RNAO’s continuing media profile: The May report

RNAO continues to be active in the media to keep nurses, other health providers and the public informed of our views and advise during these challenging times. This month, we spoke out on many important issues, including long-term care (LTC), vaccinations, nurse burnout and the measures required to bring an end to the pandemic. I thank RNAO’s communications team for preparing this summary.

On April 30, Ontario’s Long-Term Care COVID-19 Commission released its findings and recommendations. Led by Associate Chief Justice Frank Marrocco, the independent commission provided recommendations on how to address chronic and severe understaffing of the LTC sector, as well as infection prevention and control deficiencies. In a May 1 media release, RNAO welcomed the commission’s report and  was especially pleased to see the recommendation that 70 per cent of staff be full time – a recommendation that aligns with RNAO’s Nursing Home Basic Care Guarantee (NHBCG). The commission also adopted the NHBCG’s recommendation on skill mix, which calls for 20% of staff to be comprised of RNs, 25% RPNs and 55% PSWs. It also adopted RNAO’s recommendation of one NP for every 120 residents, substantially increasing the number of attending NPs. Finally, it also adopted RNAO’S recommendation of one full-time RN per 120 beds dedicated as the Infection Prevention and Control practitioner.

Now, the government needs to listen and promptly take action to ensure all of the recommendations are fully realized, including those related to skill mix, adding more attending NPs and ensuring essential caregivers do not face restrictions visiting their loved ones. They must work to deliver four hours of direct care much sooner than their proposed timeline of 2024-2025. LTC residents and their families have experienced too much devastation to not be promised adequate care levels. The commission also recommends increased funding for home care services – an issue RNAO raised in its Enhancing Community Care for Ontarians 3.0 (ECCO 3.0).

In QP Briefing on May 3 (which I reiterated in a QP Briefing Podcast on May 7), I said that Minister Fullerton is ultimately responsible for the fact that residents died of neglect, and both her and the Ford government should have known early on during the first wave that neglect was costing lives. The tragic deaths were avoidable, yet no preventative action was taken. RNAO hopes that the provincial government will heed the advice laid out, which included all of the recommendations RNAO made to the commission, and immediately implement them. That same day, CTV News quoted RNAO estimating staffing shortfalls of 63% for RNs, 51% for RPNs and 13% for PSWs in LTC settings required to meet the four hours standard of care. In a Canadian Press article on May 3, I said “that unless [Minister] Fullerton is willing to legislate higher staffing levels in long-term care, other changes won't help”.

Unfortunately, the pandemic continues to take the lives of Ontarians, including health-care workers. On April 30, we learned of the loss of Lorraine Gouveia, a dedicated RN who worked at Maple Grove Care Community in Peel Region. “I feel horrified that we continue to lose Ontarians. This shouldn’t be happening anymore,” I told the Toronto Star on May 1. Our thoughts and deepest condolences are with Lorraine’s family, colleagues and friends. Read RNAO’s statement on her passing.

To protect nurses and other health workers, it is imperative that they be fully vaccinated. On May 7, we issued a media release calling on the Ontario government to prioritize nurses’ second dose, since many – even those working directly with COVID-19 patients – only had their first dose. As I told in a widely reported Canadian Press article (May 6), one shot is not enough. RNAO member Amanda Dodge, an ICU nurse, expressed her frustration to CTV News on May 6 that she still had not received her second dose. On May 7, I told the Toronto Sun that Premier Doug Ford should kick off National Nursing week with a second round of doses for nurses in hospital intensive care and other critical care sectors. On May 10 I spoke live on 980 CFPL about the urgent need to protect frontline health-care providers. That same day, the province announced that it would be prioritizing high-risk health-care workers to receive their second dose. This is an example of the power of speaking out and ensuring your voice is heard. It is through the advocacy of our members and the media amplifying our message that we can impact change and ensure nurses are protected from the COVID-19 virus so they can care for others.

RNAO also publicly addressed doctors being paid substantively more than nurses while serving as nurse extenders in ICU, or as vaccinators. This occurs while there are still hundreds of RNs eager to work in ICUs and other units. The situation is similar for vaccination sites. There are thousands of primary care and home care nurses (NPs, RNs and RPNs), as well as 4,500 RN Care Coordinators, not being utilized for vaccination rollout. I spoke to CBC News on May 11 and 12 about how such huge pay discrepancies must upset nurses who are training doctors to do these jobs. The Ontario Medical Association said it was ultimately up to the Ministry of Health to decide how to compensate physicians working as nurses. “If there is nothing to hide, then why not tell us how much they’re getting paid?” I asked in the same CBC News article. As I said in a Globe and Mail article on May 12, the wage discrepancy is causing resentment among the nursing community: “The message that it sends to nurses is that they are not valued in the system for the work they do.” Readers will remember that nurses’ pay has been constrained by Bill 124, and their real remuneration (after inflation) has been going down. RNAO put out an Action Alert asking the premier to exempt nurses and other health-care workers from Bill 124, which forcibly suppresses the compensation of health-care workers by freezing wage increases at 1 per cent. Nurses must be paid fairly for the challenging work that they do on a daily basis. If you haven’t yet done so, please add your voice to over 4,000 who have already signed our Action Alert.

As we continue to work through the third wave of this pandemic, nurses and other health workers are burnt out. On Global News (May 5), I explained that it is the piling up of many stress factors that affect nurses’ mental health, such as the inability to take time off. In the same story, RNAO member Eram Chhogola, an emergency trauma RN, said that the pandemic has been difficult: “This pandemic has become very challenging and taxing.” Chhogala has seen first-hand the devastation caused by COVID-19. “When (patients are) incredibly short of breath and I think that’s the hardest thing to see,” she said. Another RNAO member, Debra Lefebvre told City News on May 8 about the mounting exhaustion: “We are moving toward a place in our careers where we’re feeling a large amount of moral injury and that we’ve been abandoned.” RNAO is dedicated to continuing to advocate on your behalf and encourages you to use your voices to share your experiences and mobilize change. If you need mental health support, please see our list of resources. Please know, YOU are not alone.

On May 20, Ontario announced its new Roadmap to Reopen, a three-step plan to lift public health measures based on ongoing vaccination rates and the improvement of key public health indicators. The province is expected to enter the first stage on June 14, which would allow for non-essential retail to open at 15% capacity, outdoor gatherings of up to 10 people and outdoor dining with up to four people per table. RNAO says this approach, which would have the province stay in each stage for 21 days before moving to the next, is a reasonable approach. We must ensure a fourth wave is prevented and be cautious about advancing the June 14 transition to Step One. The province also lifted restrictions on several outdoor activities ahead of the Victoria Day long weekend. Missing from the list of listed restrictions was outdoor visits with LTC residents, which I flagged immediately in a tweet and also communicated directly to the Premier’s office. On May 21, the Ontario government sent around a memo that LTC residents would be able to have outdoor visits with friends and family. In response to the great news, RNAO tweeted: “This weekend we’ll see more smiles on residents' faces as they smell the gardens and resume some of life’s simple pleasures.” RNAO’s tweet was cited in a May 21 Canadian Press article.

On May 26, the province’s Financial Accountability Office released a review that found the province needs to hire over 37,000 nurses and personal support workers by 2024 to meet their LTC commitments. On CBC News, (please watch at the 9:47 mark) I said that hiring more nurses sooner is crucial for the sector. “It’s essential, not by 2024, (but) by 2022 because if not residents in long-term care will continue to face detrimental consequences.”

In May, vaccine eligibility expanded to anyone 12 or older. Canada’s Chief Public Health Officer Dr. Theresa Tam said that once 75 per cent of the population receives their first vaccination, public health measures may be lifted. Calling it a ‘one shot summer’, Canadians could expect to be able to meet with others outside. I told Radio-Canada (May 14) that this news is encouraging and will motivate people to get vaccinated. In a Zoomer TV panel discussion on vaccine disclosure (May 18), I made it clear that vaccinations are important: “We need to encourage and help health professionals understand that being vaccinated is good to protect ourselves, our communities and our patients.”

On May 14, the Ontario government announced $35M in funding to increase enrollment in nursing education programs in publicly-assisted colleges and universities across the province. The new spaces will be available for fall 2021 and winter 2022 cohorts and will eventually introduce 870 RNs into the health-care system. Money is also being allocated for RPN seats. While pleased with the announcement, RNAO is concerned that Ontario still has the lowest RN-to-population ratio in the country. We simply need to bring many more RNs into the system. RNAO is pleased that the government is committing to a 10 per cent increase of BScN seats and hopes further commitments in subsequent years are in the works. This news follows our recent Work and Wellbeing Survey, which found that many young nurses (26-35) are considering leaving the profession post-pandemic. “This allows those nurses already working to think, ‘Well maybe there is help on the way,” I told City News on May 18. 

On May 30, it was announced that Ontario’s Chief Medical Officer of Health Dr. David Williams will be retiring at the end of June. As you may recall, RNAO has been calling for Dr. Williams to resign since last year, when he failed to act using the precautionary principle at the onset of COVID-19. In August 2020, I told QP briefing that we simply cannot have more of Dr. Williams’ wavering guidance. More than 1,800 residents died, and many could have been saved if universal masking had been ordered early in the pandemic for health providers in long-term care as well as surveillance testing, as RNAO had called for. On May 30, 2021 I told the Globe and Mail that my concern regarding Dr. Williams going back a year was not just “confusing communication” as pointed out by other critics, but also “failure of content in his message.” The new chief medical officer of health will be Dr. Kieran Moore, who is the current medical officer of health for Kingston, Frontenac, Lennox and Addington Public Health. Dr. Moore is also on Ontario’s COVID-19 Vaccine Task Force. I told the Toronto Sun (May 30), throughout the pandemic, Dr. Moore has demonstrated that he follows the precautionary principle: “He has shown consistently that he takes decisive action and that he is ahead of the curve.” RNAO very much welcomes this new leadership and we are confident Dr. Moore understands and appreciates that nurses play a crucial role in ending this pandemic.

RNAO’s advocacy and media outreach resulted in 297 hits in May (as of May 28). We will continue to speak out for our members and for the health of all Ontarians. To keep up with our media coverage, visit RNAO’s official COVID-19 Portal press room.