Inquiry releases its report into long-term care homes
After months of anticipation, a public inquiry, called for by RNAO, delivered its recommendations for ensuring the safety and security of residents in the long-term care (LTC) system.
Announced by the government in 2017, the inquiry was prompted by the crimes of former nurse Elizabeth Wettlaufer. Over a nine-year period between 2007 and 2016, Wettlaufer killed eight residents at several nursing homes in south-western Ontario by injecting them with insulin.
At a media conference on July 31, inquiry commissioner Justice Eileen Gillese released her report, which contains 91 recommendations that cover measures the Ministry of Health, the College of Nurses of Ontario, home-care service providers, and the Office of the Chief Coroner should adopt.
RNAO CEO Doris Grinspun says the report honours the lives lost and provides a detailed plan of improvements needed to overhaul the sector. It exposes systemic issues that made it possible for Wettlaufer to get hired by an LTC home even though she had been fired from her first nursing job at a hospital after stealing narcotics and using them to try to kill herself. It calls for a requirement that homes adopt better hiring and screening practices, including background checks and improved training with respect to hiring and discipline. And it urges the ministry of health to increase the number of registered nursing staff in LTC homes by conducting a study and publicly releasing the results by July 31, 2020.
“We have long said that regulated staff must be increased in long-term care. It is the only way we can ensure dignified, safe and quality care,” says Grinspun.
RNAO was also pleased to see a recommendation that the government “encourage, recognize, and financially reward long-term care homes that have demonstrated improvements in the wellness and quality of life of their residents.” Grinspun says this addresses a major concern of nurses and nursing home operators. Currently, the government cuts funding to LTC facilities when resident care complexity decreases as a result of implementing best practices. This is because, as residents experience less pressure injuries, fewer falls, and overall improved health outcomes, a facility’s case mix index (CMI) decreases. Since CMI is what is used mainly by government to allocate funding, the overall funding decreases. RNAO says this kind of perverse logic actually discourages some home operators from improving quality of care.
RNAO was granted standing at the inquiry, and was represented by Christine Mainville, Lauren Binhammer and Gabriel Edelson, lawyers with Henein Hutchison LLP.
A platform for a healthy Canada
At its Sept. 11 meeting, RNAO’s board of directors released a list of recommendations it wanted federal parties to make note of as they finalized their policy platforms ahead of the Oct. 21 election. A platform for a healthy Canada outlines nine recommendations, including access to health care, social determinants of health, environmental determinants of health, and fiscal capacity. Now, with a new government in place, RNAO will continue to pursue its priorities.
Expanding Canada’s publicly funded, not-for-profit health system – specifically by setting up a national phamacare program and covering dental care and home-care services – is central to RNAO’s federal platform. Re-establishing a national chief nursing officer to contribute to health policy development and human resource planning is also a key recommendation.
The platform contains four recommendations aimed at improving the health and well-being of Canadians, especially Indigenous Peoples. These include implementing the United Nations Declaration on the Rights of Indigenous People as the framework for reconciliation and ensuring Canada’s laws are in harmony with the declaration. Implementing the “calls to action” of the Truth and Reconciliation Commission is another recommendation. RNAO wants the new federal government to ensure sufficient funding and resources to address social, economic and health challenges identified by Indigenous nations, including access to health care, education, adequate housing, and clean water. RNAO is also urging Prime Minister Justin Trudeau and opposition leaders to respond to the National Inquiry into Missing and Murdered Indigenous Women and Girls by implementing the inquiry’s calls for justice in its final report.
Given 1.7 million Canadian families are in need of housing, and more than 235,000 lack a permanent home, RNAO is urging a greater focus on and more investments in housing.
The health effects of climate change are always on RNAO’s radar. Nurses are asking the new minority government to work with the opposition parties to establish greenhouse gas emission targets, develop a stronger national carbon pricing framework, phase out fossil subsidies, and provide more funding for public transit and active transportation.
RNAO says its recommendations can be implemented by increasing the federal government’s fiscal capacity. Increasing corporate taxes and making individuals pay their share of taxes will generate the revenue needed to make the investments RNAO says are necessary to create a healthier Canada.
As in years past, RNAO members were actively engaged during the campaign, highlighting elements of the platform during candidates’ debates and forums, and engaging candidates one-on-one in their ridings. See some examples in our election coverage and at #NursesVote on Twitter.
Transgender clinic opens in Kingston
A new health clinic that opened in Kingston in May is breaking down barriers for transgender and intersex patients seeking health care and resources. Thanks to funding from the Local Health Integration Network, and a dedicated space in the Kingston Community Health Centre, RN Heather Geddes, along with a lead physician and colleague in social work, is helping more than 100 patients with a wide range of services, including hormone therapy and referrals for surgical transitions. “We provide a safe and inclusive environment for the transgender community,” says Geddes. “We provide both medical and social aspects of care...including counselling for family and friends if needed.” The clinic also offers free mental health counselling for patients experiencing gender-identity issues. “The thread (through) all of our programs is to help those who need it most, such as supporting clients experiencing poverty, food security issues, adverse childhood experiences, or are a newcomer to Kingston,” says Geddes. “It’s the best job I’ve ever had…You see how happy you’re making people.” (The Kingston Whit-Standard, Aug. 1 and Kingstonist, July 29)
National pharmacare plan benefits all
In light of a national advisory council’s recommendation to implement universal, single-payer public pharmacare in Ontario, RNAO CEO Doris Grinspun spoke to various media outlets about how Canadian employers should get behind the plan as it will solve many challenges around access to prescription drugs. “When you have national pharmacare, you also get better drug pricing on prescription medicines,” Grinspun says. Currently, Canada’s prescription drug coverage model includes dual public and private coverage, while provinces and territories each adhere to individual formularies. From workers’ health to financial outcomes, universal pharmacare will aid all aspects of the workplace, notes Grinspun. “(Employers) should get behind the plan – and the sooner, the better – because then they also have more power and they can work collectively (to) help influence and push for the issue of bulk purchasing…and proper prescribing.” A national pharmacare plan benefits everybody, not just employers or employees, Grinspun adds. (Canadian HR Reporter, Aug. 1)
Raising awareness about hepatitis C
To mark World Hepatitis Day on July 30, RN Dominica Anderson and fellow nursing colleagues set up a booth at Memorial Park in Sudbury to raise awareness and provide screening for the virus. An interim hepatitis C treatment nurse and primary outreach testing nurse with Reseau ACCESS Network, Anderson did the screening with Point of Care, a tool that provides real-time, lab-quality diagnostic results within minutes. “Because hepatitis C is such an easy virus to cure, it’s super important to be tested. It’s easy to diagnose, it’s easy to treat,” says Anderson, who encourages everyone to get tested as part of routine blood work. Hepatitis C is contracted through exposure to infected blood. Tattoos, piercings, acupuncture, unprotected sex where blood is present, sharing needles, organ transplants, and contaminated medical equipment are all possible means of contracting the virus. About 29 million people globally are living with hepatitis C. Many of those with the virus don’t even know they have it, says Anderson. (The Sudbury Star, July 30)
Image source: Material republished with the express permission of: Sudbury Star, a division of Postmedia Network Inc.
New course for ICU nurses
To prepare RNs for the intensive care unit (ICU), the Chatham-Kent Health Alliance (CKHA) and Bluewater Health have teamed up to create a new critical-care education course. The course includes lectures, simulations, case studies and skills shadowing. “Not only are nurses receiving the fundamentals, they are provided hands-on experience through case studies in a simulation lab,” says Shane Helgerman, CKHA program director of critical care. Before the course was available locally, nurses in the community were sent to out-of-town workshops and online courses to acquire the necessary skills for working in the ICU. The course is facilitated by professional practice nurses, a registered respiratory therapist, and a stroke co-ordinator, with support from the Neurosurgery Education and Outreach Network. “We hope that by offering the...course, nurses will feel more confident to consider a position in the ICU knowing they will receive the fundamentals of critical care,” says Lisa Regan, the Bluewater Health program director for critical care. (The Chatham Daily News, Aug. 20)
RNAO BPSO wins QI award for work on preventing falls
In September, RNAO BPSO Meadow Park, a long-term care (LTC) home in Chatham, won the Quality Improvement Team of the Year award from the Ontario Long-Term Care Association (OLTCA). The award was presented at OLTCA’s annual convention, which took place in conjunction with the Biennial Global Ageing Conference in Toronto. “This was an incredible honour,” says Jessica Francis, the home’s co-director of care. “Our nomination was based on our BPSO work with the (preventing) falls BPG (best practice guideline). We owe a huge thank you to the entire RNAO team for the amazing positivity and support throughout our journey thus far.”
RNAO LTC-BPG co-ordinator Beverly Faubert, who has acted as coach to Meadow Park as it continues to implement BPGs, “…has been absolutely incredible and represents RNAO so well. She is a major asset to the RNAO team,” adds Francis.
Letter to the editor
RN Andrea Baumann writes a letter to the Waterloo Region Record (July 26) about keeping a new supervised consumption site open in Cambridge.
I was deeply troubled to read about the opposition to the opening of a supervised consumption site in Cambridge. As a registered nurse, I have seen the devastating effects of drug use, including fatal overdoses. We need to do more for people in our community who are struggling with drug addiction.
Supervised consumption services are one part of a multi-pronged approach to addressing harms from drug use. Supported by robust public health research, these services save lives by preventing fatal overdoses from a toxic drug supply. Harm reduction services — including supervised consumption services — offer non-judgmental and safe health services that meet people where they are at. Health-care workers can then help individuals who access these services connect with other health and social services, including addiction treatment.
Cambridge residents who use drugs are often on the margins of society and face stigma and discrimination when accessing health services. Yet, each one of us is a human being and deserves access to safe, evidence-based health care. Health policy decisions must be based on the best available research evidence, not on hearsay, opinion or fear. "Not in my backyard" is not reason enough to continue to forestall the opening of this essential service.
Protecting funding for public health
More than 3,700 nurses and members of the public have signed an April RNAO action alert in response to the provincial government’s decision to cut funding for public health. By the end of May, the government slowed its course, announcing it would not move on the cuts for the current year.
RNAO has long advocated for the public health sector because public health nurses play a key role in the health of individuals and communities. In this role, RNs help to prevent and control infectious and communicable diseases, reduce harm from substance use, and ensure the safety of food and water.
That’s why RNAO CEO Doris Grinspun joined other nurses and physicians in May to speak out against the cuts.
At a media conference at Toronto’s City Hall, organized by Joe Cressy, municipal councillor and chair of the city’s board of health, Grinspun said the cuts – especially at a time of deep public health restructuring – create instability and place critical front-end services at risk. While RNAO understands the government’s desire to make the health system more effective by creating 10 public health entities in favour of the existing 35 public health units, Grinspun implored Premier Doug Ford not to cut public health funding. She said the government risks repeating past mistakes, citing the SARs outbreak in which 43 people died.
Private members’ bill to address opioid crisis
RNAO is supporting a private members’ bill aimed at addressing Ontario’s growing opioid epidemic. Mississauga PC MPP Natalia Kusendova, who is an RN, tabled the legislation, called the Mandatory Police Training Act, 2019, in May. If passed, it will require that police officers, special constables, First Nations officers, and inspectors receive ministry-approved training to administer Naloxone for opioid overdoses.
At a May 16 media conference to promote awareness of her bill, Kusendova was praised by RNAO CEO Doris Grinspun for her leadership on the opioid issue: “When people are dying each day, that’s all the evidence you need that we are in the midst of the greatest public health crisis of our time, and having officers trained in carrying Naloxone, and how to administer it, is an important part of a comprehensive approach to saving lives.”
Naloxone is used to temporarily reverse the effects of an overdose from drugs such as fentanyl, oxycodone and heroin.
Grinspun says the bill addresses one of the recommendations from a coroner’s inquest looking into the death of Brad Chapman, a father of three from Toronto who died at the age of 43 of an accidental opioid overdose. RNAO, which had status as a party to the inquest, fully supports the recommendation that the province ensure adequate funding for police officers to be trained and equipped with Naloxone.
As a registered nurse, Kusendova says she believes in “providing police with every tool at their disposal to save lives.” This includes “recognizing the signs and symptoms of an opioid overdose and how to safely and effectively administer Naloxone.”
Across Ontario, 1,265 people died from an opioid overdose in 2017, and figures show that opioids were responsible for the deaths of 1,471 people in 2018.
