Dr. Doris Grinspun

Seventeen years ago, Ontario nurses were rattled by the arrival of Severe Acute Respiratory Syndrome (SARS), and the blatant dismissal of our expertise and insight during a scary time for Ontarians. January 2020 marked the arrival of another deadly respiratory illness known as COVID-19, which was declared a pandemic by the World Health Organization on March 11. Since the early days of this global emergency, I have been filled with pride in our profession and the strong nursing voices that are now heard loud and clear. Without exception, nurses and RNAO are sought out for the robust expertise we bring to clinical practice settings, policy decision forums, and media. We are counted upon for factual information, sound analysis, and trusted advice at home, across the country, and around the world. No doubt it has been an immensely difficult time for all of us, and nowhere more than at the frontlines of care – a reality we must always remember.

Since the turn of a new year, millions of people worldwide have been diagnosed, and far too many have been lost to COVID-19 (see current numbers HERE). While the initial focus was in Hubei, China, the virus has now taken hold in countries on every continent. The hardest hit at this time are the U.S., Spain, Italy, France, Germany and the United Kingdom. Health professionals, especially nurses and doctors, have been and will continue to be at the forefront of this public health crisis.  

I am eternally grateful to the hundreds of nursing and other professional colleagues who have responded to my updates, reaching out to share experiences, concerns and also thanks for the work we continue to do.

Since January, I have taken it upon myself to provide daily updates about the virus, including the most trusted links for health-care providers to access accurate and up-to-date information. My report became so extensive that I worked with the RNAO team to transform it into a blog. I am eternally grateful to the hundreds of nursing and other professional colleagues who have responded to these updates, reaching out to share experiences, concerns and also thanks for the work we continue to do for the protection of all health providers and patients. 

The availability of personal protective equipment (PPE) has consistently been nurses’ top concern, with added worry of the consequences of this shortage in long-term care, home care, primary care, Indigenous communities, among those experiencing homelessness, and within corrections. 

Given the extensive community spread of COVID-19, and the evidence that asymptomatic persons can spread the virus, RNAO released a statement on March 25 recommending all health workers use surgical masks while at work. With limited stock, we recommended this requirement start in nursing homes and other settings where patient populations are most vulnerable. As more surgical masks become available, all health workers in all settings should be using them, we said. At the time of writing this column, we learned of significant progress on protocols for safety in long-term care and retirement homes. We will continue to urge for universal masking across all sectors. 

RNAO will also continue to urge government – provincial and federal – to move aggressively to secure PPE, which includes surgical/procedure masks, N95 masks, gloves, gowns and eye protection. There is absolutely no time to lose, and although we continue to hear from both levels of government that progress is being made, for us, success means PPE for every health provider who faces patients, residents or clients – at all times and in every sector. We have taken additional steps to secure existing supplies from simulation labs, dentist offices, and all other education and health organizations that have stock that is not immediately needed. 

Nurses have also contacted us to express concern about conflicting messages about self isolation. On March 22 alone, I received more than 50 emails from staff nurses concerned about contradictory directives, and fears for their health, that of their colleagues, patients and families. I discussed this matter directly with the health minister, and her message was crystal clear: any health professional who has traveled abroad MUST self-isolate for 14 days upon return. The federal government also announced on March 25 that all returning travelers, regardless of whether or not they have symptoms, will be obligated to self isolate for 14 days. RNAO’s voice on this, and our evidence-based advocacy, prevailed. And it will continue to prevail. 

RNAO is also advocating for much more aggressive testing and contact tracing, as advised by the World Health Organization. This is important for the general public and even more so for all vulnerable populations. Ontario is sorely deficient in this regard.

Expecting a heightened need to resolve human resource shortages as the pandemic continues, we launched VIANurse on March 12. To date, we have called for RNs, NPs and nursing students to volunteer their expertise in virtual care, clinical care in diverse areas, critical care including ICU, primary care, and also non-clinical services. Hundreds of RNs and NPs have already been deployed to various health organizations across all sectors, and we hear daily praise about this free-of-charge RNAO redeployment service and even more so about the stellar work of our colleagues.

Students have also been enlisted to lend a hand where they can. RNAO has been in touch with its undergraduate nursing student members who have completed their first year of study, many of whom are qualified to work as personal support workers (PSW) in long-term care homes. Thousands of students are now working in nursing homes and we can’t thank them enough given the difficulties the sector is experiencing.  

This public health crisis will continue for the foreseeable future, and I urge each of you to continue to read RNAO’s daily updates and keep in touch with experiences, questions, challenges and solutions.  

And please remember, RNAO has mobilized its might and influence like never before. We are here for you and we know these are stressful and exhausting times – so please, lean on us. The only silver lining we have is coming together and working as one people – for the good of all.