Janine Curtis ties the epidemic of burnout among health care providers in Newfoundland and Labrador to misinformation about the real causes of poor access to hospitals and clinicians.

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In the summer of 2022, the CEO of the Central Regional Health Authority in Newfoundland and Labrador issued a press release in reaction to incidents of harassment of nurses, physicians and practitioners working in the local hospital. The online harassment was described as “harsh and derogatory”, often directed at staff members by name, as well as potentially “defamatory” in some cases.

The harassment of health care workers in this instance was the result of online misinformation.

With serious gaps in equitable delivery across the province, those who cannot access care have levelled the blame against the only tangible target they can conceive: healthcare workers. This is misinformed blame as the more useful subject of frustration would be the structural causes contributing to inequitable delivery. Healthcare workers continue to face backlash and harassment from the very public that they are exhausting themselves trying to care for. While the validity of the public’s frustration is not in question, it is misdirected towards healthcare workers who are running themselves into the ground trying to deliver services.

Misinformation has plagued healthcare services in a post-pandemic world. There has been a notable erosion of public trust and reliance on both healthcare delivery and on the character of medical practitioners as a whole. Patient mistrust is reaching a critical point as highlighted by stories like that of Shannon Lush, a Newfoundlander who has spent years suffering with unmet healthcare needs and has seen her trust in public delivery of healthcare “collapse”. This phenomenon has been identified globally, with Newfoundland and Labrador being no exception.

Photo Credit: DC Studio/freepik.com.  Image Description: A physician at their desk, staring at the monitor and showing signs of exhaustion and burnout.

A press release from the Newfoundland and Labrador Medical Association states that 30% of residents in the province, approximately 163,000 people, do not have a family doctor, contributing to an increased burden on local emergency services. People are turning to hospitals to meet their healthcare needs, presenting a massive ratio difference between numbers of patients and available personnel to care for them. The Registered Nurses’ Union of NL says that hospitals are running over capacity and despite this surge in demand, the number of nurses tasked with dealing with growing care needs has stayed the same.

A system that seems to only have space for a portion of Newfoundland and Labrador residents leads to healthcare workers representing a tangible target for these feelings of frustration based in inequity. In turn, providers see themselves increasingly frustrated by a system that requires them to shoulder massive caseloads and endure incidents of violence at work. It is not ethical or reasonable to expect that healthcare workers sacrifice their own physical and mental health for that of their patients. It is not ethical that those who are making these sacrifices face the brunt of the harms from this misplaced blame.

For some tangible numbers, data from WorkplaceNL shows that in 2023 there was one claim from nurses every two days for injuries, and one claim every 13 days for assaults and violence. With healthcare delivery on the island already stretched to the limit, there has been a mass exodus of healthcare personnel, with many practitioners reporting that they are being pushed to a breaking point. Notably, five physicians who make up the internal medicine department at St. Clare’s hospital in St. John’s resigned at the same time. Incidents like these are a symptom of an overworked system, one that is riddled with misinformation over what the actual issues are.

While there is a notable shortage of healthcare providers in the province, there is no shortage of compassion. It is imperative that these issues be addressed before the service gaps in the province widen any further. We must not let misinformation worsen the burnout crisis by perpetuating further harms against healthcare providers.

It is the duty of the provincial government to ensure ethical delivery of healthcare services for patients and providers. Better quality service delivery is directly related to a higher degree of public trust. Improved support for service delivery would in turn reduce the likelihood of misplaced blame on healthcare providers, and lessen workplace violence and burnout, leading to safer interactions for all.

It is time that we start caring for those who care for us and address the structural factors that make healthcare delivery more dangerous for everyone involved. The blame game has gotten us nowhere. Addressing understaffing and violence, along with other workplace conditions, is an imperative way to improve equitable healthcare service delivery for Newfoundlanders and Labradorians.

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Janine Curtis is a Master of Health Ethics student at Memorial University. This commentary was originally written in the context of a graduate seminar on health misinformation and lies.