The cancellation of Greyhound trips in Western Canada and northern Ontario is causing health concerns for those in the affected communities. In Ontario, the move affects seniors who can no longer drive to their medical appointments. Since Nov. 1, Greyhound stopped service between Sudbury and Thunder Bay, affecting cities like Sault Ste. Marie and Terrace Bay. Carol Huard, chief nurse at Thunder Bay’s McCausland Hospital (Terrace Bay), says the change makes it difficult for people in these rural communities. “We have a lot of elderly people. We have a lot of people who don’t like to drive in the city anymore. They would essentially be stranded without the Greyhound,” says Huard. In Terrace Bay, more than half of the 1,600 residents are 50 years or older. Some can no longer drive or rely on their children, who have gone to work in the big cities, adds Huard. (CBC Northern Ontario, Oct. 26) 
 

Ontario’s patient ombudsman may be no more after speculation at Queen’s Park that Premier Doug Ford does not intend to fill the vacancy. The patient ombudsman is in charge of ensuring the voices of patients and caregivers at hospitals and long-term care homes are heard. The role was previously filled by Christine Elliott, who left in February to run for the leadership of the Ontario Progressive Conservative Party and later became health minister. RNAO CEO Doris Grinspun says the position should not be eliminated. “The public needs to have a point-of-contact to speak about health system experiences and improvements. We have a lot to learn from the public and, at the end of the day, they are recipients of the care,” Grinspun says. The public has increasingly been using the office since it opened in 2016. In its first year it received 2,000 complaints. In 2017, that number went up to 2,300. Between July and October 2018, the patient ombudsman has taken 850 complaints, a higher monthly average than the year before. If the position is not filled “a voice will be lost – the voice of the public,” says Grinspun. With the top job vacant, the office still has 17 staff, including early resolution specialists, investigators, and other administrative staff. (CBC News, Dec. 4) 

Concerned nurses and members of the public gathered in Sudbury on Nov. 12 for a town hall meeting hosted by the Ontario Health Coalition. RNAO member emeritus Dot Klein, head of the Sudbury Health Coalition, says she has seen a lot of change in the health system over four decades as a nurse, but never “the level of care we have here now.” The ruling practice in hospitals, she says, is to “…get the job done for the least amount of money.” This leaves RNs vulnerable to budget cuts. Health Sciences North (HSN) has cut positions at the hospital this year. “This is unsafe and puts both patients and staff at risk,” says Klein. The hospital is always running at more than 110 per cent capacity, she adds. In November, RNAO responded to a Canadian Institute for Health information (CIHI) report that found Ontario is the second-lowest per capita spender on hospitals in Canada (see more in Policy, page 22). On Dec. 11, hospital spokesperson Jason Turnbull announced that after several months of working with unions, retirement incentives, attrition and other measures, there are “no plans for a further round of layoffs at HSN.” (The Sudbury Star, Nov. 13)

 RNAO members did some door knocking this fall, visiting the offices of MPPs, many of whom took office for the first time following the June provincial election. The visits, an annual RNAO event known as Queen’s Park on the Road, give RNs, NPs and nursing students the chance to sit down with their local representative and discuss nursing and health priorities that affect the care and well-being of people in their communities. To date, 36 Queen’s Park on the Road visits have taken place and 25 others are being co-ordinated. Here are some of the key issues that have come up in meetings:  

• mandating RN vacancies in hospitals be posted and filled, and that all new nursing hires in acute care and cancer care hospitals be RNs 
• ensuring all first home care assessments are conducted 
• by RNs 
• increasing access to health care by enabling NPs to work to their full scope 
• changing funding models in long-term care and supporting minimum staffing levels to improve quality of care and resident safety
• making sure the premier’s pledge to increase access to public dental services for low income seniors is extended to all Ontarians living on low incomes
• ensuring all communities that require ‘consumption and treatment services’ are approved and funded 
• implementing recommendations of the Truth and Reconciliation Commission of Canada
• developing a climate change plan that ensures Ontario can meet its greenhouse gas emission targets

Visit QPOR.RNAO.ca for more information and links to a photo gallery. 
 

RNAO welcomed the government’s long-awaited decision to allow sites offering supervised injection and overdose prevention services to continue operating.

RNAO CEO Doris Grinspun attended a media conference on Oct. 22 where Health Minister Christine Elliott said she reviewed the evidence and saw first-hand the work RNs, NPs and other health workers are doing to combat the growing opioid crisis. She announced that all existing sites currently offering harm reduction services will continue operating, and that these and any new sites will offer a new delivery model that aims to connect clients to treatment options when they are ready.

Under the government’s plan, all existing sites will be rebranded as ‘consumption and treatment services.’ In addition to the sites currently operating in the province, Elliott said the three additional sites that were “paused” while the government conducted its review (in Thunder Bay, St. Catharines and Toronto) meet the criteria to apply. She says she believes they will be able to begin offering services once their applications are given the go-ahead.     

RNAO encourages members to sign the association’s action alert thanking the government for heeding its advice on this issue (RNAO.ca/AA-SIS-OPS-thanks). 

The public hearing phase of the Long-Term Care Homes Public Inquiry wrapped up at the end of September. And it ended with a submission from RNAO highlighting significant systemic issues it says need to be addressed if the ministry of health wants to ensure seniors in nursing homes receive safe, quality care.

Lawyers representing the association – which has standing at the inquiry – presented recommendations aimed at addressing two critical areas: the funding model and 
staffing ratios. 

RNAO argues the funding model in nursing homes should be changed to encourage homes rather than penalize them for implementing best practices that improve resident health outcomes, including reducing falls and lowering rates of incontinence. 

On the issue of staffing ratios, RNAO’s submission outlines the need for all homes to have a staffing mix of at least 20 per cent RNs, 25 per cent RPNs, and no more than 55 per cent PSWs. All homes should also have at least one NP per 120 residents. This is especially important given more than 50 per cent of residents in long-care homes are 85 years or older, and 90 per cent of all residents have some type of cognitive impairment.

RNAO also recommends clarifying the reporting obligations of nurses and nursing homes as it relates to resident safety. Employers should be mandated to disclose termination notices related to safety issues to prospective employers during reference checks.

The next phase of the inquiry includes formal consultations between stakeholders and the inquiry lead, Justice Eileen Gillese. To view RNAO’s closing submission, visit longtermcareinquiry.ca
 

Former RNAO president David McNeil will become the president and new CEO for the Brant Community Healthcare System (BCHS) on Dec. 10. For 17 years, he has been VP and chief nursing executive for Health Sciences North in Sudbury. In his new role, McNeil will oversee the operation of two hospitals within BCHS: the Brantford General Hospital and The Willett Hospital in Paris, Ont. “I’m honoured and excited about the opportunity,” McNeil says. “I look forward to meeting the staff, physicians, volunteers, patient and family representatives, as well as the community broadly. Together, we will set the priorities and directions for BCHS and the people we serve.” 

McNeil served as RNAO’s president from 2010 to 2012. He also co-chaired an RNAO-led provincial task force in 2014 that identified barriers and enablers affecting recruitment and retention of RNs, NPs and RPNs in rural, remote and northern Ontario communities, and proposed recommendations for a more sustainable workforce.