The Fight for Working Conditions in Health Care Acceptable to
Those Who Do the Work

Nurses Step Up Their Fight Against Mandatory Overtime and Other Pressing Issues

Quebec health care workers in Mauricie region participate in "No Mandatory Overtime" day of action April 8, 2019. (FIQ)

Nurses across Canada are tackling the crisis in working conditions in the health care sector. Those working conditions have a deep impact on the health and safety of health care workers and on the patients in their care. Nurses are demanding not words but deeds in concrete measures from the government and administrations of the health care institutions to correct the situation. At this time, a major focus of their actions is the opposition to mandatory overtime, which governments and administrations have forced upon nurses as a constant system of crisis management.

Quebec Interprofessional Health Federation (FIQ)

Some 76,000 nurses, licensed practical nurses, respiratory therapists and clinical perfusionists, members of the Quebec Interprofessional Health Federation (FIQ) held a successful "No Mandatory Overtime" day of action on April 8. Members performed no mandatory overtime during the day of action. According to the FIQ, the successful action without major incident proved that the health care system can operate without mandatory overtime.

Shortly after they held their day of action, the FIQ leadership held a meeting with the Quebec Minister of Health and Social Services to push forward the nurses' demands for the upgrading of jobs. This would mean for example upgrading jobs from two-day a week to a certain stability with full time or four-day weeks. This would also be accomplished without rotation of nurses where they are constantly moved from one institution to another, possibly even over long distances.

A concrete agreement was reached whereby the Minster pledged that the CEOs of health care establishments will soon call the local unions together to begin the work of upgrading jobs so that definite action plans can be worked out before summer. An agreement was also reached to do a summation of the pilot projects regarding nurse/patient ratios that were carried out in a number of health departments of various institutions across Quebec. The joint summation will determine the parameters to be used for ratios to be deployed in institutions where the need is particularly critical.

New Brunswick Nurses Union (NBNU) Addresses Mandatory Overtime

NBNU is tackling the problem of the inability of nurses to leave at the end of their scheduled shift. They are coerced into working shifts as long as 24 hours under the pretext of "patient abandonment." The result leads to an unsafe working environment and unsafe patient care, which is unacceptable according to the nurses' union.

NBNU is highlighting the fact that registered nurses are governed by the Nurses Act and by the Code of Ethics for Registered Nurses and the Nurses Association of New Brunswick (NANB), as their licensing body. As registered professionals, nurses must be allowed to exercise their judgement on their own fitness to practice. The Code says:

"Nurses maintain their fitness to practice. If they are aware that they do not have the necessary physical, mental or emotional capacity to practise safely and competently, they withdraw from the provision of care after consulting with their employer. [...]"

Given the seriousness of the issue, NBNU has collaborated with NANB to produce a safety package, which includes Guidelines for working beyond scheduled shifts and a Letter addressing their concerns, which reads:

"This letter confirms that on the following date: _______, on the following unit/facility: _______ you, _______, my supervisor, have requested that I, _______, remain on duty beyond my scheduled shift. I have also notified you that, in my professional opinion, I do not feel safe to practice beyond my scheduled shift due to personal health reasons (including fatigue), and I have requested that you make every reasonable effort to find alternative relief.

"Please be advised that the Collective Agreement governing my employment does not provide for mandatory overtime. Please be further advised that practice guidelines of the Nurses Association of New Brunswick provide that the following situations are not considered abandonment: refusing to work extra hours or shifts beyond the posted work schedule when the nurse has given proper notice, and withdrawing from care due to fitness to practice concerns (personal health issues, including fatigue) with appropriate notice.

"Please confirm your decision in writing:

"Authorization to Leave

"I acknowledge that I have read and understood the above, and that you have advised me that you do not feel safe to practice during the extra hours that I have asked you to work. I will find an alternative relief and allow you to leave work at _______.

"Signature of Supervisor


"Requirement to Work

"I acknowledge that I have read and understood the above, and that you have advised me that, in your professional opinion, you do not feel safe to practice during these extra hours. Notwithstanding your professional opinion, I am nonetheless requiring you to work from _______ to _______.

"Signature of Supervisor"

The letter is meant to counter the threats and pressure exercised on nurses resulting in them not being able to leave at the end of their shift.

Registered Nurses' Union Newfoundland & Labrador (RNUNL)

RNUNL is waging a campaign to oppose insufficient nurse staffing levels. The union points out that staffing problems are leading nurses to be forced to work on occasion 24-hour shifts or five shifts in a week that can extend to 16 to 20 hours of work or sometimes up to seven 12-hour shifts in a row. This also leads to patients having to be flown out of the province to receive the care they need. RNUNL is demanding the withdrawal of the implied rule that the health care system is to function on the basis of the exhaustion and lack of safety of nurses, which puts them at risk as well as endangering patients. The union demands the immediate hiring of more nurses so that the sector reaches adequate staffing levels.

This article was published in

Number 16 - May 2, 2019

Article Link:
The Fight for Working Conditions in Health Care Acceptable to : Nurses Step Up Their Fight Against Mandatory Overtime and Other Pressing Issues


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