Government’s plan to gut and prohibit harm reduction programs will lead to more deaths
Following an announcement from Ontario’s Minister of Health that the province will close 10 supervised consumption services (SCS) sites across the province, RNAO CEO Dr. Doris Grinspun told CBC News’ Power & Politics (Aug. 20) that more people will die and communities will be overburdened. “The government knows very well that not everybody is ready for treatment,” Grinspun said. And while RNAO welcomes the newly announced Homelessness and Addiction Recovery (HART) Hubs, as these will provide mental health and social services, “…we were expecting also an expansion of SCS and CTS (consumption treatment services).” The closure of these 10 SCS sites means persons will be using substances alone in alleyways, and that’s a death sentence for them, given the high level of toxic drugs circulating, Grinspun said. Drug toxicity killed 3,800 people in 2023, and that number will go up in 2024, she warned. In addition to more deaths, the decision to exclude SCS and needle exchange from the new HART hubs will lead to a rise in HIV and hepatitis C infections, as people will be injecting with used needles, which will be left in our streets, parks, coffee shops and parking lots, thus also making communities more unsafe. The failed policy will place a burden on paramedics and emergency departments. “It will cost a fortune in taxpayers dollars,” Grinspun said, noting the already overburdened health system will soon deal with a higher influx of people in crisis. “My heart sunk (at the news),” said RN Hannah Stahl, who works at an SCS site and co-leads Toronto’s Street Nurses Network. “When people fall through the cracks of the system, this (SCS) is what caught them,” she told the Toronto Star (Aug. 20).
Sign RNAO’s Action Alert calling on Premier Doug Ford to withdraw his plan to gut and prohibit SCS sites in Ontario. And read more in Grinspun’s Conversations with Members in this issue.
RNAO celebrates Pride
RNAO and members of the Rainbow Nursing Interest Group (RNIG) marched in Toronto’s Pride Parade alongside tens of thousands of other attendees to celebrate 2SLGBTQI+ communities (Two-Spirit, lesbian, gay, bisexual, trans, queer, intersex, and other sexual and gender minorities). “Thank you to everyone who participated in Pride festivities and who continue to advocate for equity, diversity and inclusion in health care and beyond,” said RNAO CEO Dr. Doris Grinspun, who took part with NP President Lhamo Dolkar on June 30. Pride month may have ended, but RNAO remains committed to working with members of 2SLGBTQI+ communities to improve health access and advance safe, appropriate care for all. Visit RNAO's Pride 2024 Portal, the 2SLGBTQI+ In Focus page on the website, and download your free copy of the best practice guideline: Promoting 2SLGBTQI+ Health Equity.
Earlier this year, RNIG asked its members to share personal stories to raise awareness of the challenges they face in their practice and providing care. Read Queer nursing: Stories of thriving 2SLGBTQI+ care providers. These are the first in a series of stories that will be published in RNJ and the RNIG newsletter.
New data shows Ontario’s nursing shortage is getting worse
A report by the Canadian Institute for Health Information (CIHI) reveals worsening nursing workforce trends in Ontario. The province now needs 26,000 additional RNs to catch up to the RN-to-population ratio in the rest of Canada. The gap between Ontario’s ratio and that of other provinces and territories has widened three per cent since 2022. “We need more RNs across all sectors working full-time at full scope, providing direct care to Ontarians,” RNAO President NP Lhamo Dolkar said in RNAO’s media release response to the troubling news (July 25). In a follow-up interview with 570 News (July 29, starting at 1:12 in the program), Dolkar reiterated what RNAO has said for years. “This is the ninth consecutive year that Ontario has had the worst RN-to-population ratio.” Dolkar also said the nursing shortage “has been an ongoing issue. We have to focus more on harmonizing the wage upwards across all sectors.” Compensation is important, she said, but not the only issue. She also addressed the need for safer working environments, healthy work-life balance, full-time opportunities and mentorship as vital to retaining and recruiting more nurses.
More support, less stigma saves lives
A community forum held in Brockville on July 25 brought together organizations working to support people struggling with mental illness, substance use and issues such as homelessness. The forum, which included a number of booths, was organized by Rideau Community Health Services, in partnership with the Brockville Police Service. A handful of crosses were planted in the grass to honour the lives of local residents lost to mental illness or substance use. RN Andrea Keller’s son Tyler died from overdose in March 2017. He was 26. “There are services around, but if you talk to (people representing them at the forum), every single one of them, they’ll tell you we need more,” Keller said. Amber Gilmour, a community health RN who works at Rideau, said they didn’t have enough crosses to mark all of the lives lost. “There’s a lot of shame and stigma,” she said. “People don’t always get the chance to be remembered.” (Brockville Recorder & Times, July 26)
Clinic sees drop in overdose thanks to safer-supply program
The Peterborough 360 Degree Nurse Practitioner-Led Clinic has seen a major reduction in overdose deaths since introducing its safer-supply program in 2022. A June 2024 report published by the clinic revealed a 79 per cent decrease over the previous six months compared to the first six months of the program. Approximately 86 per cent of the 30 individuals surveyed reported using less or no fentanyl after 12 months in the program, with half of those reporting a reduction in use and the other half reporting abstinence. NP lead and clinic director Kelly Pensom said: “This program has highlighted the positive impacts on the health and wellbeing of people who use drugs when their care is embedded within a destigmatized primary care team dedicated to trauma informed harm reduction.” The Peterborough program is one of 25 pilot programs funded by Health Canada (Global News, June 13).
RNAO member is new minister of long-term care
RN and MPP Natalia Kusendova-Bashta became Ontario’s Minister of Long-Term Care after a cabinet shuffle announced on June 6. Kusendova-Bashta, a proud RNAO member, had previously served as the parliamentary assistant to her predecessor Stan Cho. At RNAO’s AGM, she reminisced about attending her first political event as a nursing student, and described how it inspired her to pursue a career in politics. “The very first time I went to Queen’s Park was with Dr. Doris Grinspun…as a student…I fell in love with it…I fell in love with the incredible advocacy work that nurses do,” she told colleagues at the AGM opening ceremony. Kusendova-Bashta said she believes health should be considered in every government policy. In her role, she wants to ensure seniors have the quality of care they deserve. “I realize all the challenges that lay ahead,” she said about fixing long-term care. “And I find comfort in the fact that I have incredible leaders and experts, many of you in this room (at the AGM) who will guide me, as you have in the past.” We need more nurses across the continuum of care, she said, including and especially in long-term care. More NPs in long-term care “is how we will build capacity,” she said. Read more about NPs in NPs improve access and equity of care across Ontario.
Sudbury program eases loneliness in older adults
An innovative program in Sudbury is connecting older adults with children through intergenerational storytelling. Public Health Sudbury and Districts partnered with The Older Adult Centre to host GrandPals, an idea developed in Canada, at the local public library. The aim is to tackle the issue of isolation. “It’s neat to find a program like this established in Ontario,” said public health RN Larysa Vares. “We had three GrandPals (older participants) and each week we had eight to 12 children attend. Each GrandPal was paired with three to four young people every week,” Vares explained. The goal is to keep the children with the same senior every week so they can form a bond over the span of the seven weeks. “At public health, we have a role to play in healthy aging for older adults. We look at ageism and social isolation particularly. Those are two big societal issues,” Vares said. (Sudbury Star, May 15)
Supporting international RNs to practice
A Brampton hospital is making strides to integrate more internationally educated nurses (IEN) into its workforce. William Osler Health System launched a Supervised Practice Experience Partnership (SPEP) program two years ago to help IENs who are going through the nursing registration process and need to satisfy two of the requirements: evidence of practice and language proficiency. RN Manpreet Gill took part in this program and says it helped her get licensed and land a “dream job.” She described the experience to the Brampton Guardian (May 12) as “…very different than back in India. Here we are using different equipment. Osler gave me the opportunity to learn the hospital structure and how to work (as a nurse) in Canada.” Her experience is not indicative of every IEN’s experience in Ontario. RN Emil Patricio, who currently practises in Guelph, had to travel to Alberta and pay $7000+ out of pocket to be licensed before moving back to Ontario. “People from the Philippines are known for health care…our education there as a nurse is very comprehensive,” he said, acknowledging that he was disappointed by the challenges he faced. Patricio spent a decade volunteering at local hospitals and working as a PSW while working towards his recertification. RNAO CEO Dr. Doris Grinspun acknowledged that although RNAO is not the regulatory body, she apologizes “…on behalf of the profession to every single internationally educated nurse who is going through hurdles that are absolutely preventable.” RNAO continues its support and advocacy for IENs, and created a discounted category of membership – IEN associate – for those who reside in Canada but are not yet registered to practise. (CTV News, June 5)
Vaccine clinic helps children face fears around needles
A pediatric vaccination clinic at Children’s Hospital, part of London Health Sciences Centre, is addressing the stress and anxiety children can often feel when getting needles. The clinic was initially launched as a pilot project during the pandemic (2021). It has since received provincial funding that allows it to become permanent. The clinic has helped more than 300 children and the hospital expects the number to double within the next year. “Our goal is to work with each child and their family to come up with a game plan that will allow that child to successfully receive their vaccine on their own terms,” NP Leah Ethier said. The clinic supports babies as young as six months and children and young adults with special needs up to 18 years of age. Its success rate (vaccinations administered without requiring a second visit) is 92 per cent. (London Free Press, June 18)
Niagara Health wound care team healing patients
Niagara Health’s Wound Care team is helping to provide care for patients who may be dealing with serious issues, such as sepsis. RN Abi Osisanwo is one of five nurses trained to identify wounds early and provide appropriate treatment. Some illnesses, such as necrotizing fasciitis, can result in scarring, loss of a limb, sepsis and death. The wound care team at Niagara Health works collaboratively with nurses, doctors and other health-care workers to help patients who may come to hospital with pressure injuries or bed sores. “The body is amazing,” Osisanwo said. It “…heals itself but our role is to help prevent complications, such as infection or inflammation that would delay healing.” Interested in learning more about wound care? Attend the self-directed Wound Care Champion Program, designed by Wounds Canada in collaboration with RNAO. (St. Catharines Standard, May 30)
Sudbury supervised consumption site in need of support
Sudbury’s only sanctioned supervised consumption site (SCS) – formally called Minoogawbi, La Place, The Spot and informally known as The Spot – was forced to close its doors at the end of March. The city terminated its funding of the site at the end of December 2023, suggesting the province step in. The site continued to stay open through March thanks to donations. RNAO President Dr. Claudette Holloway was in Sudbury in January, sharing with local media that the SCS affects more than just the clients it serves. “When you fund this kind of treatment centre, it’s going to have an impact and reduce pressures on hospitals and emergency rooms,” she said (CTV News, Jan. 26). In the same CTV News story, RN and Sudbury and District chapter executive member Neil Stephen added that SCSs “see a reduction in local crime rates.” SafePoint, an SCS in Windsor, also closed on Jan. 1 and is seeking funding. However, the government has frozen approvals on SCS applications while it reviews safety protocols around the sites. This freeze is having a direct impact on those who rely on these services. “People who use these toxic substances recognize that they could die. (With these sites) they have access to not only safe supply, people who will witness in case they collapse but also have access to people who accept them for who they are – who help them try to get other services and give them medical care,” said RN and harm reduction advocate Kathy Moreland (AM 800, April 2). Join the more than 1,200 people who have already signed RNAO’s Action Alert to call on the premier to lift the freeze on SCS approvals.
National pharmacare announcement
Federal minister of health Mark Holland introduced Bill C-64, An Act respecting pharmacare, in the House of Commons on Feb. 29, 2024. This initial stage of national pharmacare – which RNAO has long advocated – will include coverage for contraception and diabetes medications, once provinces sign on to the plan. This will ensure Canadians are able to get the medications they need without the worry of how to pay. In a media release, RNAO President Dr. Claudette Holloway said “this legislation is significant because it brings us one step closer to RNAO’s long-standing push for a universal program. When fully realized, it will advance equity and fairness in our health system.” RNAO CEO Dr. Doris Grinspun said that nurses support pharmacare, but the program must expand. “It goes without saying that nurses stand fully behind (the plan). We also stand fully behind...a single payer system. Our end goal...is that it be comprehensive," Grinspun said, adding that she wants Ontario to be the first province to sign an agreement with the federal government. (Benefits and Pensions Monitor, March 7)
Changes to RNAO’s membership team
Daniel Lau, RNAO’s director of membership and services for 22 years, stepped down from his role in January 2024 and is set to retire in June. Continuing to work as a special resource to CEO Dr. Doris Grinspun, Lau says he is immensely proud of the growth of RNAO and will miss working with the team. “During my time at RNAO, membership grew from less than 15,000 to more than 50,000,” he says proudly.
Joining the senior management team is RN Morgan Hoffarth. “I thank Daniel – deeply – for his immense contributions to RNAO,” says CEO Dr. Doris Grinspun. “Daniel leaves big shoes to fill and I am confident that RNAO’s membership growth will continue to cross many milestones under Morgan’s leadership.”
Hoffarth was RNAO president from 2020 to 2022 and says: “During my presidency, one of the areas I focused on was membership and the importance of supporting and engaging with members. The transition to director of the membership department is aligned with my vision as president. I believe RNAO membership is critical for nurses across the province.”
Hoffarth attended McMaster University, where she obtained a BScN. She also has a master’s degree in nursing from York University. Having worked in both acute care and long-term care settings during her career, Hoffarth’s most recent role was director of care at St. Joseph’s Health Care London.
RN and former patient now work as colleagues at rehab hospital
RN Jorge Santos has the unique experience of getting to work alongside one of his former patients at Toronto’s Holland Bloorview Kids Rehabilitation Hospital. Santos’ colleague is Emily Chan, a social worker who, until the age of six, underwent physical rehab at the hospital. Santos says the experience of working together 30 years later has been incredible. “Working with her is just – too special. It’s so amazing because I was part of her development…she showed me a picture of us when she was two (years old). When I saw that picture, I had tears in my eyes,” said Santos. Chan says she’s looking forward to helping other children with disabilities regain their full independence. (Global News, Jan. 23)
Mexico joins the #BPSO social movement of science
RNAO’s Best Practice Spotlight Organization® (BPSO®) Program is again expanding its reach beyond Canadian borders. Two organizations in Mexico – the University of Monterrey (UDEM) and Christus Muguerza, a health organization that includes 15 hospitals – have joined the program with a promise to implement BPGs related to pain management, falls and vascular access. A signing ceremony took place on March 19 in the city of Monterrey, Mexico.
"We’re proud that the BPSO program has expanded to more than 1,500 health organizations globally and is considered the gold standard for quality care and teaching," RNAO CEO Dr. Doris Grinspun says of the program she founded, and that celebrated its 20th anniversary in 2023. "We look forward to working with Mexican leaders to support them as they engage in this social movement of science, implementing guidelines and evaluating their positive impact."
Read more about these new international partnerships in the newsroom at RNAO.ca
Membership category update recognizes IENs
RNAO has changed the name of the Newly Graduated Nurse membership fee category to New RN in Ontario. The change now includes internationally educated nurse (IEN) associates. IENs who are newly registered with the College of Nurses of Ontario and are eligible to practise in the province are eligible for free RNAO membership thanks to the generosity of HUB International, one of the association’s affinity partners. Learn more about this new category on RNAO.ca
Expanded health centre provides care for vulnerable youth
NP Beth Hayhoe has been volunteering with Toronto’s Yonge Street Mission for nearly 30 years. The organization recently spent $3 million to expand its health and dental centre for youth in the city’s downtown neighbourhood. The site – which went from a 700-square-foot basement to a 4,600 square-foot space thanks solely to donations – provides care for people between 16 and 24 who are in precarious living situations. Eye exams, dental care, physiotherapy, mental health care and podiatry care are among the services provided, with wraparound supports such as employment and housing. Hayhoe says many of her clients have grown up without a lot of support in their lives. She hopes that with a newly renovated centre dedicated to serve youth, they will see that “they’re valuable enough to make this beautiful place for them and to have people come and take care of them.” (CBC News, March 2)
NEW BPG soft launch: Clinical Practice in a Digital Health Environment
Following the intense and exhaustive work of an expert panel, researchers, policy makers, people with lived experience, and the guideline development team at RNAO, the association’s newest BPG was previewed during a webinar in March, six weeks before its official release during Nursing Week 2024 in May. Clinical Practice in a Digital Health Environment is the result of a years-long development process that included the determination of scope for the BPG and the research and development of key evidence-based recommendations that will help nurses to strengthen their professional practice as today's health environment becomes more digitized.
Watch for details of RNAO’s various Nursing Week events for full details on the upcoming launch and publication. (RNAO.ca/news)
Roving simulation cart brings education to nurses
Mackenzie Health in Richmond Hill offers simulation training for its staff through Sim2You, a mobile simulation unit that allows teams to learn in non-traditional ways. “Using the Sim2You roving cart, we’re not only ensuring that training is more accessible to our staff, we’re also enhancing how they can adapt some of the real-life situations they may encounter in their day-to-day work caring for patients,” said simulation program lead and RN Christina Scerbo. The mobile unit, which was introduced a little over a year ago, takes its cues from staff. In a recent exercise, a mannequin’s arm was sprinkled with powder before a nurse disinfected it to insert a central line. A blue light was then directed at the arm to identify spots that may have been missed and where there’s a risk of infection. These simulations allow staff to learn how to adapt to situations and how to work as a team. “Our simulation labs immerse health-care professionals in dynamic scenarios, fostering swift and coordinated actions,” said RN Deborah Lefave, one of the program’s educators. (Hospital News, March 27)
Letter to the editor
In a letter to the editor published before the release of the provincial budget on March 26, RNAO CEO Dr. Doris Grinspun takes aim at clinics that charge for health care and advises on how NPs and NP-led clinics must be fully covered by the province to ensure timely access to quality care by NPs. (National Post, March 24)
Unfortunately, Eileen Murphy’s experience of being charged for health care in Ontario is not an isolated case. RNAO, which represents registered nurses and nurse practitioners in Ontario, knows of other clinics in the province that charge clients to access nurse practitioner services. This is unacceptable. Also unacceptable is that 2.3 million Ontarians don’t have consistent access to primary care.
To keep healthy and prevent complications when ill, everyone must have access to primary care in our publicly funded health system — without having to pay a fee. Nurse practitioners play a critical role delivering comprehensive, top-notch primary care and access to their expertise is essential. Access to nurse practitioners must be covered by the province and not via a price tag to patients.
RNAO calls on HOOPP to get rid of fossil fuel holdings
In September, RNAO sent a letter to the Healthcare of Ontario Pension Plan (HOOPP), which represents nurses and other workers in the hospital and community sectors, urging that it immediately stop any new investments in fossil fuels and divest all its holdings by 2025. This is a must to ensure pension investments focus on a just and sustainable future, not climate disruption. In the letter, RNAO CEO Dr. Doris Grinspun and President Dr. Claudette Holloway applauded HOOPP’s commitment to put $23 billion into accredited green investments by 2030, but said the fossil fuel shares it holds are at “at odds with RNAO members’ professional values and our commitment to serve the public as the first mandate of health professionals is ‘do no harm.’” In a radio interview (The Energy Mix, Nov. 20), Grinspun said that HOOPP is a “tragically literal example of investing in one’s own demise.” Earlier that same month, RNAO President Dr. Claudette Holloway and President-Elect Lhamo Dolkar attended the March to End Fossil Fuels in Toronto. RNAO continues to call on the provincial and federal governments to put forth a science-based plan to respond to the climate emergency. Sign RNAO’s Action Alert.