The RN staff from Local 069 Cypress Regional Hospital: Medical – Surgical Department and SUN Provincial have successfully escalated 66 Work Situation Reports (WSRs), and 28 subsequent WSRs.

Since 2022, a pattern of workload and professional practice concerns has been documented on WSRs without collaborative problem-solving or resolution by the Joint Nursing Advisory Committee, Unit Leadership, or through escalation to the SHA Board of Directors.

An Independent Assessment Committee (IAC) is the last resort within the collective agreement to address workload concerns specific to registered nurses and to resolve WSRs.

The IAC Panel of three RN experts unanimously confirmed the concerns brought forward by SUN members, stating:    

For RNs in the Medical Surgical Department to fulfill the requirements of their nursing roles and responsibilities and to have an appropriate workload, sufficient staff and resources must be in place to manage the overall care and Department requirements.  Without these appropriate supports, non-nursing tasks and functions by default become the work of RNs who are on the unit 24/7, negatively impacting their workload and ability to fulfill their RN roles and responsibilities (IAC, 2025, p. 5).

While our focus in this process has been to address areas of concern for RNs in their ability to meet the practice expectations outlined in their professional standards and competencies documents, our ultimate concern is for safety and wellbeing of the patients and their families.  We trust that this report will be helpful in resolving these important challenges (IAC, 2025, p. 112).

 

The IAC Panel made 18 recommendations related to:

  • Patient Acuity, Complexity, Dependency & Safety

  • Staffing

  • Leadership, Mentorship & Support

  • Recruitment & Retention, and

  • Junior/Senior Mix, Onboarding/Orientation, Stress & Burnout

 

Binding recommendations have been confirmed between SHA Leadership, SUN Provincial, and Local 069 and are inclusive of:

  • Medical-Surgical Department Nurse-to-Patient Ratio of 1:4.

  • Addition of a Float RN 24/7.

  • Addition of 2.0 FTE RN Relief Lines, to be reassessed in 1-year.

  • Two Supernumerary Charge RNs 24/7, when the Nursing Unit Coordinator is not on shift.

  • Formal education/training plan for Charge Nurses and ensure that each RN completes the training before being assigned the role.

  • One Full-time Medical-Surgical Department Clinical Resource Nurse.

    Implement a formal, regularized, transparent, evidence-based, and collaboratively developed onboarding program for new graduates and nurses new to the unit that includes orientation, coaching, mentoring, and peer support.

 

The IAC Panel provided additional observations, applicable across Saskatchewan when they stated:

The IAC Panel believes that the learning and outcomes of this IAC process has applicability to other Medical-Surgical Departments in comparable communities/facilities, given the comparator data provided by SHA.  It would be appropriate for other Medical-Surgical Departments to benefit from solutions to address workload, without having to complete the IAC process for each Department, one Department at a time (2025, p. 112).

Local 069, Cypress Regional Hospital, and SHA Unit Leadership will continue to discuss the report's non-binding recommendations for an improved work environment focused on safe, competent, high-quality, and appropriate RN practice and healthcare services.

To learn more about WSRs, the Nursing Advisory Process, and the Joint Nursing Advisory Committee, you can review the SUN website's WSR/NAC Learning Modules & Resources and NAC Leadership.