The Thompson General Hospital laboratory is down to a skeleton crew and the union that represents lab technologists is warning that one injury or resignation could compromise its ability to provide full emergency room services.
The Manitoba Association of Health Care Professionals said in an April 25 news release that nine of 12 positions at the lab in Thompson are vacant and that the three lab techs there are at high risk of burnout, having sometimes been called upon to work 47 hours straight in a combination of regular and on-call shifts.
“Those types of circumstances are not sustainable for anyone,” said MAHCP president Jason Linklater, who was in Thompson on Tuesday.
“We are beyond crisis,” said MAHCP vice-president Tanya Burnside, a Thompson resident, during an April 25 information picket outside Thompson’s hospital that was organized by the union, which is seeking a new contract and recently had a strike mandate vote with 99 per cent of members in favour. “They’re really holding the hospital together right now. Three of them. It’s unbelievable. We’re at the point if one more would leave or have an injury or just not be able to work for whatever reason … we have no lab.”
Although the situation at the lab is particularly critical, there are other pinch points that are straining the hospital’s ability to perform all its functions.About 40 per cent of Thompson positions for technologists to run diagnostic imaging equipment like CT scanners and X-ray and ultrasound machines are also vacant.
“Staffing levels are depleting,” said Linklater. “There’s a huge element of risk. Hospitals cannot stay open without access to lab services.”
The province’s Shared Health department, which runs health care services like labs and diagnostic imaging, says there are challenges but that stopgap measures and longer-term plans are being used to ensure the continued provision of medical lab services at Thompson General Hospital.
“Efforts to maintain services for residents of Thompson and surrounding communities are a top priority,” said a department spokesperson in an email. “In an effort to ensure no interruption to services within the community’s emergency department, lab staff are asked to pick up overtime, relief staff are being scheduled to provide coverage, and point-of-care testing has been implemented at the Thompson Clinic to reduce demand on the lab without affecting patient care. We recognize that current staff are working very hard to support ongoing services, and we sincerely thank them for their efforts. Recruitment of medical laboratory technologists is underway, resulting in one recent hire and a number of other applications that are now underway. Career fairs are being held throughout the north during the month of May, in The Pas (May 15), Flin Flon (May 16) and Thompson (May 18).
Recruiting, which has has been difficult in Thompson for many years, even in high-paying professions, is made more difficult right now as a result of a general labour shortage and demographic trends that are resulting in many baby boomers retiring. Other jurisdictions are also offering more attractive perks to people like medical lab techs.
Saskatchewan is dangling up to $40,000 in incentives for lab techs right now, Burnside says.
“Why are you coming to Manitoba if you’re a new grad?” she said. “You’re not.”
Situations like the one at the Thompson lab only exacerbate recruiting challenges.
“When you look at all the vacancies, do you really want to come here if you’re looking for work-life balance?” Burnside asks.
Burnout and insufficient pay is also promoting people to switch careers entirely, Linklater says.
“At first it was losing people to other provinces. Now we’re losing people to entirely different occupations altogether.”
Christine Nielsen, CEO of the Canadian Society for Medical Laboratory Science, a national professional association and certification body, says it has long been known that this day would come.
“We’ve been sounding the alarm bells for 15 years about this moment, which is an inability to meet the demands for lab testing, given the number of people in the labour market,” she said in an interview from Toronto.
The genesis of that problem dates back to the 1990s, when more medical lab technologists were graduating than the market could provide jobs for. That resulted in training programs shutting down and never starting back up. Now that baby boomer medical lab techs are retiring, there is a gap in the labour force.
“I’m Generation X,” she said. “We’re missing a lot of us in the workforce and that’s who should be taking over the jobs as the baby boomers are retiring and they’re just not there in many cases.”
Red River College is the only place in Manitoba with a program to train medical lab technologists.
“Literally no province has enough graduates right now,” Nielsen says.
With fewer and fewer people being relied on to provide lab services, particularly in remote and rural locations, burnout keeps going up. In 2016, Nielsen, says, lab techs were saying “it’s a little stressful at work.” By 2020, during the pandemic, “it was like, ‘I don’t know how much longer I can work here. I’m not feeling supported. There’s not enough staff. I’m under pressure to work long hours.’”
Though there are short-term solutions, like bringing in more foreign trained techs or filling in gaps with locum techs on short term contracts, they don’t always work well for smaller communities.
“Rural and remote areas may not be of great appeal to newcomers because they don’t have their communities there,” Nielsen said. “Part of the problem with a locum is it creates a huge disparity because you’ve got your full-time loyal employee who’s working side-by-side with somebody who is qualified but they don’t know all of the equipment. They don’t know all of the systems, so their productivity is lower and they’re earning higher wages and that creates a bit of a rub in the workplace.”
Efforts are being made to train and certify more techs but that process takes years. Hospitals in smaller centres like Thompson may not have that long because shortages can cascade through the system.
“If you don’t have a flourishing hospital, you’re not going to be able to draw physicians to the area,” she said. “It’s not a good situation for the care of patients.”
In addition to making it more worthwhile for techs to work in Manitoba, Burnside says the provincial government needs to try new approaches.
“They need to be innovative and look at programs where they invest in our youth and take them through school and get them up here working,” she said. “There are people that want to do that. There just needs to be a program to help guide our youth into these professions. We're willing to be part of that solution, but we need the government to step up.”