The Southlake Regional Health Centre president and CEO is being accused of throwing her nurses under the bus and violating the hospital’s code of conduct after publishing an online blog describing an overnight shift at the regional health centre.

Arden Krystal, who took over the helm at the Newmarket hospital in 2017, publishes a column to encourage open dialogue about “hits and misses” at the organization, but her attempt at transparency has faced a backlash.

In the Dec. 11 issue of her blog, “The Real Deal with Arden,” Krystal reported her observations after spending time “on the front line” — a 12-hour night shift accompanying two patient transporters.

Krystal had words of praise for staff working in the palliative care, intensive care, birthing and post-anesthesia care units and the ER.

A former registered nurse herself, she said she was filled with admiration and pride at the commitment, compassion and purpose she observed.

“But,” she added, “I did also see some areas for improvement — some of which concern me greatly.”

She described staff using the “f-bomb” in front of patients and family, nurses ignoring visitors waiting to be buzzed in and garbage, soiled linen and dressings left on a patient’s floor.

She observed stretchers made up with hospital linen and arranged in lounges for nurses to sleep on during breaks — and those breaks often lasting three hours, leaving the floor understaffed and delaying patient transfers.

“This is not OK, folks. The (emergency department) is usually filled to the brim and they need help. And, it’s not fair for patients to get less care than they deserve.”

On one unit, Krystal said, the hallway was crowded with furniture removed from the report room to allow space for nurses to lie out on stretchers during breaks.

The hospital’s old, outdated buildings with narrow hallways are already crowded, she said.

“Creating even more clutter creates hazards for trips and falls and makes evacuation more difficult.”

During one of those sleep breaks, she said, a patient was brought to be admitted to the floor, but was ignored by the three nurses there.

One nurse was sitting at the desk reading social media on her phone. The other two were in conversation.

That was disrespectful, she said.

“How hard would it have been to greet the patient and reassure her?”

She noticed staff keeping themselves warm with patients’ linen, while ignoring a “freezing” elderly patient on a hallway bed, exposed with only a gown on and blanket at her feet.

“It broke my heart to see the nurse helping herself and not helping the patient,” Krystal said. “Come on, this isn’t what we stand for at Southlake.”

Several nurses defended their need for more sleep time, saying they are finding it hard to cope with high stress, working in a “broken system” and asked to do more with less.

Krystal said research from the National Sleep Foundation actually shows a short nap of 20-30 minutes provides the maximum benefit for maintaining alertness and reducing grogginess.

“Longer naps of two to three hours make it hard to wake up quickly, be alert and may cause subsequent safety issues as a result,” she said.

In a statement emailed to YorkRegion.com, Vicki McKenna, president of the Ontario Nurses’ Association, said it is unfortunate Southlake chose a public forum to comment on internal matters.

“As this is a labour relations issue, the Ontario Nurses’ Association will not discuss issues of this nature in public. We will address the comments in private in the near future.”

Reaction from the public to the blog was quick — and scathing.

“As a family member who has a daughter working as an RN at Southlake and recently had my father and husband land in the cardiac ward the same week, I’m horrified and disgusted that you would use a public blog to trash any of your employees,” Cathy G. posted on the blog.

“Envision what you have written on the front page of the newspaper. Is this really how you want Southlake portrayed? The CEO openly calling out nursing staff in a publicly degrading way, like they are child criminals requiring public flogging?” Ellen posted.

Steph posted that she wished the CEO had chosen an alternative route, such as an email for staff only, rather than a public blog.

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“This does not inspire confidence in your facility and staff. I would be afraid to come to Southlake.”

Krystal defended the blog, agreeing that it is an unconventional approach, but saying conventional approaches do not seem to be working.

“I admit that being this open may feel risky, but I think it’s a risk we should take,” she posted online.

“It is only through transparency that things change . . . The fact that we name these issues and talk about them — and try to fix them — should fill folks with more confidence.”

One Southlake employee suggested Krystal had violated code of conduct rule by “discussing workplace conduct, concerns and conflicts in front of others” and contravened the social media protocol advising against posting content damaging Southlake’s reputation.

Krystal said hospital policies do not preclude her or anyone from making factual observations that don’t identify individuals for the purpose of trying to make improvements.

In her latest post to the blog Dec. 16, Krystal addressed some of the controversy over the public nature of the discussion.

Some of those concerns were valid, she wrote, and in order to make it only internal to the organization, “on Friday, we took the link off the external website.”

Comments are now closed. The link, however, can still be viewed and shared.

More people read the Dec. 11 blog than any of her other blogs to date, Krystal said.

“I’m sorry if discussing this broadly has offended some people. This blog wasn’t meant as a criticism of all nurses or other staff,” she said, adding the overwhelming majority of Southlake employees are caring, compassionate and hard-working.

Morale is hurt when those who work hard and follow the hospital’s standards see others not following them, with no consequences, she said.

There was some positive feedback to the blog.

Gwendolyn Robertson wrote it is good to have someone “steering the ship that doesn’t pontificate, lays it out as it really appears — and appears to honestly give a darn.”

Others posted that, as employees, they have seen nurses argue about who gets first break, with three-hour breaks the norm and “everything put on hold until they wake up.”

“Excuses have to stop. Patient care is our business,” wrote another.

Krystal was not available for an interview, but provided this emailed statement to YorkRegion.com: “I use my blog to communicate ideas and generate two-way conversation about both our successes as an organization and areas where we can work together to improve.”