Author name: Healthcare Salute

My name’s Adele. I’m a registered nurse here at First Nations Health and Social Secretariat of Manitoba. We are an intensive home visiting program. 

Empowering families, working in partnership with our communities, is what I love most about my job.

I’m First Nations. We work in First Nations communities, and we’re able to watch families grow. We need to break that cycle of the attachment and bonding that we’ve lost. And this program, we find it’s based on research that works. 

Being from northern Manitoba, where communities are so dispersed — and from my own personal experiences as a young mother in a small town — I wanted to give back and care for our communities.

Manitoba is unique in geography. We have 63 First Nations throughout the province, seven tribal councils — and programs are not in every community. 

Some of our reserves are close to the bigger centres. When you go up north, it’s fly-in. At our nursing stations, you have the nurses start at 8:30; acute care, 8:30 to 4:30 or 8:30 to 5:00.

Doctors fly in and fly out. Some stay, some don’t based on their contracts. Emergency care is basically done on a nurse-in-the-middle-of-the-night basis. Doctors won’t be there, and it’s MedEvac. 

With a shortage of nurses… public health gets put on the wayside. Yes, our immunizations get done, but there’s so much involved in an immunization clinic for a public health nurse.

I don’t think the access to care is there. Then if you’re status or non-status, there are issues around medical-service coverage.

On March 17th, [2020], the worldwide pandemic was announced and we were all sent home. We packed ‘er up that day and went home. 

Our organization worked very quickly on communication. As nurses at FNHSSM, we’ve got to call our partners. What are we doing? What’s going on?

We tried to talk to the nurses up in Shamattawa, Tadoule Lake, but we were losing connection on our phones — and this is our healthcare system. This is how we operate, through phones and emails and faxes. We couldn’t get through because of connectivity. Like, this is ridiculous. We can’t have a great meeting, a conversation of what we’re doing as healthcare providers.

I would say it was 18 months to two years that it was all hands on deck, focusing on COVID-19. Basically, we acted as a band-aid to our healthcare system, in helping our communities protect themselves from COVID-19.

Tests were sent to the community to test for COVID-19. We needed two nurses to work the lab. We’d gather the samples and then we’d test them all day. 

You’d take a break in the afternoon, then you’d be the swabber. This alternated every day or however you were comfortable. 

We even went out in full PPE, from door to door. We were doing swabs through the doors and taking them back to the lab. 

One community, we were with the military, and we followed the military nurse around and helped. We were going in and doing mass testing, and bringing people with positive results out to Winnipeg for isolation.

This was how we were dealing with our 63 communities. But the pool was getting smaller. Nurses were getting burnt out. 

In our communities, we have a lot of families that either live with 10 or more people — you know, three or four families within a small house. If one family member contracted COVID-19, then we needed to bring that family out to isolate. There’s nowhere in the community for them to isolate. 

The province started the AIA — Alternative Isolation Accommodations — program. They got hotel rooms in the city for us to bring people out for isolation. 

Alternative Isolation Accommodations was a huge project for our families. We operated in a more culturally sensitive way. It almost brought back the residential school feeling for a lot of the families: being taken from the community, placed in a room, and given food at the door for breakfast, lunch, and dinner.

Our nurses worked tirelessly to provide comfort and care traditionally and holistically. They were able to set them up in teams to do ceremonies, like funerals. It’s our culture to have mass gatherings for funerals. There was a lot of coordination about how to set that up for families to grieve.

Diabetes is a pandemic, and an epidemic in our communities in Manitoba. The province has the highest rates of diabetes in its First Nations people.

Within our organization, we have the Diabetes Integration Project. There’s three teams that travel to the community and do [estimated glomerular filtration rate] kidney testing. 

The Diabetes Integration Project needed a director like yesterday. So I started that role. 

It’s a huge project. And at the same time, there’s a pandemic.

Our health centres are busy with a multitude of chronic conditions, and we don’t have the diabetes programs that we should in our communities. So things were getting left untreated and misdiagnosed, and quality care was gone. You’re finding more and more amputations. Blood sugars are high. 

You want to delve into racism with our governments, because of the high numbers of diabetes in First Nations people. The amputations are triple [the rate of other diabetics in Canada]. It’s like we’re not being heard. 

It took a toll on me, being in that role. I thought I was ready. It’s a huge role. It’s an important role. I didn’t want to be the one to mess up such a great program. 

I was feeling a lack of confidence as a nurse. Maybe it was because of burnout that I felt vulnerable.

I made the decision to step down. I was busy with home, worried about home. My mom was getting over cancer, they live far away, we all went through — everyone goes through this in a different way. 

Stepping down, I felt like a failure, that I couldn’t do such a position. But the team said, “No, Dele, you did fine. You just didn’t have a chance. You didn’t get the chance to do it because of having to deal with the pandemic.” 

We were making sure our families were being taken care of, through our nurses that were employed here and in the program, and in our home life, and doing deployments and all the reports that were due, while being worried that the government’s going to take our funding back. Nurses were constantly moving around because they were not happy anymore — and I guess I was one of them.

Our workforce is in trouble. We have high turnaround, whether it be home visitors or nurses, doctors, and therapists. 

How are we preparing now? Us regionally, how do we prepare our nurses and our home visitors when they enter homes? What are they going to see? What are they going to find? What do we do? 

We’re doing a lot of strategic planning on our end about how to support that. It’s heartbreaking, but it’s reality.

I love this organization and what they stand for: making our communities better. And we’re a strong voice. 

So that’s what I am hopeful for in my career and where I work. We can get through to leadership, we can get through to the government, we can move forward for our people. We ran our own communities until before time and we just need to resurface that.

I work as a critical care and emergency room nurse in Ontario.

I really do love nursing. Nursing has changed me as a person. It’s this closeness to humanity, being a nurse, and the ability to know myself and to understand the other from a non-judgmental perspective. Nursing has granted me that gift.

It was hard to watch most people from racialized communities being disproportionately affected by COVID-19. I remember walking into an ICU [in a] hospital that was located in a predominantly white neighbourhood. But over 80% of the beds were occupied by racialized people. And I was shocked, like, why is this happening and why are these people more affected than any other?

Most of these people live in crowded housing. Most of these people do not have paid sick days. Not everyone has a luxury of staying at home when they’re sick.

People don’t want to hear that the system is racist. And there are factors that have contributed to, you know, racialized people being affected more by the pandemic.

People had to tell those stories. I felt like I had to tell that story. 

News anchor: Birgit, you’ve been sharing on social media how many nurses have left the profession since the last wave. What do you think, do we have enough hospital staff to handle a fourth wave?

Birgit: Absolutely not.

I love the fact that I’m able to impact people’s lives, however small. Whether that is being at the bedside with patients who are in very vulnerable states and being able to make a difference: it could mean just washing their hair or supporting a family member who’s feeling completely hopeless. I like the fact that I’m able to be a part of that journey for people.

There’s always been this pool of nurses who work for private agencies. The main goal is supplying hospitals with nurses when they’re short staffed.

So I work as part of a nursing agency. I’ve done this for over five years. The only way I could be a part of my daughter’s life and her school and be a mom at home was to find something that was flexible, and it was only agency nursing that afforded that.

I work in critical care. I don’t expect my shift to be easy. There’s a lot of psychosocial aspects. There’s a lot of emotional pieces to it. We see patients die. We wrap dead bodies.

But with COVID-19, that became too frequent, and we needed more mental health support available to nurses, whether or not they asked for it.

And that wasn’t happening. If you were a staff nurse, maybe you had access to the EAP program offered by the organization. But if you were a casual, part-time agency nurse, you didn’t have any form of support. And that hasn’t changed.

And the fact that we had Bill 124, which was already implemented, the wage suppression legislation from 2018 up until during the pandemic, and still now while we are in the pandemic, was just unheard of. People were leaving the profession because they were feeling disrespected.

The workload had increased at this time significantly. Fewer nurses were doing the work because most people were off sick.

I remember those early days of hearing about the pandemic and starting to see patients with COVID-19. It felt unreal. I remember looking after a patient at that time who wasn’t isolated, who didn’t come with the typical symptoms of COVID-19, which we now know. And this patient eventually had COVID.

I was called while I was working at another facility two days later to go home and isolate because I had been exposed. I remember that very moment. The triage nurse telling me I needed to leave, I couldn’t be in that space at all. It was really shocking. You know, the lack of support and everything.

So I went home. I wasn’t too sure like what to do. Public health messaging at that time wasn’t really clear, and as we know, there’s no paid sick days for most workers in Ontario.

I did isolate for two weeks, unpaid. It was hard. My greatest fear was bringing it home to my daughter.

I remember on many occasions I would wear a mask at home because I wasn’t too sure if I had been exposed or maybe I had COVID. 

I remember a time when a patient was dying and the family could not come to the bedside. I had to support the family through an iPad, and I had to stand there while they watched the patient take the last breath and just be of support. It was really hard.

Nursing is a profession that’s driven by empathy and compassion. So it’s hard not to cry with a patient, or cry with their families. So I remember many days having my N-95 mask soaked in tears, and in that particular situation, I cried so much, because it was just heartbreaking.

And when we had lockdowns, most people didn’t have support, especially racialized communities, people who don’t have their extended families here. It was a struggle. It was a struggle.

How do you expect a nurse to come to work while having little ones at home to take care of, and there are no extended families to help and they still have to pay their bills? Whether in good faith or not, people will have to put food on the table. And I did take care of a patient who eventually had COVID and was very sick, who had gone to work sick. Because that was the only way he had to cater for a little one and he was a sole-support parent.

It was really hard to see nurses being harassed in emergency rooms, or people yelling at nurses for long wait times. We end up bearing the brunt of all the chaos in the healthcare crisis, unfortunately.

And it’s the same thing: the government calling us heroes, however, having Bill 124. I can’t stop saying that. It’s the same thing, calling us heroes and fighting us in court. So it starts from the top and people just follow suit.

My name is Eram Chhogala and I’m an ER and trauma nurse here in the GTA.

I really love how I can make a difference in someone’s life. I really love that I can be that physical presence when they don’t have a family member there to comfort them. 

I’d probably also say that it’s through the heavy influence of my late father. He was someone who really believed I had potential to help others. 

COVID-19 was a very evolving virus. It’s a very novel virus. So the information, the variants, the transmission, the mode of transmission — [in the beginning,] all this information was changing. Every single day there was a huddle, or every single day you’d have to say, “Okay, how do we isolate based on these symptoms?”

When you went in, it was getting report for your shift and making sure that everything was sanitized, being really careful washing your hands. And I’m telling you, when I washed my hands, they became dry, cracked, and brittle. They were destroyed. We had rashes and cuts and scars all over our faces because we had been in those masks for hours and hours. We had been in rooms with goggles on that would cut into your face and skin.

I remember when I was triaging and there was a patient who came in and he said, “Don’t you think you guys are kind of overblowing it?”

It was like everything had changed. This is ridiculous. Now I feel like this is a catastrophe.

[One day] I was at work and I got a phone call, and my dad was like, “I’m really short of breath.” I felt like something just hit me.

So I called an ambulance. I remember they had transferred him into the ER, into the resus room, and they were doing treatments on him. This was actually the ER that I was working at.

They said, “Okay, well because of his age and so forth, we’re gonna put him in the ICU.” I said, “Okay, I can understand that.”

One morning, I received a phone call from the intensivist and he said, “Your father’s oxygen is really going low.” I said, “Okay.” So he said to me, “I’m going to have to put your father on life support.”

For many days, I don’t really think I ate or slept. And every single time my phone went off, I nearly jumped up and almost fell to the floor.

People have often asked me, “Why did you work while he was hospitalized in the ICU?” And I’ll tell you why. I did that so I could see my father, because there was no other way. I wanted to be physically present and near him.

But it was also a way for me to find out what was happening.

A lot of people believe, and while this is true, that physical presence is very important. But it’s also the emotional and the spiritual presence that’s near. And I would watch him through that glass door.

I broke down, through the progression of many weeks. I’m going to say that was the hardest month of my life.

I remember the day before my father died. I stayed in that room with him and I fell asleep in the recliner that was there. 

The next morning, the physician came in with a nurse and he said, “I really have to speak with you.” And he said, “I’m really sorry. We’ve done what we can do. We’ve exhausted our efforts and there’s nothing else we can do at this point.”

I had to do my own support. The way that I seek self-support is I’m very spiritually inclined, so I’m very much into meditation, spirituality, and prayer. That’s where I sought my comfort. 

The supports for mental health were not available. I say this on behalf of a lot of healthcare professionals — province-wide, nationwide, worldwide. It was a reoccurring theme. Everyone was burnt out. People were breaking down. 

It’s like a healthcare professional’s worst nightmare coming to life. Seeing or experiencing things like the backlash of community members not believing that this disease was real: the protestors, the trucker convoy, the assaults, the violence against ER workers. It became gruesome and it added on and added on, into a chaos.

Then a lot of people were wondering, “Why did, why are healthcare professionals leaving? Why are nurses are leaving? Why is there such high turnover?”

Well, these are the reasons why. There’s only so much tolerance a person can take.

This is what I had been seeing. Watching it all evolve, it was like it was unravelling.

But I think what’s really important is, we need to send a message out there for people who didn’t really experience this pandemic, for those who didn’t really understand what this pandemic is about, to actually see the insights and the reality coming from healthcare professionals in the field. [It’s important] for someone to actually tell you, and for someone like myself to explain to you what’s happened, not only on a professional standpoint, but also from something that’s happened personally.

I think a lot of people can see now that healthcare professionals are people who actually do care. 

Most of the injury comes from my father’s death. What if there was more I could have done? I often think to myself that he’d be here right now. I often think to myself that he’d be his jovial, down-to-earth self, sitting next to me right now.

I wouldn’t feel so alone sometimes. My father was like my best friend, and that’s a bond. This is something that I can’t let go.

COVID can give you a really different perspective. It gave me a very different perspective on life. It’s not that I never regarded that, but when it happens to you, it becomes very personal.

My name is Krissha. I’m an RPN, registered practical nurse, and I was also a nurse manager at a long-term care home. I help patients and staff with managing the symptoms of dementia.

In early 2020, we were hearing the rumbles about COVID-19. There was a patient who had a fever, a cough, and their oxygen started going down. We self-isolated that person.

The next day, we were all crying because we know exactly what was happening. We were not prepared. We didn’t have PPE. All of our face shields were expired. All of our N-95s were expired. We couldn’t even reorder them. We didn’t even have face masks. So we were kind of like, it’s finally here. You know, we’re so scared. That was the first time ever in my career that I was scared. I was scared to be a nurse.

I got a call that I tested positive and I started crying and I told my parents and my brother. I had to tell my work. And they’re like, okay, someone’s going to be in touch with you. I never heard anything.

I decided to go back to work because they were really short. They had no staff at work. So I came in and I was like, “Hey guys, what can I do to help?”

So it was just me with 32 patients who had COVID with dementia. The patients didn’t really understand that they had to stay in their rooms. They’re normally out and about walking.

It felt really like you were just by yourself. I don’t even know how I did it. I was like, I can’t believe this is happening to me on my first day back.

So three o’clock rolls around and that’s when the new shift starts. And then there’s no nurse coming. It was 3:30. I was like, “I need to go, I need to rest. I just did an 18-hour shift.”

There was only one PSW who showed up. One. I was actually livid. I called my manager to actually tell me what’s going on with the staffing. This is supposed to be what [she is] managing. She didn’t pick up her phone. She didn’t pick up her phone!

Who is gonna take care of these people? You know?   

So there were 32 patients. Me and one PSW. We went to the back and we cried, because we were scared and we felt really helpless. 

I had to really gather myself. I was like, “You know what? I just have to do what I gotta do, because it needs to get done.”

So I slept underneath my desk. And then I went home at seven o’clock in the morning, just to go back to work again at nine. 

I remember those shifts kept on happening over and over again. I remember crying in an elevator and I was like, “I feel like I’m suffering.” And then I think I was like, “Would it be better if I just magically die?”

One night, we were doing a check on a patient and we found a patient who was dying. That was terrible, because I felt like I really neglected this person, even though I probably wasn’t assigned to them, but the fact that like they were managed under my care — or you know, the whole home — it’s really unacceptable.

I was so ashamed to tell her daughter that we just found her like this and we couldn’t do anything to save her. I remember, I’m like, “I’m so sorry.” I was like, “This is not — but now this is the important part. You get to say bye to your mom, but just letting you know, you have to self-isolate for 14 days after this.”

The coroners won’t even come in, so we have to put people in body bags. I had to personally toe tag them and zip them up.

I visited my family doctor and I said, “I’m not doing well. I’m not sleeping. I’m having nightmares. I’m having nightmares of myself being in a body bag, being zipped up. I have nightmares of not being able to breathe.”

I have a panic attack that lasts for a whole entire day. I was really debilitated. I didn’t know who I was. I didn’t even brush my teeth. I didn’t even take a shower. I was just in bed all the time, sleeping.

So I filed that claim and my work fought me. They said I didn’t get COVID there.

It really made me feel like I was just worthless. They did wrong. 

Looking back at it now, it was like the saddest and the worst point of my life. I felt like I was violated.

Now with therapy…I used to blame myself a lot because I couldn’t do as much as I could. I felt really guilty and shameful because I couldn’t — I was supposed to be their caretaker and I couldn’t take care of them because I couldn’t even take care of myself.

The fact that there’s so many nurses who are leaving the healthcare system, it just shows that no one’s willing to put up anymore. No one’s willing to put up with short staff, ineffective management, ineffective policies. As much as they want to take care of somebody else, they also have to take care of themselves too.

You know, I interact with some of my new patients, and they’re so grateful for the fact that we’re giving to them and we’re taking such good care of them. That’s what still keeps me going. It’s no longer for the government or for the organizations. It’s now for just the people who I serve.

My name is Lily. I’m a personal support worker. I work in a retirement home.

I like the fast pace. I like the residents. They have all the stories. So when they tell me about their aches and pains, I’m like, okay, that will be me in a few years.

I just like my job. 

So let me explain how I can be an essential healthcare worker and be undocumented. 

When I came to Canada in 2014, it was under the live-in caregiver program. When you came under that program, it was supposed to be sponsorship by a Canadian family for two years of work, and then you could apply for your permanent residence. My client died before that happened. As soon as he died, I had to leave.

I had to go back home, apply from there, and then come back. When I came back with that sponsor, they had changed their minds because it took like six months. So by the time I got here, I was unemployed. No home, no job.

People were desperate for PSWs, desperate.

Now, I had all the qualifications as a PSW. Remember, I had to get it to work here anyways. I just started looking and calling and emailing my resumé, updated everything. And I started getting jobs. 

I’m a personal support worker and I assist the residents in the nursing home with all activities of daily living. That means personal care, reminders about medication, helping them in the dining room. Sometimes you have to cut their food up. Sometimes you have to walk with them in the hallway for exercise. Sometimes you have to get them out of a spiral because a lot of residents in long-term care have mental illnesses, they have other disabilities. You just need to help them calm down a lot.

It’s a combination of things to help the residents, basically. 

Long-term care. During the pandemic, it was like a rollercoaster. At the beginning we didn’t know what was going on, right? So it was one day we went to work, it was normal. The next day, we had to wear masks. We had different protocols about what we had to wear, what we had to sanitize after every change.

And then a lot of people who were getting COVID were isolated, so the job changed from people coming into the dining room to eat to tray service for every single room. It was different for the residents as well, because they couldn’t leave their rooms. For them, it was torturous.

The most challenging part of my job was not the job itself, but getting vaccinated. They were asking for proof of vaccination and I didn’t have it. For somebody like me, with no status in Canada, it was a problem to get vaccinated because we have no OHIP cards, right?

So we have no healthcare. So we actually had to push back. To get vaccinated. I mean, come on. It’s a pandemic. It doesn’t care if we have status here. We live here, we work here, and we just — we actually had to fight to get vaccinated. 

I became undocumented January of 2020. COVID started later that same year.

So my status changed, but I never stopped working. They always need PSWs, always. 

When a lot of the residents started passing away because of COVID, when the families couldn’t come see them, they had to look at them through the windows. This was in the heart of the pandemic. That was hard to look at.

A lot of  the residents who passed away, their last moments were spent online. A lot of times the families never saw them before they passed away. That was horrific.

But then you can’t really argue with the protocols because everybody was panicking at that time, right? From the government to the managers at the home, I mean everybody. So I guess they thought it was the best thing, but I didn’t agree with that at all. At all.

People dying, they’re supposed to have a little dignity in the end. Something better should have been done. 

For immigrants who are here working without status, it is very challenging to get up every day, go to work, and remain sane. Okay? It was a whole depression. It was the frustration of everything. Every day, you would have to get up and go to work because a lot of people, because of the vaccination rules, had left! They didn’t want to be vaccinated.

So your work would be doubled because, whereas before you would have like six or seven residents, now you have 14. You had to make sure they ate, were washed, and you’re dealing with all your personal stuff too.

It’s not only me affected, not only healthcare workers, but refugees, farm workers, students. We are here already. We work, we pay taxes. We are making a contribution to your society. We are taking care of your elderly people, and yet you just discard us. Like if we are actually nobodies.

We worked through the pandemic. We still have to be masked and gloved and we have to show proof of vaccination for jobs, just like every other Canadian here. Why is it that we have no status?

We feel like we’re criminals when we actually live in a healthy country. You know, we need status for all of us. That is what’s gonna change everything.

I think a lot of Canadians are blind, basically, because they don’t understand what status — even when we say we want status for all of us, a lot of the times after our videos are put online, they have some really nasty comments: “Send them back” and “We have no jobs here for everybody.”

We have to deal with that and sometimes in our faces too. We come to Canada to work, we are looking after their families, and then they leave these comments like it’s fine to say things like that.

I like to read, so I’m always researching how and why. Just to try to not give up on this because I came here with — I promised my children two years away. It’s been eight years now. Everybody’s grown up.

I’m still here fighting for permanent status that I should have been given. I lost it. Not through fault of my own. Right? Yeah.

My name is Mekalai Kumanan. I’m a family physician. I practice in Cambridge, and I also serve as the president of the Ontario College of Family Physicians. 

I’ve always been told I’m a serious learner and I come across as very serious about my work. I think medicine draws people who are hardworking and to some extent, overachieving . I definitely fit that mold of wanting to always give it my all and make sure I know everything I need to know in order to do my job well. 

When I first heard about COVID there was an element of, you know, this is a really scary thing. It seems really scary and I don’t need to worry about it yet.

I felt like overnight we shifted so dramatically in how we were approaching our work. There were so many things we didn’t know, but then we knew at some level we had to protect ourselves and protect our patients. No matter how much we saw and read and understood before we got to that point, it felt like it hit us like a ton of bricks. 

I mean, it was honestly very overwhelming. 

I don’t know that I ever felt quite that level of sudden stress and sense of overwhelm as I did in the early days of the pandemic. And I don’t even know if I felt like I had the time to stop and think about how I was managing it.

You just kind of did what you had to do. And it may not have been the healthiest thing at the time.

I think I just kind of tried to roll with it as much as I could. There were always those fears and kind of thoughts. I felt very strongly like I had to do what I had to do as a physician and as a leader.

But I also had fears. I didn’t want to get my patients sick. I didn’t want to bring something home to my family that I knew nothing about. There were a lot of what ifs, and I learned to push those to the back of my mind a little bit.

There was a time in the first few weeks of the pandemic where I thought I was balancing reasonably well and keeping work as separate as I could. But I don’t know if I fully understood how much that was affecting my kids. It often would show up in my daughter’s writing, where she would speak about my mom’s a physician or a doctor and this is what she’s doing, but then she would talk about not being able to hug me and not being able to cuddle with me.

We were balancing so many things as physicians and really trying to do the right thing and maybe not always fully appreciating how it was affecting us and how it was affecting our families and our personal lives. 

I remember so many headlines of otherwise healthy people who contracted COVID and passed away, right? And so for me, there were a lot of what ifs and do I need to speak to my husband about this? Do we have our affairs in order?

I think there were times where — and it wasn’t often, because I pushed this to the back a little bit — but, you know, what if something happened, what if I brought home, what if I was asymptomatic and brought an infection home, brought COVID home to my family? What might our family look like if something were to happen? And how would we deal with that? What would our new family look like? Like these are thoughts that went through my mind. Sorry.

When I look back, I don’t think I realized it at the time — very much in fight or flight mode. There was so much coming at us, such high stress and such. I don’t want to say pressure, but this feeling of wanting to do it right, wanting to get it right, not wanting to get my patients sick, not wanting to get my family sick.

I just went into this mode of “What do I need to do?” And I was always on, and really never, in retrospect, felt like I could really slow down and turn my mind off. I know there were days where I just needed to get away, and so I would just get in the car and drive.

I don’t know if I knew where I was going. Like a few times I drove to — I remember kind of landing in a grocery store parking lot, and of course everything was shut down, so it was pretty quiet. There was really nothing for me to do at that time, but it was just getting away from all of the stuff coming at us, all of the information, all of the stress that we were feeling. I just really felt that need to remove myself from it to some extent.  

So we were initially asked to pivot to virtual care, so we could do whatever we could to keep our patients safe and really try to minimize exposure for them. 

I can think of a number of patients who delayed care, and then by the time we saw them, they were much sicker.

I can think of one patient in particular who I was on the phone with her and her husband. The husband, towards the end of the call, said something about her falling. When I asked more about that, it came out that she had had a number of falls over the prior month.

So I said, “Okay, let’s bring you in.” They were reluctant, but they were willing to come in. I was able to review everything we were doing in the office to keep people safe.

When I saw her and assessed her, it was very concerning for Parkinson’s disease. We were then able to get things set up for her. She was then able to see a neurologist, and ultimately was diagnosed with Parkinson’s.

What stood out for me with that example, and many others, was the early stages of the pandemic took away that relationship piece that we have with our patients. As family physicians, that is so important in terms of the work we do. It changed how we practice so significantly. 

And I think feeling that, you know, a need to run into it, rather than away from it. Because as a healthcare worker, I felt a really strong sense of — maybe I would say obligation for lack of a better word — but this need to care for my patients. Like, we’re in the middle of a pandemic. We can’t walk away from this. 

I think there’s a lot of work to do in terms of addressing burnout in healthcare workers. But I do feel like we’re starting to understand that it’s important to recognize it and build in the right supports.

I think as physicians we’re doers, and we just find a way to keep going and push through. One of the ways that I’ve been able to work through my hardest days is remembering those interactions with patients that are the most meaningful to me.

I’m Dr. Naheed Dosani, and I’m a palliative care physician and health justice activist.

I spend a lot of time providing palliative care for people who experience structural vulnerabilities like poverty and homelessness. I spend a lot of time not just medically caring for people, but talking to the people I care for, talking to their caregivers, providing emotional support. It is a privilege and an honour to be able to be part of such a vulnerable time in people’s lives, and I take that very seriously.

I got to care for a lot of people who were sick with COVID-19. I saw an amount of suffering that I’ve never seen before. And I’m not sure if we’ll ever really get space to talk about it, other than maybe this conversation right now. 

I remember conducting a test for a man who ended up testing positive. And the recommendation was to isolate. He became very sad and I said, “I’m so sorry about this result. What’s upsetting you most about the situation?”

And he said, “Well, to be honest doctor, I actually don’t have a home. I live in a shelter where multiple people are in one room. So I’m just processing what this means for me. And I guess what this means for me is that to isolate, I’m going to have to leave the shelter. So what I’m going to do is, I’m actually going to sleep on the street for the next few nights so that I don’t get the people that I live with sick. So I can make sure that they’re safe and they’re healthy.”

I couldn’t help but cry in that moment. He cared so much about his friends and roommates at this shelter that he was going to sleep on the streets to protect them?

That’s another moment when I realized that this COVID-19 pandemic is not impacting us equally. That people who lack privilege and the resources to support themselves are going to be disproportionately hit and they’re going to be hit hard. 

It affected me in some ways that I still can’t put in words. I remember coming home to my wife in the early days, changing out of my clothes and showering and separating and then connecting with my wife and trying to put words to what I saw that day — and I couldn’t. I would just fall into her arms and cry.

I stayed up many nights thinking about the many people who have suffered, not just due to the COVID-19 pandemic and that virus, but due to the policy decisions that led to many more people having to suffer — as a result of inaction, as a result of a lack of clarity around policies and a lack of our governments stepping up to support and help people. I’m convinced that many more could have survived had we acted sooner and in a more appropriate fashion.

You know, you can only do so much as an individual health worker. And that really, really made me upset and made me really, really question the system. It demoralized me, actually.

I channelled those feelings into activism. I wrote op-ed articles advocating for things like the collection of race-based data. I advocated for improved policies to support people who experience homelessness, to advocate for those who are most vulnerable and didn’t have the privilege of, for example, just staying home. 

The activism really did help because I was able to convert feelings of anger, sadness, and resentment into feelings of productivity and change and hopefully inspiring people in our communities.

But remember that this was all on top of my regular day job. And so this was an extra role.

In some ways, it felt unfair that we were health workers who were already dealing with the brunt of the pandemic on the front lines, having to see so much sickness and suffering. And then on top of that, we were health workers who in our free time had to advocate around health equity and improving conditions for people who didn’t necessarily have the resources to advocate for themselves.

On one hand, I’m grateful to have had the opportunity. On the other hand, that’s kind of unfair when you think about it — to put that burden on people who are already so burdened.

I know many health workers — friends, colleagues that I talked to — who felt the same way, and who are still dealing with the ramifications of that. I’m not sure if the public really realizes the impact that this pandemic had on us while we were working — but also while we were not working. It’s the conversations we were having at the dinner table, the conversations we were having on Zoom family calls, and what we were doing out there publicly on social media, as we advocated for public health even when our governments didn’t necessarily have our backs. That takes a toll on people, and I wish more people would talk about that. 

One of the approaches that really helped me through the pandemic to be able to work through my moral injury was the fact that we held grief circles. What would happen is we would descend on that site — it might be a shelter, it might be a healthcare facility, for example. We would light a candle, hold a minute of silence, and then we would cry together. We’d laugh together. We’d remember what it was like to care for the person.

As the pandemic went on, we actually moved our grief circles to virtual grief circles. And it really helped.

While I know that these grief circles just scratched at the surface of what many health workers were experiencing, many people — my friends and colleagues would say, “This is the first time I’ve been in a space where there was a structured space for us to grieve.” 

And it got me thinking about why in healthcare, talking about grief is so…not common. Why is that the case? 

I’m lucky to work in an environment with colleagues where we talk a lot about our social contract as society and our accountability — or what we call social accountability — as we deliver healthcare.

I think that’s really important, to have a connection to your moral code. And you know, why we do this thing called healthcare. We’re more than technicians. We are dealing with human beings, we are dealing with people who are dealing with some of their most vulnerable moments. We work in spaces like a hospital or an emergency department where all of society’s feelings tend to crash into this one place in space, whether we like it or not.

We will never have a healthy workforce if we don’t take care of the hearts and souls of health workers. That’s so key. That’s so crucial.

My name is Todd Tran and I’m an occupational therapist working at a downtown hospital in Toronto.

I love being an occupational therapist because I can practice full scope. The way I describe it is a combination of two professions that’s merged into one. We’re a bit of a physiotherapist and we’re also a bit of a social work/clinical role, providing supportive counselling. We focus on the holistic picture of the individual: their physical, their spiritual, mental health.

It’s a really interesting sociological perspective or phenomenon that occurred to me with the pandemic. Being an Asian individual, that’s my first identity. Already, I know it’s not a good light to be Asian during this pandemic. I know what I’ve seen on TV with violence against Asian people. My second identity is being a healthcare worker — so it was having to not identify yourself, and being more hidden away or being in the closet. My third identity, which is being a gay man, I’m already checking every so often in terms of the environment. Is it safe to self-identify as gay or not?

Those three identities really came out during the pandemic, which is interesting, because it’s a social phenomenon that has never happened. It’s almost as if it was three strikes against me. Not cool.

I laugh at the same time, but it’s not funny. It’s unsettling, right? It was scary for me to see the freedom convoy, the protest in Ottawa. Then coming to Toronto, the messaging from where I work was to try not to identify yourself as a healthcare worker. 

I said to myself, “This is nuts. We help people, we support people, we keep people alive. We keep people independent, we maximize their functioning as OTs.” 

Then to hear the messaging that on the weekend when the convoy freedom protests are coming to Queen’s Park, if you are around downtown in the area, try not to identify yourself as a healthcare worker.

It was familiar for me, but also unfamiliar for me. As a person who identifies as a gay individual in the LGBT community, I’m familiar with being in the closet. So I had to hide in the closet that I’m a healthcare worker. But at the same time, I had questions like, “Why do I need to hide myself as a healthcare worker?” The emotions that come with that are very unsettling. Frustration. More than anything, it’s really sad. That’s what I’m feeling right now.

Our redeployment to various types of COVID programs was very unique. It had never happened before. It was the first time in my career of working as an occupational therapist for 20-something years. It was exciting because you were doing something else.

But at the same time, there’s also anxiety or fear of the unknown, even for us to be redeployed in a hotspot in the GTA area. We were going to be doing certain things that were out of our normal routine and responsibilities. To me, the question was, “What’s that going to look like? For sure, I’d like to help out. How can I help out at my best capacity?”

There wasn’t really an alternative. There wasn’t a way for us to say, “Actually, we’re uncomfortable with that,” or “Could I negotiate something else with you perhaps?” or “I think I can contribute in this capacity versus this capacity.” There was a lack of negotiation and a lack of autonomy.

One time at a hotspot area — it was in a postal code that has a more marginalized, equity-seeking population — we were doing first doses. We had a whole bunch of people lining up. But then something happened on that particular day, which was that somebody posted to Facebook saying that first-dose vaccinations were available for anyone.

Thousands of people came into that hotspot from all over the GTA area. It was described as a rock concert without the music. People everywhere.

But my thought was, this is for a marginalized, equity-seeking population. So why don’t we focus on people with that postal code, versus those perhaps from Forest Hill or from a different, higher [socioeconomic status] area in Toronto? It triggered me because as a person of colour and also as a person who grew up in a marginalized area in Toronto as an immigrant, I said, “This is not equitable.”

With the COVID pandemic, there were a lot of inequities in terms of the marginalized population, the equity-seeking groups. They were on the fringes, they were impacted severely — homelessness, all of that. 

If we don’t take care of that population, what does it say about our society as a whole? It was emotionally conflicting. In terms of ethics, what do we do? It was confusing. It wasn’t consistent. It was frustrating. 

But I also understand that the leadership team was doing this for the first time. I sympathize with the decision that they made. But being in the front line, seeing all of this, it was conflicting. I think it’s morally distressing, actually, that’s the word I’m looking for. It’s quite morally distressing, witnessing this in front of your eyes. You just have to say, “Is this really happening?”

And wave after wave after wave. It’s pretty exhausting when you’re asked — they were asking for more and more and more. 

At one point, I had accumulated about maybe five-to-six weeks of vacation days. I wanted to take a few weeks off here and there, but was not able to. We weren’t given permission to take vacation at that point in time because it was the peak of a wave.

I felt so resentful. If I can’t use my vacation, then I’m not going to be 100 percent. If that’s what you want from me, me being not 100 percent, that’s not right. That’s not cool. That’s a lack of autonomy. Anger came up, resentment came up. But at the same time, I’m like, “I have to play nice. I have to be helpful. I have to push myself a little bit more.”

But they were pulling quite a bit. Pulling a lot from me in terms of my attention, my resources. It was pretty frustrating. I get it. But I also realized that giving people time off so they can recharge and come back 100 percent is much better than working on 50 percent capacity mentally.

I was on a shift in the COVID vaccination clinic one day. I got a phone call and it was my therapist. He said, “We have an appointment today at such and such a time, and I’ve noticed that you’re not here.” And then I realized, oh my God, I missed my mental health appointment.

Another time when I was on another shift, my therapist called me again and said you missed a second time. And then I said to myself, oh my goodness, because I am pulled in different directions, I’m not even able to maintain my own appointments. 

That gave me insight. That was when I realized, wait a minute here, if they’re not gonna take care of me, I need to take care of myself somehow. So my mindset shifted over to, if I need to call in sick, I will have to call in sick. Or if I need to take some time off, I need to take some time off going into work and not wanting to be there and going into work being resentful.

Lack of control, lack of autonomy — especially with the ethical implications that I witnessed — the moral injury and the frustration, [the inability] to really take some time off to reflect and to recharge and to ask yourself what is happening, and to give yourself self-compassion, was so important. To do that in order for you to come back into the raging pandemic, I would say, would’ve been a benefit. It would’ve been nice to just take a break here and there.

We need to talk about this. We need to learn from this. And if this happens again ever in the future, another pandemic, then we need to use this so that we can move forward with conscious and informed decision making or informed leadership so we don’t make the same mistakes again.

My name’s Tracey and I work in a coronary intensive care unit. 

I am in my 34th year of nursing. I absolutely love my job. There is an inherent trust that is provided to me when somebody’s having the worst day of their lives. I can’t think of another job I would love more than the job that I have.

There was this huge evolution throughout the pandemic. Initially, it was people banging pots and commercials that said we support you, we appreciate what you’re doing. We went from that to, within a year, advertisements to tell people they had to behave with respect towards the staff in hospitals, because it was becoming so much more of a confrontational workplace. 

The Canadian Nursing Association, again, at about that 12-month mark, started sending out papers saying our nurses are in trouble. We’re having supply chain issues, we’re having drug issues, we’re having staffing issues. 

Basically, by that point, anybody that could get out, did. Anybody that was even close enough to retirement left. I had friends who, really, it would’ve been in their best interest to stay five more years. They just left. 

You were so physically exhausted and so emotionally exhausted and psychologically exhausted and spiritually exhausted by the time you came home. All I did was basically drink coffee and stare at a wall. I had nothing left. 

Like, where do you start? How do you catch up on three years of lost sleep? How do you catch up in being able to feed your body the nutrition it needs to be able to sleep, to be able to move, to be able to practice any kind of self care?

You aren’t a good partner if you come home and stare at the wall and drink coffee. You’re not a good parent. You are not a good friend. You are not a good mom. You’re not a good daughter. 

All of your relationships are at risk when you suffer from PTSI. Because you pass that trauma on. You pass it on in mentorship — and that should matter.

I remember speaking with a charge nurse on one of the COVID units. She had been practicing for 14 months. She was in charge of a unit in a pandemic, and she said, “I don’t feel resourced for this.” She said, “I don’t feel like I’m a clinical expert at any of this.” And she said, “I don’t know if I’m going to stay nursing. I’m so burned out.”

Many, many, many of the staff on that unit were brand new nurses. It’s absolutely heartbreaking to hear our young professionals speak like that, but they’re speaking their truth. 

Like, what have we done to create a resilient environment? What have we done to give them the skill set that they need to grow professionally? What supports are in place? What mentorship is in place? And there isn’t any. If we can’t make people last two years, how are we supposed to make them last 25?

We need to be really careful about mentorship. Right now, we’re so damaged that we’re passing on our trauma — and we need to care about that. Let’s be really, really clear that the healthcare system was in trouble before there was a pandemic, and we need to take some palpable, meaningful steps on how to address it.

We probably actually need lifetime support. I can’t sit and listen to somebody that tells me, although it is very good advice, you need to eat healthy, you need to sleep, you need to practice box breathing and journaling. 

Yeah, I get it. But I’m a shift worker, as is most of the nursing staff that work in hospitals. So please tell me what that looks like when you’re a shift worker. Please tell me what it looks like to eat nutritiously when we don’t have access to food at the hospital for 14 hours out of a 24-hour day, because they close all of the cafés. Please tell me how I’m supposed to eat properly when I don’t get a break or how I’m supposed to drink enough when I have a mask on all of the time. 

Box breathing, although it’s got some benefits in terms of grounding, we’re so far past that. There’s only so much you can write in a journal. We need some meaningful, trauma-informed help so we don’t pass this on.

You can listen to these people, learn about these ideas. But can you be well in an environment that makes you sick? And I’m not sure I know the answer. We need to fix some of the fundamental flaws in our system, which is absolutely crumbling — now. 

Whether it’s true or not, it feels like we’re disposable. Some of our healing will come out of research to prove how detrimental the environment has been. Hopefully through that, we’ll be able to get more robust help than what is currently available.