.

In her role as steward, she has had to coax workers to see a trained professional.

“People will say, ‘Oh, my family is a great support,’ and that’s great… but family members aren’t necessarily trained clinical counsellors.

“Progress has been made in reducing the stigma around mental health, but there’s still mountains to climb,” she said.  

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HEU member outside her hospital workplace

Overworked and isolated

Triffini Benedict, a scheduler at Royal Columbian Hospital, says she and her colleagues have struggled with inadequate training, unreasonable productivity expectations, and isolation.

“Sometimes, when you’re going into a portfolio that hasn’t had a program clerk for several months, the work piles up,” she said.

Administrative jobs don’t always have the same mentorship and training of frontline health care jobs, where you’re on the floor and getting hands-on experience. “Everyone has this expectation of a program clerk or an administrative staff to be able to walk in and just figure it out,” said Benedict.

Due to short-staffing and the delay of opening a new building at the hospital, Benedict had to take on the workload of two-and-a-half people for a year. “I felt so alone and isolated, and asking for help didn’t yield any results,” she said.

Eventually, she got a new supervisor who advocated for more staffing. “Up until then, I was just working for free after work because I had to get it all done and I didn’t know what else to do.”

Nonetheless, the workload had taken a toll, and she had to take four months of unpaid sick leave to recover.

Since her return to work, efforts have been made to build more resilience and community within the program clerk team. Regular lunch meetings and a work-related group chat give staff a way to ask for help and support each other through tough deadlines.

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