Street nurse Cathy Crowe's key chain.
Street nurse Cathy Crowe's key chain. Credit: Cathy Crowe Credit: Cathy Crowe

On the same day Ontario Health Minister Sylvia Jones said the province has “not seen a mass exodus of nurses” leaving the profession – a remark some nurses say was “dismissive” and “painful” to hear, I stopped my active nursing license.

I say stopped, not resigned. It’s a more active description of my decision.

Like countless nurses, I’ve had enough.

Grant you, I am not an emergency room or intensive care unit nurse. I am not seeing paediatric COVID patients. I work in the nebulous area of community health, public policy, and advocacy, informed by decades of frontline work as a street nurse in the social welfare disaster called homelessness.

Yet, I feel equally dismissed as my hospital nursing colleagues.

During the pandemic I collaborated with frontline workers to fight for the most basic public health measures: portable toilets, free masks for unhoused people and two metre spacing of cots and beds in shelters. I say fight because none of it was easy. For the struggle to obtain the two metre physical distancing of sleeping spaces, we had to take the City of Toronto to court (and won). These stories are expanded upon by people who fought the good fight in Displacement City. Fighting for Health and Homes in a Pandemic.

I watched the unlearned lessons from SARS repeat themselves.

Community health nurses in the early days of the pandemic worked without adequate PPE and without extra funding despite an additional workload. I helplessly watched as 43 nurses, who were providing homeless health care in the pandemic, were terminated when the Ontario government ended funding, as if the pandemic let alone homelessness was over.

Like my hospital colleagues I have listened and watched as nurses who are working in what can only be described as a war zone become ill or get COVID or burnout – or all three. It is highly likely their mental health may be permanently damaged.

Decades of government neglect to the health care system is now patently apparent. It’s safe to say nurses are now politicized, and they are angry.

It’s not unlike the government’s decades-long neglect to housing.

I am reminded that the term street nurse is in fact a political statement. It says that homelessness has gotten so bad in our very rich country that a nursing specialty called street nursing developed.

When I worked at Street Health, the first nursing-led organization in the country that provided homeless health care, we were directed to engage in politics and to speak out. Always. ‘I See and am Silent’, the motto of the old Mack School of Nursing did not apply to us.

Nurses are not encouraged to advocate by speaking out.

Working at a community health centre my manager told me I could not speak about the tuberculosis outbreak that had hit the homeless population and had killed several men. I was also told I could not do outreach at Tent City because they were outside of our ‘catchment area’. Sadly, the nurses I worked with did not support my fight for whistleblower protection in our contract.

I was dangerously close to being penalized for my advocacy when the Atkinson Charitable Foundation awarded me their Economic Justice Fellowship. I was freed to work as a street nurse locally and nationally without constraints for six years. That freedom spoiled me and to this day I am reminded that for the most part nurses do not have that freedom.

Admittedly, leaving nursing has been on my radar despite friends and colleagues discouraging me from making that decision.

I am stopping.

I have been a nurse for 50 years. I was too tired to even go to my 50-year reunion this summer. 50 years of nursing is too long for anyone.

Nursing can be rewarding but it is hard work with few benefits. For most of my career, I’ve been in non-unionized positions with weak benefits and certainly no pension plan.

Street nursing? I will leave that to your imagination. Back in the days of Street Health I naively thought street nurses would eventually not be needed. Surely our governments would smarten up and re-institute a national housing program. There were about 3,000 homeless people in Toronto back then, today the numbers have more than tripled.

Our governments do not respect that everyone has a right to a home, and I would add the same disrespect applies to those of us working in the field. We are usually dismissively labelled as ‘advocates’, as if that is an insult.

In my memoir A Knapsack Full of Dreams. Memoirs of a Street Nurse I recount examples of being thwarted by inherently anti-nursing sentiment in the workplace. Suffice it to say these experiences were both a result of nursing’s historically undervalued role and a harbinger of what was to come.

Which brings me back to today. Today’s nurses are on the receiving end of governments’ contempt. That same disdain is displayed towards the vulnerable public, especially the elderly and children. It’s intentional neglect.

While there were early signs of appreciation and support for nurses (electric hearts in windows, people banging pots and pan outside windows at the dinner hour, roti, and pizza deliveries to emergency room staff), that quickly faded.

The Ontario government attempted wage suppression legislation in Bill 124.

Hospitals began to ask nurses to do double shifts, give up vacation days, work in specialty areas they were unfamiliar with and stay silent.

Meanwhile hospital CEOs tour health ministers and premiers for photo ops and funding announcements (but not for nursing) and refuse to publicly criticize the same governments that are making irresponsible policy decisions causing death and injury within their walls.

The same CEOs have also refused to call for emergency medical aid from the Red Cross or the military. An exception last week was the Children’s Hospital of Eastern Ontario (CHEO) that called for Red Cross aid.

Private for-profit nursing agencies continue to rake it in. Most of the media coverage focuses on their higher hourly nursing rates and ignore the company profits, let alone this component of healthcare privatization.

Shoppers Drug Mart and other pharmacies are doing equally well. Vaccinations at drugstores and COVID testing is now normalized. Ontario is now piloting Paxlovid prescribing by pharmacists. Across the country pharmacists are entering into treatment of urinary tract infections, herpes and more. All examples of privatization instead of enhancing public health and primary care.

Today as we end year three of the pandemic this is the norm: rotating emergency room closures, 200 per cent occupancy in paediatric ICUs, 10-hr waits in emergency departments, heated trailer waiting rooms outside emergency rooms, cancelling of surgeries and diagnostics, nurses helping patients say goodbye to loved ones on an iPad.

Think about what these nurses have seen.

There really should be an inquiry to examine how Medical Officers of Health were allowed to ignore the science and the recommendations of hundreds of infectious disease experts. Their refusal to touch mask mandates with a ten-foot pole and to adequately fund the needs of the health care system are criminal.

As author and social activist Seth Klein has written in his book The Good War: Mobilizing Canada for the Climate Emergency “It will always fall to social movements to push political leaders to make needed changes.”

That’s certainly been my experience. I’ve had an exceptional career in part because I took part as a nurse in social movements. This included anti-apartheid work, fighting the return of the death penalty, declaring homelessness a national disaster, exposing the health risks of shelter conditions such as tuberculosis, fighting for and winning housing in the Tent City campaign.

I’ve received seven honorary degrees, an international human rights award and became a member of the Order of Canada. I have loved nursing.

But today, I’m stopping but I’ll still be in the social movements fighting for housing and healthcare.

Cathy Crowe

Cathy Crowe

Cathy Crowe is a street nurse (non-practising), author and filmmaker who works nationally and locally on health and social justice issues. Her work has included taking the pulse of health issues affecting...