ONTARIO—A new peer-reviewed study has raised alarm about the deteriorating conditions faced by Ontario’s hospital workers, most of whom are women and many of whom are from racialized communities. The report, titled ‘Running on Empty,’ highlights the severe staffing crisis that is undermining both the well-being of healthcare workers and the quality of patient care.
The study, published in ‘New Solutions: A Journal of Environmental and Occupational Health Policy,’ was co-authored by Dr. Margaret Keith and Dr. James Brophy, who have previously conducted extensive research on working conditions in Ontario’s healthcare sector. Dr. Craig Slatin, a US health researcher, also contributed to the study.
“Health care workers are warning us about the future of our public system,” said Dr. Keith. “They expressed a profound sense of dissatisfaction, despair, sorrow, anger, and frustration about their working conditions and the quality of patient care. There was an overarching sense of being unsupported, overworked, and disrespected, which is being driven by chronic underfunding and understaffing.”
According to the study, Ontario ranks at or near the bottom of the country in key healthcare funding measures and has the lowest per-person hospital spending of any province. The province employs 18 percent fewer hospital staff compared to the rest of Canada, Dr. Keith noted.
While staffing concerns predate the COVID-19 pandemic, the study found that conditions have worsened significantly since 2020. As patient volumes surged, staffing levels failed to keep pace, leading to widespread exhaustion and burnout among workers. The study quotes one worker who described the relentless pressure to cover shifts: “Our phones never stop ringing being asked if we can come in and cover a shift. You can be leaving work and get a call before you even get to the parking lot asking, ‘Can you stay?’ You can do that once in a while, but it’s literally every day.”
The staffing shortages have also led to unprecedented emergency room closures, long wait times, and an increase in the number of patients per staff member. One operating room nurse described the deteriorating conditions: “We see individuals who have been sitting in their beds for a day or two, sometimes three or four, because the operating rooms get so clogged. And when that individual gets to us they’re so filthy, they reek of their own feces. The beds haven’t been changed or the individual has not been properly turned and positioned. They’re getting pressure ulcers, which a patient should never get in the hospital.”
The research, conducted in collaboration with the Ontario Council of Hospital Unions-Canadian Union of Public Employees (OCHU-CUPE), involved extensive interviews with 26 hospital workers, including nurses, personal support workers, housekeepers, and clerical staff. The findings were complemented by recent polling of 775 OCHU-CUPE members, which revealed that 62 percent of respondents were dealing with exhaustion and high stress levels, 41 percent dreaded going to work, and 44 percent had trouble sleeping.
Dr. James Brophy, one of the study’s co-authors, highlighted the psychological toll on workers: “The sharp decline in their working conditions is harming their mental and physical well-being. But what is particularly jarring is the feeling of being abandoned by the government and often their own employers. It’s like your house is on fire, and everyone can see it, but no one’s coming to help. It makes you lose faith in the system.”
The study paints a grim picture of the current state of Ontario’s healthcare system, with numerous quotes from workers describing a sense of hopelessness and despair. A trauma department nurse shared her experience: “You think it can’t get any worse—and it just got worse. I was going through increasing panic attacks before work, crying before I got out of the car. I loved going to work when I first started. Now I dread it.”
Michael Hurley, co-author of the study and president of OCHU-CUPE, criticized the government’s response to the crisis: “The impact of the staffing shortages is felt every day by hospital patients and their families, and these problems will only get worse if they remain unaddressed. You’d think that the government would be acting on a war footing and taking bold steps to ramp up recruitment and retention. That they would legislate nurse-to-patient ratios to protect morale and give nurses confidence that they can provide quality care.”
Dr. Maurianne Reade, an associate professor at NOSM University and a family physician with the Manitoulin Central Family Health Team, emphasized the importance of addressing the staffing crisis for the sake of patient care: “To provide the best patient care possible for our rural patients, we need healthy, well-supported teams in our hospitals and clinics. The chronic understaffing takes a toll on the workforce and on our patients.”
Dr. Reade also noted the rejection of the ‘Patient-to-Nurse Ratios for Hospitals Act, 2024’ as a missed opportunity: “One of the key recommendations in the Necessary Action for a Just Health Care System section was for appropriate Nurse to Patient Ratios. Unfortunately, the act was rejected by our government in June. We need another version of such a bill, but with a further provision that would support patient-to-nurse ratios for emergency departments.”
Dr. Reade urged those concerned about the state of Ontario’s healthcare system to read the ‘Running on Empty’ study, describing it as “a critically important look at the challenges faced by healthcare providers in Ontario.”
As the staffing crisis deepens, the study serves as a stark warning about the future of healthcare in Ontario, calling for immediate and decisive action from the provincial government.
