Minister says healthcare workers have experienced burnout since Covid pandemic
A pilot training scheme is supporting nurses on the island in the face of a global shortage in the sector, the Minister of Health said.
Kim Wilson told the House of Assembly earlier this week that the Bermuda Hospitals Board was “overwhelmed” by the number of people qualified to take part in a residency programme for registered nurses.
She also highlighted during her Budget presentation to MPs how healthcare workers had experienced burnout since the Covid-19 pandemic hit.
Ms Wilson said: “BHB’s nurse residence programme offers newly qualified Bermudian RNs who have passed their national council’s licensure for registered nursing, which is also called the NCLEX-RN board exam, the opportunity to gain the clinical experience they need before entering their first RN position.
“BHB’s nurse resident programme has been very successful and has accommodated ten newly licensed Bermudian nurses per year, supporting them in gaining their clinical experience with oversight to complete their clinical training to be nurses.
“This past year the Bermuda College overwhelmed BHB’s residency programme with 14 new RNs and had a potentially similar sized class for next year.
“BHB has responded to this excellent challenge by piloting a nurse trainee programme to support nurses who have graduated from the Bermuda College while they wait for an open space on the BHB residency programme to complete their training.
“Previously, the nurses waiting for a nurse resident place did not have the option of working within a clinical environment.
“The new trainee pilot means that they have the option of working in various clinical departments with the additional benefit of learning specific nursing skills to enhance their clinical competency once a nurse resident position becomes available.
“In an increasingly cash-constrained environment, BHB has funded ten new posts to accommodate seven trainees plus additional anticipated new entrants in the pilot.
“At a time when there are nurse shortages being experienced around the globe, this is a way to encourage and support new nurses on their journey and increase the number of highly valued Bermudian nurses."
She told MPs that work permits had been approved for a full-time oncologist and an oncology locum, after the BHB warned last month of delays for new cancer patients while two appointments made their way through immigration requirements.
The minister said that a subsidy to cover hospital care for seniors, youth and people in need would increase from $108.33 million to almost $113 million in the coming year and an operating grant for the Mid-Atlantic Wellness Institute would go from $38.92 million to $42.16 million.
Ms Wilson said the total budget allocation for the health ministry’s headquarters in 2023-24 was $10.31 million – a decrease of $5.58 million or 35 per cent on the original estimate for 2022-23.
She explained: “Much of the change is due to the lifting of the public health emergency in November of last year.
“This means the ministry is no longer required to provide the services and manage the mitigation measures needed to control and contain the Covid-19 virus.
“The pandemic response unit has been largely stood down and the ministry is re-engaging with the community, focusing on its numerous public health services and activities.”
Kim Wilson, the Minister of Health, said that the Bermuda Health Council – which was allocated a $1 million government grant in 2023-24 – completed the development of unique patient identifiers for individuals and national provider identifiers for healthcare businesses and professionals in the current fiscal year.
She added: “While the initial intent was to integrate the unique patient identifiers into the hospital board’s Pearl system prior to launch, the health council is working with BHB to integrate these identifiers into the next phase of development and subsequently to require its use in the processing of health insurance claims and transactions.
“As the transition towards greater standardisation is still evolving, this modernisation of data will lead to a much better understanding of our population’s health needs in the future.”
The Department of Health’s total current expenditure for the fiscal year ahead was estimated at $30.43 million, an increase of $1.74 million on the original budget for 2022-23.
Ms Wilson told the House that $429,000 was allocated for administration.
She said: “Public health services are more important now than ever, given the toll that the Covid-19 pandemic has taken on our community.
“The Department of Health efforts are focusing again on prevention of non-communicable chronic diseases and mental health.
“It is fair to say, the post-pandemic period is proving challenging.
“Not unlike jurisdictions around the world, healthcare workers are experiencing burnout and the depletion of resources.”
Kim Wilson, the Minister of Health, said $308,000 was budgeted for the childcare regulation in 2023-24.
She explained: “Over the last fiscal year, all eligible childcare providers – or CCPs – those caring for a maximum of three children in a home setting, underwent the STARS inspection and the results were posted on the government website to educate the public and increase transparency.
“The majority of childcare providers met or exceeded the minimal standard receiving three stars, which is satisfactory, four stars is very good and five stars is excellent.
“Daycare centres – that is nursery schools – also underwent their pilot STARS inspections in preparation for their full STARS inspection … again, the majority of daycare centres met or exceeded the minimal standard.
“Daycare centres and childcare providers that did not meet the minimal standard were given additional monitoring and support or placed on a provisional licence if warranted.
“While some centres have readily made the needed improvements, a small number of daycare centres remain provisionally licensed and are displaying provisional licences in their premises until matters are fully remedied.
“This STARS inspection tool is comprehensive and allows the officers to evaluate aspects of childcare while providing support and guidance throughout the process.”
Ms Wilson said: “To support the childcare providers as well as the daycare centres, quarterly meetings are held to strengthen the lines of communication and provide updates and support related to inspection process.
“These meetings also afford the providers the opportunity to offer feedback and make recommendations related to the inspection process.”
She added: “There is ongoing collaboration between the childcare regulation education officer, the Bermuda College and the Department of Education to reintroduce the childcare certificate in the year ahead.
“Until such time as the course becomes available on island, the education officer has researched and shared viable online options for those seeking education in the field.
“In addition, the education officer provided professional development opportunities and training to providers.”
Ms Wilson said that the school health programme continued to face human resource challenges with only 15 per cent of school health and development assessments completed in this fiscal year.
She added: “Of the screenings conducted, 33 per cent – or 86 – of five-year-olds were identified as overweight or obese.
“While this data is based only on a portion of the cohort – approximately 52 per cent, or 257, of the target population – it is concerning.
“Factors contributing to these findings include diet, screen time, lack of physical activity and a lack of health checks."
The minister said that $1.72 million and $1.22 were budgeted for community health nursing and community health administration respectively.
She added: “While the community health nursing services team is not fully staffed at present, and yes, there is a worldwide shortage of nurses, partly due to the pandemic, there is concerted work in progress to speed up the recruitment process.
“This is in conjunction with plans to strategically address succession and retention of staff.
“Bermuda’s ageing population will demand health workforce planning at a new level so that care in the community is sustained and improved.”
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