Metro Vancouver's housing crisis is infecting other industries, and some local nurses are feeling the symptoms.
Health care workers across the region are leaving because they're unable to afford to live near work, or pay for parking every day if they commute.
"We're stretched really thin," said Christine Sorensen, president of the BC Nurses' Union.
So thin, the union says, the emergency room at BC Children's Hospital recently had 10 nurses resign, citing housing inaffordability. The sudden decrease in staffing levels pushed another to transfer, claiming the conditions were unsafe.
"Nurses are compensated fairly and recognized for the work that they do, but it concerns me if nurses can't afford to live and work here," Sorensen said.
"It's difficult to provide safe patient care when we're not fully staffed."
Nurses earn an average salary of about $70,000 a year, but Sorensen said she often hears from nurses that it's still difficult to get by in a city where the average single-family home costs more than a million dollars.
There is currently a 30 per cent vacancy in the ER at the hospital, the union told CTV News.
The hospital's chief operating officer says BC Children's was able to maintain a safe level of staffing during that time, and added that the hospital is growing. It's in a new facility, meaning more jobs are being created.
"We've recruited a number of positions and we have a new group of nurses starting in early January," Linda Lemke said.
She told CTV News that among the hospital's strategies are proactive hiring, working with educational institutions and training nurses on the campus for specialty care.
Lemke said she "couldn't say that there's been a specific trend" when it comes to nurses leaving the hospital, telling CTV some have relocated, and some have retired or gone on maternity leave.
"We have seen people go, but we've also been able to recruit," Lemke said.
Increase in overtime, extended shifts
A lack of affordable housing remains a top concern for nurses living in Metro Vancouver, the union says.
"When you don't have a unit fully staffed because people can't afford to live and work in that community, the unstaffed unit then puts pressure on the nurses that do remain to work additional shifts, work extended shifts, a lot of overtime, or work short staffed," Sorenson said.
"The nurses are saying the workload is heavy but more importantly it's unsafe."
Data provided by the Provincial Health Services Authority suggests that BC Children's spent about $282,000 in nursing overtime in the emergency department alone in 2017-18. It's an increase of more than $100,000 over the previous year.
The hospital as a whole spent $2 million on OT during that timeframe, up from $1.4 million the year before. The PHSA said at least part of the reason for the increase was that the hospital was preparing its new Teck Acute Care Centre, which opened in October 2017.
The centre has a budget for 362 nurses, an increase of 66 positions from 2014-15.
And Sorensen said across B.C., the province will need another 20,000 to 24,000 more registered nurses by 2026.
"The concern I have is how are we going to ensure we can recruit and retain our health care professionals," she said.
'I don't know what we'd do without them'
It's an issue that has parents who depend on the hospital worried about quality of care.
"You never think it's going to be you," Carly Walsh said.
In August 2017, her two-year-old son Smyth Fraser got sick. Lying on his mother's lap, helpless and afraid, he was wheeled through BC Children's Hospital for tests and treatment.
"It happened so quickly… He was helpless and he was really sick when we got there," Smyth's father Ryan Fraser recalled.
The toddler was diagnosed with hemolytic uremic syndrome, a condition most commonly contracted from E. coli bacteria that destroys red blood cells faster than the body can make them.
"His kidneys had fully stopped functioning," Walsh said.
But after two long weeks, the toddler went home healthy.
"It was a hard position to be in. You kind of hand your child over… The nurses we worked with, nurses and doctors, were unbelievable," Walsh said.
"Everyone there was fantastic. They were phenomenal," Fraser said.
Fraser said that while the facility is not something his family takes for granted, he understands why nurses might consider leaving.
"If you're able to make equal wage and your cost of living is significantly less somewhere in the Interior or other places in B.C. or even abroad, you have the same knowledge and you're able to effectively do your job," he said.
But, Walsh said, "I don't know what we would do without them."
As the boy and his two older sisters got ready for the holidays, a time of year his family once worried he'd miss, his parents said they worry about the treatment other kids will receive if nurses can't afford to live in the cities where they work.
They're hopeful something will change so that nurses don't feel that they're forced to leave.
"To potentially down the road have other patients go in there and not have that same treatment that we had, and even if they're a little bit short staffed, I can't imagine," Walsh said.
"Something needs to shift because we need them here if we want to continue to have the care we had for our son."
What are the options?
One of the suggestions brought up by the nurses' union was a subsidized housing program or housing allowance to help take the pressure off those in the industry.
It's an option health authorities have looked into across B.C. because more remote communities are also experiencing issues.
The union also suggested retention and recruitment initiatives, and purchasing housing in rural and remote areas so nurses looking to do a short stay could live there temporarily.
Some have also considered partnering with communities to create housing solutions on a municipal level, Sorensen said.
"We need some help. We need the public to identify that health care should be a priority for the provincial government and the federal government," she said.
"I think we all need to sit down and come up with some creative ideas."
