Canadian nurse living in U.S. seeks permission to work in small B.C. hospital

UPDATE, April 3, 2021: Krisztina Pap has told CBC that she received her quarantine exemption on March 28 and returned to work at South Okanagan General Hospital the following day. "The team at SOGH is very happy to have Krisztina back at work," the Interior Health Authority said, confirming her exemption.

A Canadian nurse living in the U.S. says she has been waiting two months for a quarantine exemption so she can provide care at a short-staffed B.C. hospital where seniors are the majority of patients.

Krisztina Pap is an acute care nurse at South Okanagan General Hospital in Oliver, an 18-bed hospital serving the southern B.C. town of about 5,000 people and surrounding rural areas. 

She's Canadian but lives in Oroville, Wash., just south of the Canada-U.S. border, about a 30-minute drive from the hospital.

As an essential worker, she was able to cross the border to her job without quarantining.

But on Jan. 9, at the Oroville-Osoyoos border crossing, she said a Canada Border Services Agency officer asked her a question she hadn't been asked before: are you going to care for people 65 years and older?

"I said of course," Pap said. "In acute care, we don't really pick our patients."

Pap said the agent told her that answer put her in violation of a rule forbidding border-crossing workers from providing direct care to seniors without a 14-day quarantine.

Pap said it would be impossible to not directly care for seniors at her hospital. Most of her patients are 65 and older. 

She needs an exemption from the Public Health Agency of Canada to continue working without quarantining.

The local health authority and a local MP are trying to get her one as soon as possible but it's now been almost two months of trying with no success.

'I started crying'

Pap said she was told through work in December she would need to request a quarantine exemption. She said she believed the issue was making sure she was following PPE protocols. On Jan. 4, she applied for the exemption.

But then on Jan. 9 the CBSA agent sent her home over working with people over 65.

"I was very frustrated and angry. I started crying," Pap said.

On Jan. 11, Pap went back to the crossing and was let through.

She said a CBSA supervisor at the crossing expected an exemption would be issued to her within two weeks, and with that in mind, gave her a two-week exemption to the quarantine requirement.

The permanent exemption never came. The last time she worked was Jan. 20.

The only substantive response from the Public Health Agency of Canada, Pap said, was an email last week saying the agency is busy and will consider her request.

"I think it is negligence from the public health office, especially [when] there is a shortage of nurses," Pap said.

Officials involved

The Public Health Agency of Canada told CBC News it couldn't comment on Pap's situation for privacy reasons.

Pap shared multiple emails and letters with CBC written by her manager at South Okanagan General to the agency.

They describe how it is "imperative" that Pap return to work soon because COVID-19 has increased the burden on the hospital's nursing staff, which has six unfilled positions.

"Krisztina is a valuable member of our team at SOGH," Interior Health, the local health authority, said in a statement to CBC. "We have been supporting her efforts to return to work as quickly as possible."

On Monday, local MP Richard Cannings sent a letter to federal Public Safety Minister Bill Blair and Health Minister Patty Hajdu asking that Pap be exempt from quarantine.

"We have a case here where the health of the people in the South Okanagan, I think, is being compromised because of this rule," Cannings said in an interview.

What happened?

Toronto-based immigration lawyer Henry Chang said there could be a few reasons why Pap was able to cross the border for months without the long-established rule about not directly caring for seniors stopping her.

Asking about it may not have been a priority for the border agents she encountered. They may not have been aware of those rules or how to apply them.

"It may be that they just say, oh, you're a nurse, you're crossing the border weekly, go ahead," Chang said. "And that's probably what's been happening with this particular person up until this point.

"It was inevitable the issue was going to come up at some point."

Chang said the process of getting an exemption, generally, can be lengthy.

He said it makes sense to have strong quarantine measures in place to protect seniors but the health system may benefit from having some essential requests processed faster.