To prepare for a second wave of COVID-19, RNAO CEO Doris Grinspun is calling on the government of Ontario to adopt several long-term care recommendations by July 31. In an op-ed in The Globe and Mail, Grinspun writes that during the first wave of the virus, there was a lack of early prevention measures and health-risk awareness. “Any preparation carried out was targeted to the already resource-rich hospital sector, leaving the other sectors to fend and fail for themselves,” writes Grinspun, adding there is no time to wait until April, when the results of the recently announced commission looking into how the LTC system responded to COVID-19 delivers its report. Included in RNAO’s recommendations to the government are calls to implement a Nursing Home Basic Care Guarantee that provides four hours of direct care and a richer skill-mix of regulated and personal support staff in nursing homes, ensuring personal protective equipment is fully available to all staff in long-term care and other facilities caring for vulnerable persons. RNAO is also calling for immediate and full implementation of the five-step plan proposed by RNAO for reuniting families in long-term care. In addition, less invasive surveillance testing, immediately isolating residents with the virus, and ensuring facilities have quarantine plans in place and single-occupant rooms have personal bathroom facilities. (The Globe and Mail, July 20)

Brantford General Hospital resumed elective surgeries in June, following months of these being put on hold because of COVID-19. Martin Ruaux, vice-president of clinical programs and chief nurse executive for Brant Community Healthcare System, says the surgeries resumed on a gradual basis, with the most urgent performed first. The plan was to start by working at 25 per cent of normal activity for two weeks, then ramp it up to another 25 per cent every two weeks, Ruaux says. Pre-pandemic, the hospital was performing about 42 elective surgeries each day. Those non-emergency procedures were put on hold on March 15. To resume elective surgeries, hospitals must ensure the number of COVID-19 cases in the community is stable. They must have a stable supply of personal protective equipment and medications, as well as a sufficient number of patient beds and appropriate staffing levels. “Our priority has to be the safety of patients and staff,” says Ruaux. “I’m proud of the way the organization has come through this. We’ve learned a lot that we can use during a second wave.” (Brantford Expositor, June 9)

In Hamilton, nearly a quarter of all COVID cases reported in June – 180 of 747 – involved health-care workers. A job-by-job breakdown shows PSWs bear the highest burden with 57 cases. Nurses are the second-highest with 48. Hamilton Public Health, which released the data, says 82 per cent of infected workers are women. RNAO CEO Doris Grinspun says the data make sense since the majority of health-care workers in Ontario are women. In the case of PSWs, many receive lower wages, are people of colour, and work more than one job, Grinspun adds. This is why workers need to be better protected, not only with better access to personal protective equipment, “but with good jobs that pay well and where people don’t need to be struggling,” she explains. Of the 180 Hamilton health-care workers who tested positive in June, nearly 50 per cent caught the virus on the job, with their case connected to a facility or institutional outbreak. A quarter of cases are community acquired, meaning public health doesn’t know how they got sick. (Hamilton Spectator, June 11)

Louela Manakil-Rankin and Karey McCullough were recognized by RNAO at its 95th Annual General Meeting (celebrated virtually) for their tremendous leadership in nursing education and nursing research, respectively. Manakil-Rankin, who has worked in nursing education for 20 years and is currently an assistant professor at Nipissing University in North Bay, says she has a passion for undergraduate education, and credits her professional and personal values for her teaching approach. “I believe that a competent nurse is a thinking nurse. It is someone who can reason clinically and make a prudent judgment,” Manakil-Rankin says. McCullough also works as an associate professor at Nipissing University and recently completed research on Indigenous wellness in North Bay’s Anishinabek Nation community. Her passion for research came from her own curiosity and always being interested in how thinking is informed when it comes to best practices in nursing. For more information about other RNAO Recognition Award winners in 2020, read their biographies online. (BayToday.ca, June 18)

Angela Cooper Brathwaite, RNAO immediate past-president and co-chair of the association’s Anti-Black Racism Task Force, writes a letter to the Brampton Guardian (July 9) about systemic racism in Canada’s health-care system. The letter is in response to news that Leonard Rodriques, a PSW who passed away from COVID-19, was reluctant to seek medical help because he feared he would be treated differently because he was Black.

The litany of health-system failures that contributed to the death of Leonard Rodriques, and subjected his family to untold grief and loss, can only be understood as manifestations of a health-care system deeply rooted in systemic racism. That Mr. Rodriques was reluctant to seek medical help because he feared he would be treated differently because he was Black is telling in itself. The treatment Mr. Rodriques received must be a wake-up call, and RNAO is calling for a coroner’s investigation into his death. In Ontario, a coroner may become involved when concerns are raised regarding the care provided to an individual prior to death.

There are multiple questions that must be answered: Why wasn’t he provided with personal protective equipment (PPE) in his workplace when it was known other workers had been infected? Why was he discharged from hospital even though he was a health-care worker who worked at a facility experiencing an outbreak, and was obviously suffering from symptoms? Why didn’t an ambulance show up when the family called 911? Why was the family left to deal with his body in such a disgraceful way after he died in his sleep at home? Why was he cremated against his family’s wishes?

As nurses, we send our deepest condolences to his wife Dorothy, to whom he was married for 33 years, and to his children Terena and Temall. We also thank them for the courage to speak out. We know of others who have had similar experiences, and fear speaking out.
Racism permeates every aspect of our society and its institutions, including health care. Combatting it requires substantive and sustained efforts to ensure structural and behavioural changes. Answering vital questions about the death of Mr. Rodriques is a good starting point. Calling a coroner’s inquest into his death is the first step.

RNAO is also doing its part, committed to cleaning up our own backyard within the nursing profession. This is why we are launching a task force to tackle anti-Black racism within the profession.

To show their support for nurses and other frontline workers fighting COVID-19, people from Ontario and across Canada are cheering them on every night at 7:30 p.m. local time. As part of the #TogetherWeCanDoIt campaign to #Cheer4HealthWorkers – spearheaded by RNAO’s Susan McNeil, staff, board, assembly and general members – and by now – the public at large – people are sharing videos on Twitter and Facebook of themselves banging pots and pans, singing, honking and clapping from their places of isolation, whether a front porch, deck, a balcony or through a window. RNAO’s Region 4 board representative Anita Tsang-Sit banged a pot while commending nursing colleagues and other health-care professionals during the outbreak. “Thank you to health-care superheroes who risk their lives for us every day,” she said in her Twitter video. RNAO Interest Groups representative Julie Rubel also participated, saying in her Twitter video: “We just want to say thank you. We’ll be out here every night at 7:30.” RNAO encourages everyone to take part while also keeping in mind safe social distancing (maintaining at least two metres of distance between you and others). To see how others are cheering on frontline workers, visit RNAO on Twitter and Facebook, and search the hashtags #Cheer4HealthWorkers and #TogetherWeCanDoIt.

An ongoing nursing shortage at the Chelsey site of South Bruce Grey Health Centre (SBGHC) has led to a reduction in hours for the hospital’s emergency department, which has gone from 24/7 coverage to a 12-hour schedule (8:00 a.m. to 8:00 p.m.). The new schedule will be in place until positions can be filled, says interim chief nursing officer Lynn Bos, who is recruiting RNs, but says they need more senior RNs with emergency department experience. “We have had some success recruiting new nurses in the last couple of months, however, these nurses are new graduates or have limited (emergency) experience,” she says. The situation at SBGHC is not unique as hospitals in rural communities often face challenges recruiting and retaining RNs. Nurses are required to develop a high degree of competency in a number of clinical domains and specialties, Bos suggests, and new graduates can often be unprepared to work in a rural setting without significant orientation and mentorship. (Owen Sound Sun Times, Jan. 8)