ONA v. Hamilton Health Sciences

With surgeries at risk of cancellation and the PACU one nurse short for a critical four-hour window, Hamilton Health Sciences made an emergency call. This decision examines when a genuine staffing crisis can justify bypassing routine union consultation requirements.

Background

This grievance concerns the reassignment of nursing staff between Post-Anesthesia Care Unit (PACU) locations at Hamilton Health Sciences. The Clinical Manager for the Juravinski Site PACU, faced a severe staffing crisis in early June 2023. When she took over the Juravinski Site PACU in early November 2022, there were significant vacancies. Over time, approximately 8 to 9 positions became vacant due to staff members taking positions in other cities. Despite posting positions and hiring new nurses, some of the newly hired staff lacked the critical care experience required in the PACU and needed 4 to 6 months of training and orientation before they could work independently.

By Thursday, June 1, 2023, with only one day notice, the manager found herself in crisis. The Juravinski Site PACU had a normal staffing complement of 12 nurses (including the Charge Nurse), but she could only schedule 8 nurses for Friday, June 2, 2023 (not counting the person on orientation). She needed to cover the critical gap between 1700 and 2100 hours when the unit would be particularly busy with post-operative patients. The manager reached out to the Clinical Manager for the General Site PACU to request emergency support.

The Staffing Challenge

The normal staffing complement for the Juravinski Site PACU was:

• A Charge Nurse working 0800 to 1600 hours
• Two nurses working 0700 to 1700 hours
• Two nurses working 0900 to 1900 hours
• One nurse working 1000 to 2000 hours
• Two nurses working 1100 to 2100 hours
• One nurse working noon to 2200 hours
• One nurse working 1300 to 2300 hours
• Two nurses working nights from 2100 hours to 0700 hours the next morning

For June 2, 2023, the hospital could cover:

• The two shifts from 0700 to 1700 hours
• The two night shifts
• One of the 0900 to 1700 shifts (filled by switching a nurse who usually works 1100 to 2100 hours)

From elsewhere in the hospital, the manager found PACU-trained nurses to cover:

• A nurse to work one of the shifts from 0900 to 1700 hours
• A nurse from the General Site PACU who volunteered to work from 0900 to 2145 hours
• A nurse to work the 1000 to 2000 hours shift

Despite these efforts, the manager was still one nurse short for the critical 1700 to 2100 hours period. She testified that the Juravinski Site PACU had a very busy caseload on Friday, June 2, 2023, requiring 1:1 nursing care for 33 patients. She explained that without sufficient PACU nurses for the post-operative period, the hospital would need to put the operating room on hold until a PACU nurse became available, which would result in surgeries being delayed or cancelled.

Positions of the Parties

The Ontario Nurses’ Association grieved the reassignment of nursing staff, arguing that the hospital violated the collective agreement by reassigning nurses between the two PACU units without following proper consultation procedures. The union argued that the reassignment was arbitrary and that proper procedures required notice and negotiation with the union before such changes could be implemented.

The hospital argued that the reassignment was a legitimate exercise of management rights in response to an operational emergency. The hospital emphasised the staffing crisis, the critical nature of post-operative care, and the immediate need to ensure patient safety. The hospital noted that it made reasonable efforts to find PACU-trained staff from within its own facilities before the emergency situation arose.

Arbitrator Hart’s Decision

Arbitrator Hart upheld the hospital’s authority to reassign nursing staff in response to a genuine operational emergency. The arbitrator found that the hospital acted reasonably in responding to the staffing crisis and that the reassignment was necessary to ensure patient safety and maintain critical care services. The arbitrator emphasised that hospitals must retain the ability to respond quickly to emergencies and that the union’s requirement for advance consultation could compromise patient safety in crisis situations. The decision underscores that while unions are entitled to consultation on routine staffing decisions, hospitals have the right to take immediate action in genuine emergencies.

 

Citation: Hart, Arb. · 2026 CanLII 2047