Inuvik (Sep 19/03) - Despite recent efforts to hire new nurses in the North, some Delta health centres are on the brink of closure and staff are suffering burnout.

Dr. Gerry Uswak, CEO of Inuvik Regional Hospital, says some new thinking is required if the nursing shortage is to be addressed in the North.

Uswak said the shortages of qualified staff is burning out the few nurses they have and has threatened closure of some health centres over the summer. Casual and short-term nurses have been flown in as a stop-gap measure, but Uswak says that's not the best use of health care dollars.

"We don't have all the positions filled with actual permanent live-here staff and that's becoming harder and harder to do," Uswak said. "It's the same thing in the communities."

The communities have been getting by with casual staff who may fill in for two or three months at a time and lately, with agency nurses.

Uswak said the government has expanded their definition of what constitutes a "drastic situation." In the past, the definition used the term only in the event of a natural disaster, but has expanded the term to include a health centre that is on the verge of closure because of a staff shortage. He says the new definition has been helpful to bring in new staff, but is only a temporary help and a very expensive alternative.

"It costs us a significant amount of money to fly these people in," he said.

The nationwide shortage of nurses has been magnified in the North and the inability to recruit and retain full-time nurses has left Uswak seeking another solution.

"Maybe the idea of full-time, live-in nurses is not practical any longer," Uswak suggests. "Maybe we have to develop systems of formalized job shares."

He suggests that nurses from the South could fly in for two to three month terms and be replaced by a cross-shift who will do the same term.

"What this offers is, you still have the continuity of care; each nurse gets to know the community and establish a repoire with the clients," he said. "Right now, the current system doesn't work; you can't recruit qualified individuals to provide consistent care."

Most health centres are operating without the essentials of quality health care that deal with prevention and promotion of healthy lifestyles, because they are so occupied by emergencies.

"If we are always just dealing with the end stages of disease, we're never going to make the population healthier," Uswak said.

High rent district

The primary complaint among nurses is the high cost of housing here.

"In our exit interviews, they're saying it's the cost of living -- primarily, the cost of housing," he said.

The government will not subsidize housing for nurses or other professions, but Uswak said other jurisdictions that do, are luring away nurses.

He said a fresh look at the way dollars are being spent and see if we can re-direct it in a way that will help to recruit and retain nurses.

"It's time to start thinking outside the box and look at alternative ways of delivering services and maximizing resources."

At one time, nurses here were offered a salary that was higher than in southern hospitals, but Uswak said that is no longer the case.

"In the past few years they have negotiated new contracts and they have caught up to what's offered here," he said. "The salary or hourly wage, is no longer head and shoulders above the rest."

In a long-term strategy, the GNWT has offered student loan repayment benefits, bursary programs for nursing students, the Northern Nursing program offered at Aurora College, but Uswak said these perks will help down the road, but he needs qualified nurses now.

"These are all great things, but it takes a while to get people into the system," he said. "We need skilled nurses ... we need people with experience who can work on their own or in team settings." "There are only so many graduate nurses we can absorb."

The lure of adventure and expanded work experience carries some weight among the profession, but nurses will only sacrifice so much income in exchange.

"You don't always have the adventurers coming anymore," he said, adding that the nurses are in the "driver's seat."

"They'd be stupid not to go somewhere elsewhere if it's more beneficial to them."