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Canadian union leader packs a powerful punch.

The diminutive and self-described "union goon", Linda Silas, who heads the 200,000-strong Canadian Federation of Nurses' Unions (CFNU), lit up the conference with her provocative, passionate, at times self-deprecating, and often laugh-out-loud speech. But her message--encapsulated in the title of her address If you're not at the table, you're on the menu --was deadly serious.

Opening her address, Silas warned delegates she was "French, a woman and a labour leader, so I talk ..." She proceeded to do just that for 45 minutes, captivating the conference audience. She urged health-care workers to talk about what they did; to never miss an opportunity to be on a committee or present a paper, and said health cutbacks, reviews and task-shifting were everywhere.

"We need credibility and we need to be talking at every level and on every topic, from health promotion to climate change, and what we say must be evidence-based and delivered in a professional manner," she said.

Responding to an earlier call from ICN chief executive Frances Hughes for examples of innovative New Zealand practice, Silas told nurses "you have to brag your stuff; tell your stories". She described Hughes as "a breath of fresh air at ICN".

'We need hope'

Silas led a delegation of nursing union leaders to New Zealand in July to learn more about care capacity demand management (CCDM) and told conference delegates one of the reasons for the trip was because "we need hope".

The delegation had visited Bay of Plenty District Health Board and Silas was very impressed Tauranga Hospital had its own kitchen--"it hasn't been contracted out", she said, provoking applause.

The delegation also visited Auckland City Hospital, where CCDM had proved much harder to introduce, she said.

The CFNU is to present the concept of CCDM to Health Canada. "We know it's not perfect but the tripartite model--with the three parties at the same table--is progress."

She urged nursing leaders to have the courage to defend their nursing budgets--"there are a lot of wet noodles out there." She was heartened by the response of one leader who told her finance department: "I'm not over spent, I'm under budget."

All nurse leaders should respond like that, Silas said.

'A lot of us broke'

The more nurses accepted, the worse things got, she said. "In the 1990s we did more and more and more, and a lot of us broke. A lot of us have got ruined backs and knees because we stretched ourselves too far. If we can't take care of us, we can't take care of anyone else."

Statistics from 2014 revealed that Canadian nurses did 19.3 million hours of overtime a year, the equivalent of 10,700 full-time equivalent staff, which cost $871.8 million in paid and unpaid overtime.

In 2014, 21,000 Canadian public sector nurses--almost eight per cent of that workforce--were absent from work each week due to illness or disability. This cost $846.1 million a year. Nurses were absent from work at nearly twice the rate of other occupations.

In Ontario, there were more workplace injuries a year in nursing than in mining and construction, and in Nova Scotia more than in construction. "It is hard to insure a nurse for long-term disability because of these statistics," she said.

Compassion fatigue and burnout were major problems. "Sixty-two per cent of nurses in Manitoba currently experience compassion fatigue and 71 per cent have experienced burnout at some point in their career."

Silas stressed the importance of making the links between staffing, occupational health and safety, and patient safety. Understaffing led to excessive workloads, which led to stress and absenteeism. Then burnout and injury led to further stress and absenteeism and higher turnover which, in turn led to even greater understaffing, with adverse effects on patient safety.

While the CFNU was "totally union", one third of its budget was spent on professional practice issues and of that, between 50 and 75 per cent was spent on safe staffing and patient safety.

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There was ample evidence of the costs of unsafe staffing. The Canadian Patient Safety Institute had calculated preventable patient safety incidents in acute care cost $397 million over a single year.

"As far as we are concerned, safety is not negotiable. Nurses are the most valuable asset in health care."

Nursing was the toughest and most demanding profession and the number of drugs nurses took to cope was scary, she said.

Using the quote, What you allow is what will continue, she urged nurses to speak out against inappropriate care, workplace bullying and harassment, domestic violence and child poverty.

"We have a responsibility to do it. As Aristotle said: Do nothing. Say nothing. And become nothing. We have to talk about what's happening in health care--about equal pay, about violence in the workplace. We have to wear our colours proudly and move together. We have to raise public awareness and put the fire under the politicians. As nurse union activists we have to have the courage to stand up and say 'No' when staffing is unsafe. And you have to give your confidence to your organisation," she said.

Referring to biculturalism, she said the bicultural relationship was not as developed in Canada as it was here. "We can learn from NZNO. Aboriginal nurses in Canada are reluctant to self declare and if they don't self-declare, they have no indigenous rights."

Eight provincial nursing unions belonged to the CFNU and while collective bargaining was done at provincial level, research, international relationships and other issues were undertaken nationally. The ratio of nurses to population was similar in Canada and New Zealand--1:90 in New Zealand and 1:94 in Canada.

Silas was given a standing ovation and, in thanking her, kaiwhakahaere Kerri Nuku said Silas had "put out the wero to NZNO to not be afraid to ramp it up and be courageous".
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Title Annotation:nzno conference; Linda Silas of the Canadian Federation of Nurses' Unions
Publication:Kai Tiaki: Nursing New Zealand
Geographic Code:8NEWZ
Date:Oct 1, 2016
Words:979
Previous Article:Nurses leading change.
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