An anonymous letter obtained by Yellowknifer alleges serious under-staffing, resulting in reduced safety and poor work conditions in the old Stanton Territorial Hospital, and anticipates problems will persist in the new hospital.

The letter, dated May 2019 and signed by the "Nurses of Northwest Territories," appears to have been written before the move into the new hospital.

The letter suggests nurses face staffing, patient safety, workplace safety and health and welfare challenges.

"Staffing is a huge concern at Stanton Hospital," it states.

The letter also describes a "daily struggle" to find nurses and beds for patients. This results in long wait times in emergency until a bed opens, it states.

It further alleges that surgical operations are cancelled regularly because of equipment failure and lack of beds, in addition to under staffing.

"The government will say that this won't be a challenge in the new hospital as there are more beds," it states.

Nurses are working overtime to compensate for shortages in a larger facility that demands more service, it continues.

Additionally, "some of us are being told that (we) are unable to leave the worksite after working a full shift as there is no one to care for the patient."

This shortage of qualified health care professionals is creating an intolerable workplace environment, the letter alleges.

Surgical operations are postponed, emergency department wait times are long and both patients and staff are suffering as a result.

"What will it take for our voices to be heard?" it states.

In response to the letter, Sue Cullen, CEO of the Northwest Territories Health and Services Authority (NTHSSA), acknowledged that nursing shortages are a concern.

"We have challenges when recruiting for skilled health and social services positions; this is especially true in nursing," she stated in an email. "Across Canada nurses and health professionals are in high demand, we are not exempt from this pressure. The effects of nursing shortages are felt particularly strongly in areas that demand further specialization within our hospital facilities."

In response, she said, there has been targeted campaigns on Facebook to increase interest in GNWT careers; attendance of conferences to facilitate in-person hiring; hiring support through LinkedIn; "competitive salary and benefit packages"; relocation assistance and professional development and training in specialist areas.

"I recognize that Stanton has gone through a massive amount of change in the past few years and resources have been taxed with work related to preparing for transition to the new hospital," she wrote. "I believe we are nearing the peak of this change and appreciate this has put additional stress on the staff within the busiest care site in our system."

Her letter states management has reduced the ratio of nurses to management, and revised the role of clinical co-ordinator to be less administrative. It also created a schedule that allows nurse managers and patient care co-ordinators to focus more on nursing, while adding a senior manager nursing role in February to assist efforts.

She stated nursing staff has increased and management has pursued ongoing job posting. It has also added a nurse educator mentor. She encouraged staff to contact her office directly for further feedback.

David Maguire, manager of communications for the Northwest Territories Health and Social Services Authority, indicated Cullen's letter would serve as the organization's official response.

When asked how many complaints were received, Maguire wrote via email that staff regularly work with leadership through meetings, discussion, and other "informal ways."

"Regarding staff feedback, at the NTHSSA, we encourage openness and transparency between our staff and management to ensure continuous discussions about quality improvement," Maguire wrote. "This is the preferred method for dealing with any issues that arise."

Nursing shortages affect the entire country, stated Denise Bowen, executive director of the Registered Nurses Association of the Northwest Territories and Nunavut, in an email to Yellowknifer.

"Overall, all Canadian provinces and territories are experiencing nursing staff shortages, which is a concern to our association and to nursing organizations Canada-wide," she wrote, citing a 2017 Canadian Institute of Health Information report that "we are seeing the lowest growth in the number of nurses in the past decade."

According to the Canadian Nurses Association, "these shortages have also led to long wait times in hospitals and clinics, patient safety concerns and poor work situation for health care professionals."

"These issues are mirrored in the concerns raised in the open letter the nurses have written," she said.

In regards to the nurses' complaints, she said the organization deals with a variety of issues where it provides support and advice.

"I couldn't say if we have received calls on the short staffing issues, nor if they were specific to (Stanton), new or old."

Yellowknifer also contacted the Union of Northern Workers and Health Minister Glen Abernethy for comment, but neither have responded.