“There isn’t a culture of safety. Nobody is thanked for bringing a concern forward.”
–Adriane Gear
Last month, another B.C. nurse risked career ruin to reveal disturbing truths about what’s going on in our healthcare system – this time at a Vancouver Island nursing home.
Just as reports of rampant drug smoking and dealing in hospitals rocked the public and sent the B.C. government scrambling for cover, so too did nurse Lana Lekopoy’s revelations that younger, severely addicted and mentally ill patients are being housed with elderly residents, and that their erratic, bullying, sometimes violent behaviour is endangering staff and seniors.
It doesn’t stop there.
The abuse Lekopoy described isn’t unique to Dufferin Place in Nanaimo and it didn’t just start last month.
Healthcare sources revealed individuals crippled with addictions and brain injury from drug use have for some time been diverted into the long-term care system to ease the burden on homeless shelters and hospital acute care wards across the province. These patients are being loosed, unchecked and untreated, into nursing homes not designed to house them, onto staff ill-equipped to care for them.
The violent outbursts, drug dealers and other criminal activities reported in Dufferin aren’t happening every day in every hospital and healthcare facility, said Adriane Gear, president of the BC Nurses Union. “But we do have some very concerning pockets around the province, and clearly [Dufferin] is one of them.”
Gear said complaints in her inbox about illicit drug use in hospitals are diminishing since recriminalization, while incidents in long term care homes are on the rise.
So why is the public only hearing about unsafe conditions in long-term care now?
‘Everyone’s scared’
“Everyone’s scared, because when they have brought it forward to the employer, there have been some repercussions,” said BC United MLA Coralee Oakes, who has met with numerous healthcare worker constituents worried about the risks they’re facing on the job.
Nurses who speak out can get their hours cut and their shifts filled by other nurses, said Oakes, whose riding stretches from Williams Lake, north into Prince George. Some feel so overwhelmed and unsupported, they go on stress leave or leave healthcare entirely, she said.
“It’s their vocation, it’s their love, it’s their passion. But they’ve just had enough.”
“It’s their vocation, it’s their love. But they’ve just had enough.”
Coralee Oakes
Oakes said several nurses in her riding left healthcare to go work in the mill.
A May survey by the nurses union of members revealed a third of respondents across B.C. are considering leaving the profession or have made plans to do so. Also from the survey, a majority of nurses are exposed to illicit substances, violence, and verbal or emotional abuse every month; about 40 per cent are exposed to weapons, and almost all are working short-staffed.
If healthcare work conditions are this unsafe, why won’t more nurses speak up?
Healthcare is not a safety culture
“There isn’t a culture of safety. Nobody is thanked for bringing a concern forward,” said Gear.
It’s a remarkable admission. For decades, every major industry – oil and gas, mining, construction and manufacturing – has adopted a safety-first approach on job sites, with daily safety briefings and pro-active discussions on improving worker safety.
For healthcare professionals, silence is safer.
“If you feel like you’re going to be reprimanded or shunned for reporting something, you’re not going to report it,” said Gear.
One nurse from Fraser Health who asked that her name not be used, explained: “If [nurses] complain about unsafe work situations due to feeling they can’t meet standards because of staffing levels, acuity or workload or acts of violence, whether verbal or physical, it often leads to staff being investigated or targeted.”
The nurse in “moral distress” who reported the situation is penalized for not meeting standards, with some employers going so far as to report them to the college, she said.
“So nurses are frustrated and feeling unsupported. Demoralized, [some] are choosing to leave the profession.”
The reality is, in healthcare, there is tremendous underreporting, said Gear.
“I get it. Nurses report, and then they feel like nothing happens or they feel that there’s retribution for reporting,” she said, adding one of the big challenges for the union is convincing nurses to trust the reporting system.
Then there’s the confidentiality clauses.
“As professionals, we have to sign confidentiality agreements. It is not advisable for nurses to be speaking out publicly. That is the role of the union to raise concerns and to amplify the voice of nurses,” she said.
But nurses who make the gut-wrenching decision to risk their career and blow the whistle on unsafe healthcare conditions do so as a last resort. Because the system hasn’t listened.
Gear defended the union, saying it advocates behind the scenes, escalating issues to the health authority, the provincial government, and the media, if necessary.
Nurses also have different tolerance levels of what they feel that they’re willing to accept or endure in the workplace, she said.
“I think we’ve been very solid and clear on our position that these patients absolutely deserve care. And care should not be provided at the cost or the expense of any nurses’ safety.”
The responsibility for a safe workplace lies with the employer, and if health authorities are allowing illicit drug use, for instance, they’re violating their own policies, she said.
“If nurses and others, are not feeling like they have a safe workplace, then clearly enough hasn’t been done,” Gear said.
‘Those numbers are disgusting’
Nearly 5,500 “act of violence” claims have been accepted by WorkSafe BC from long-term care and acute care staff (including nurses) from 2019 through 2023, 1,031 of those last year. Claims are generally for short-term and long-term disability, or fatalities, according to WorkSafe.
“Those numbers are disgusting. That should not be happening,” said Gear. “And when you think about it in the context of a not just a provincial or a national, but an international nursing shortage, and that nurses are a finite resource, it blows my mind that employers are not doing a better job at keeping nurses safe.”
“It blows my mind that employers are not doing a better job at keeping nurses safe.”
Adriane Gear
The biggest obstacle for healthcare workers may be the boss who plays dumb.
Gear said she’s had multiple conversations with nurses related to illicit substance exposure, where they were trying to have proactive conversations with their employer. “And getting comments like, ‘Oh, so you don’t support people with addictions. Oh, are you discriminating against people with substance use disorder?’
“Just really co-opting that conversation, when what the person is saying is, ‘I’m a professional. I have a patient that needs care and I want to be safe. How can we do both?’”
And so, those nurses won’t report anything.
“Bad things are not even being called out,” said BC Conservative MLA Elenore Sturko, the former Opposition critic for mental health and addictions. “The person is more likely to be punished than get the problem solved.”
Bottom line said Gear: “The majority of healthcare spaces are not psychologically safe. The people that need to change it are the employer.”
Unions can’t ‘bite the hand that feeds them’
Privately, some nurses confided they hold both the employer and the union responsible for not acting on safety concerns since both are informed by staff of workplace issues. In an earlier interview, Lekopoy said health authority administrators and union representatives turned a blind eye to complaints from Dufferin Place staff.
Unions are reliant on government and have to be careful not to bite the hand that feeds them, according to Sturko.
“Unions want to be hard, but also need to negotiate with the people they are criticizing,” she said.
“That’s why whistleblowers are often the ones who are the most effective change makers. Look how successful they were at raising the issue of drug use in hospitals.”
Unfortunately, they’ve often anguished their way through so many months of unholy havoc on the job, they blow the whistle as they exit, so that nurse is lost from the system.
Ministry of Health investigates itself
“The issue that is of huge concern to me in terms of allegations brought forward [by Lekopoy] is that this woman was facing a violent and dangerous work situation that wasn’t remedied, which is why the Ministry of Health is investigating,” Premier David Eby said.
Sincere though the Premier’s intention might be, It’s hard to imagine a Ministry of Health investigation will get to the bottom of anything. It’s basically asking the ministry to investigate itself since health authorities are part of BC Health – the same ministry that condoned housing substance use patients in Dufferin Place in the first place.
Any investigation is also unlikely to examine why BC Health allows unsafe work conditions for nurses at all, and why a culture of silence and punishment exists for those who report them.
Lekopoy and her colleagues had repeatedly, over “months and months and months,” reported unsafe conditions to health authority administrators and union reps only to have their concerns dismissed and no remedial action taken.
Dufferin has reportedly had numerous WorkSafe BC claims by staff and at least one inspection violation related to “violence management” dated May 21 that resulted in an enforcement order the health authority complied with in June, according to an email from WorkSafe BC.
The agency declined to provide details about specific claims at Dufferin, except to say seven “act of violence” claims have been accepted from 2019 until the end of 2023. The data doesn’t include bullying or harassment files or break down how many claims related to patients with substance use and mental health issues. In total, 226 approved ‘act of violence’ claims were made by staff in long-term care last year, 32 on Vancouver Island.
WorkSafe did not provide data for 2024, but at least one more claim was made this year by Lekopoy, who has been on stress leave since February.
It all adds up to a lot of people knowing about unsafe conditions in Dufferin and other long-term care facilities and not doing much, if anything, about it.
Even after four weeks of repeated emails and phone calls, neither BC Health nor any of the five regional health authorities would reveal how many non-senior patients with severe addictions and mental health issues are being housed in B.C. long-term care facilities.
When B.C. Health Minister Adrian Dix was asked on July 31 to explain the decision-making behind putting these high-needs patients into long-term care facilities with elderly residents, and what he thought about the disruptions and violence some were causing, he wouldn’t concede the patients were there, let alone that violence was occurring as a result of their occupancy.
It was only after Lekopoy went public in Northern Beat on Aug. 12, that any public health officials even admitted publicly that younger people in active drug addiction were being housed in long-term care. At that time, Vancouver Island Health Authority announced it would stop taking new admissions at Dufferin and Summit long-term care in Victoria and planned to build two new stand-alone facilities for these high-needs-type patients (at some undefined date in the future).
Given the culture of silence and denial that seems to permeate so many levels of BC Health it’s not surprising nurses remain afraid to speak out.
‘Public has a right to know,’ says Premier
When asked about Lekopoy’s fear of facing retribution for speaking publicly, B.C. Health Minister Dix committed to an interview, then backed out at the last minute. His office provided a statement attributable to him instead that read in part, “while I can’t speak to the individual circumstances of staff HR matters, I can confirm staff are not targeted for sharing concerns about their experiences in the health care system.”
His statement further advised, “Island Health has safe reporting policies and practices in place internally to further support staff who raise concerns and I encourage you to reach out to them to better understand the protections staff have in place.”
The Premier, on the other hand, went further.
Nobody should lose their job or professional licence for bringing information forward that is of broad public interest, Eby said in an interview on Aug. 21.
“The public has a right to know and it’s also helpful for me to hear concerns from frontline healthcare workers… and they shouldn’t face retaliation for it.”
The Premier recently defended a Victoria firefighter who was suspended for a day for writing an open letter to the premier asking him to stop a harm reduction organization from setting up shop next door to where his young daughters play. Eby said he appreciated the firefighter speaking up and called for him to be reimbursed and an apology issued.
“It’s also helpful for me to hear concerns from frontline healthcare workers… and they shouldn’t face retaliation for it.”
David Eby
As for Lekopoy, he said between the whistleblowing legislation and her collective agreement, “there’s a whole bunch of protections in place. If she faces any [disciplinary measures], government would take action, because we’ve set up all these processes to make sure that she would be protected.”
But he pushed back against the notion that nurses are muzzled.
There was a huge public discussion about safety in hospitals related to drug use because nurses went public, he said.
“It led to very significant reforms from our government around relational security and further investments around safety, and in fact, resulted in the end of the decriminalization initiative related to the use of hard drugs.
“The impact of health workers coming forward to raise concerns has been considerable in the province in just the last six months.”
Fallen heroes
If that was a success story for workers’ empowerment, B.C. nurses didn’t get the memo.
Otherwise, more nurses would speak out. So far, Lana Lekopoy is the only B.C. nurse to attach her name to public testimony about unsafe long-term care work conditions.
In a functional system, there’s no need for whistleblowing because organizations deal with issues internally as they arise. Our nurses are so scared of professional blowback, they’re not only not reporting unsafe incidents to their employer, some are leaving the careers they love instead.
“Our health care professionals’ code of ethics requires them to put the public interest at the forefront, but how can they when they are contractually muzzled?” asks Collen Middleton, co-founding director of the volunteer citizens group, Nanaimo Area Public Safety Association.
Democracy requires public discourse, and voters demand transparency and accountability so they can have those discussions, he said.
“Incidents pile up under the cloak of confidentiality making [public] discourse impossible.”
Collen Middleton
“Instead, all of these incidents pile up under the cloak of confidentiality making this discourse impossible if not for the brave health professionals risking their livelihoods… [who] are pushed to the brink and past the threshold of mental health crisis.”
How can it be that in 2024, during the worst staff shortages to befall this province, BC Health is not taking the health and safety of its most prized employees seriously?
“The people who work in long-term care are heroes,” Eby said.
True.
But as it stands now, our “heroes” are falling like doomed soldiers on a meth-smoked battlefield in a healthcare system that is no longer healthy and has lost its ability to care.