Dear Colleagues: Welcome to our Saturday, June 6 report – now in the fifth month of COVID-19 in Ontario. Visit the COVID-19 Portal for the many resources RNAO offers on COVID-19. You can refer to earlier update reports here, including thematic pieces in my blog. Feel free to share this report or these links with anyone interested – they are public.

Colleagues, on Tuesday I wrote that I can’t let go of the image of George Floyd gasping for air and pleading for his life – “I can’t breathe.” And as I said, that image evokes the immense brutality, insanity and terror brought about by anti-Black racism and all forms of systemic racism in our midst. RNAO released a statement that I am reproducing in full below. I am also encouraging our readers to take action and vocally speak this weekend, and always, against anti-Black racism and all forms of hate, discrimination, prejudice and violence:

• Speak out on social media using hashtags such as #ICantBreathe and #BlackLivesMatter

• Sign a petition against racism and police brutality, like the one here

• Read, educate yourself and take action – I found this article useful, although its focus is the United States

• Read resources for ending anti-Black racism from a Canadian women’s perspective

• Read about institutionalized racism

• Check out the National Museum of African American History, especially the section on “Talking about race”

•  Write a letter to your local newspaper or call a local radio or TV station 

• Call or write to your federal, provincial and municipal representatives

• Join many Canadians who are participating in peaceful and powerful vigils and protests while keeping proper COVID precautions – use a mask, keep physical distancing at all times, and try to isolate after that, just in case you got the virus despite your precautions (note: there has been some advice about potential violent infiltrators in Toronto protests, unrelated to organizers – act with caution)

• Join my weekly webinar – on June 15 we will focus the webinar on taking action against racism       

Statement – RNAO stands together with our Black sisters and brothers

RNAO mourns the death of George Floyd and all those who have succumbed to anti-Black racism and violence. RNAO stands together with sisters and brothers who continue to suffer the scourge of anti-Black racism and discrimination everywhere. RNAO unequivocally condemns racism, oppression and discrimination in all forms. In light of recent atrocities in the United States, Canada and around the world, we stand in solidarity with the loved ones of those who have suffered at the hands of law enforcement and those who experience gross inequities because of the colour of their skin.

RNAO’s Policy Statement on Racism (2002) states that racism is systemic in our society and endemic in our institutions. Racism excludes people from decision-making processes and leadership and economic opportunities, marginalizing and oppressing them. RNAO reinforces its position that no sector is immune to the ingrained effects of racism—including health care. Nursing has a history of excluding women of colour, who could not even enter nursing school in Canada until the 1940s.

RNAO marked a milestone when Dr. Jocelyn Hezekiah, a leader in nursing education, became RNAO’s first Black president (1979-1981). In 2003, she authored Breaking the Glass Ceiling: The Stories of Three Caribbean Nurses, a book showcasing how these nursing leaders paved the way for Black nurses to be recognized in their own right in the Caribbean and internationally.

The struggle to achieve equal access for women of colour to professional development, training, promotions and leadership roles remains unfinished. RNAO released its Organizational Statement on Diversity and Inclusivity in the spring of 2007. It commits to “…providing an environment that is free from racism, prejudice, discrimination and harassment. We strive to reflect the diverse communities within our organizational structure (board, staff members and students) and to promote equitable access to the programs and services we offer.” 

The late Dr. Joan Lesmond, a prominent Black Canadian leader and an RNAO past-president (2004-2006), launched the project that led to RNAO’s Embracing Cultural Diversity in Health Care best practice guideline (BPG). Among its recommendations, the BPG asks health-care providers to: “State and continually explore, through reflection and feedback, how one’s own biases, personal values, and beliefs affect others.” It also calls on providers to: “Recognize and address inequitable, discriminatory, and/or racist behaviours or institutional practices when they occur.”

As Black Canadian leader and current RNAO president (2018-2020), Dr. Angela Cooper Brathwaite, states: “For too long, many nurses and their clients have suffered the injustice of systemic racism in Canada. We must be drivers of positive and sustained change for future generations. We must call on the nursing profession and the broader public to examine how racism manifests in and beyond our health-care system, and advance evidence-based practice to achieve more equitable population health outcomes.”

RNAO CEO Dr. Doris Grinspun says RNAO is dedicated to achieving health equity in our system, and advocates for the examination of policy issues through a ‘social determinants of health’ lens. “RNAO commits to raising public awareness about racism and violence, with particular attention to violence most recently experienced by people of colour. We must put a spotlight on injustice, and mobilizing to enact real change."

The COVID-19 pandemic has invoked fear, and has led to uncertainty and hardship in the lives of many Ontarians. This has been compounded by the recent, tragic events that illuminate the inequities and prejudice that remains deeply embedded in our society. The pandemic has exacerbated social and economic inequities that exist in our system, and it is widely known that the virus has disproportionately affected Black and other marginalized groups.

“As we seek a return to a new normal,” Grinspun says, “this cannot be a ‘normal’ defined by deep-rooted racism, violence, discrimination and injustice. We must stand united and say: No more.”

RNAO’s 95th AGM goes virtual - June 11-13, 2020

On June 11, Thursday’s Opening Ceremonies from 6:00pm to 7:00pm we will feature remarks from Christine Elliott, Deputy Premier and Minister of Health and other political party leaders and celebrate our LTC BPSOs designation ceremony for 2020. On June 12, Friday, from 4:00pm to 7:00pm, we’ll hear from Premier Doug Ford, and we will conduct our usual business including the Association’s auditor, provincial committees, followed by my yearly report that will undoubtedly showcase RNAO in action during these unprecedented times. As always, we will enjoy the consultation session on resolutions, media and member recognition awards, our president’s remarks and the passing of the gavel from President Angela Cooper Braithwaite to incoming President Morgan Hoffarth.

All this is followed by an important closing keynote panel on Saturday from 11:30am to 1:00pm titled: Celebrating the Year of the Nurse: Scaling Up Our Voices, featuring international nursing leaders Barbara Stilwell, Executive Director of Nursing Now Global and Mary K. Wakefield, former Administrator, Health Resources and Services Administration (HRSA) and Deputy Secretary, U.S. Department of Health and Human Services under President Obama. This session will focus on the history of nursing and set the foundation for the next generation of nurses. Submit your questions by June 5, 2020:  https://myrnao.ca/agmkeynotequestions

Looking forward to spending energetic and meaningful three days virtually together!

Visit the AGM portal for program and other details, to stay updated on AGM-related announcements and instructions, and to register: https://rnao.ca/agm-2020

Registration: Register online today. It’s free for all members and the public. All events will be broadcast live on RNAO.ca, YouTube and Facebook. 

One member, one vote: Make your voice heard – Voting is already open and closes on June 11 at noon (ET)

RNAO members play a central role in deciding governance issues that affect the current and future direction of RNAO. One member, one vote is how you can make your voice heard. Information on items that require a vote by all members is now available here: https://myrnao.ca/rnao_election 

This year, members are asked to cast their vote on three items:

1. Amendments to RNAO’s bylaws to redefine region boundaries
2. Approval of KPMG as RNAO’s auditors for fiscal year end, Oct. 31, 2020

2020 Candidates listed on the ticket of nominations for board of directors

Your messages: Voices and responses

Each day we receive numerous messages. Each day we also welcome new readers to this daily report: Thank you deeply for the work you do always and especially during this public health crisis, and also for keeping us well informed. You can see previous reports here. Feel free to share these updates with other health professionals and other organizations both at home and abroad. RNAO media hits and releases on the pandemic can be found here. Daily Situational Reports from Ontario's MOH EOC can be found here. Many of the articles you see here are posted in my blog, where you can catch up with earlier issues. The COVID-19 Portal is here.

Responding to racism against people of colour

We received the following note:

Hello, I am a long-time RNAO member, and am writing to you today to inquire about   opportunities or programming around racial/cultural allyship and to support people of colour.  I do so in the wake of increased violence and acts of racism; I am horrified by the treatment of Asian Canadians in our own country and the deaths of George Floyd and Ahmaud Arbery, as well as the current questions around the death of Regis Korchinski-Paquet.

While our provincial group of nurses are already overwhelmed by challenges presented by COVID-19, I am wondering if there are any current opportunities or potential for supporting our community members experiencing increased racism and threats to safety. We nurses are a strong voice, and I believe in our power for change. I look forward to hearing from you.

Allison M. Dalby, MN-NP (Paediatrics) 

Response: Dear Allison, messages such as yours inspired us to draft the RNAO statement you read above. I am grateful that you agreed to participate as a resource person in our forthcoming webinar on Monday,  June 15, 6:45 to 8:00 p.m. that will be focused on this topic. Everyone is invited and the details will be posted soon in our webinar page here.

Mental health and addiction

We will continue to address this key topic in our next weekly webinar, Monday, June 8, 6:45 to 8:00 p.m. ET. We are thrilled to have three expert panelists: Kimberly Moran (CEO, Children's Mental Health Ontario), Camille Quenneville (CEO, Canadian Mental Health Association, Ontario), and Adrienne Spafford (CEO, Addictions and Mental Health Ontario). You can read their important article posted in my blog here. To register for the webinar, go here.

Together we can do it

MOH EOC Situational Report #132 here for Friday, June 5

Situation:

• 344 new cases were reported in Ontario today, bringing the cumulative case count to 29,747 (this includes 23,583 resolved cases and 2,372 deaths).
• In Ontario, a total of 809,053 tests have been completed, with tests performed at Public Health Ontario Laboratories and non-Public Health Laboratories. There are currently 12,247 tests under investigation.
• 749 patients are currently hospitalized with COVID-19; 118 are in ICU; and 94 are in ICU on a ventilator.

EOC report #130 for June 3 informs of the following actions taken:

• The website for temporary pandemic pay has been updated with more information on the implementation of the program.
• In consultation with the Chief Medical Officer of Health, Ontario has extended the provincial Declaration of Emergency to June 30. The decision supports the government's efforts to respond to the COVID-19 outbreak and protect the health and safety of Ontarians as the province reopens in a measured and responsible way. The extension, under s.7.0.7 of the Emergency Management and Civil Protection Act, was approved by the Ontario legislature yesterday.

EOC report #131 for June 4 informs of the following actions taken:

•  The Ontario government has appointed Dr. Jane Philpott as the special advisor to support the design and implementation of the new Ontario Health Data Platform (formerly known as PANTHR). This data platform will provide recognized researchers and health system partners with access to anonymized health data that will allow them to better detect, plan, and respond to COVID-19. As well, this platform will support projects from the Ontario COVID-19 Rapid Research Fund.

• Guidance for Summer Day Camps has been posted on the ministry’s website.

EOC report #132 for June 5 informs of the following actions taken:

• The Acute Care Guidance Document has been updated for consistency in language with other guidance documents. The Summary of Required Precautions table has been updated as well. Both English and French versions are here and here.

Staying in touch          

Please continue to keep in touch and share questions and/or challenges of any kind, and especially shortages of PPE. Send these to me at dgrinspun@rnao.ca. We are responding daily and are continuously solving your challenges. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!

Thank you deeply colleagues in the front lines; in administrative roles; in all labour, professionals and sector associations, and in governments in Ontario, in Canada and around the world. We are here with you in solidarity. These are stressful and exhausting times; the only silver lining is coming together and working as one people – for the good of all!

Together, we must redouble our efforts to tackle COVID-19 with the best tools at hand: full, accurate and transparent information, calmness, determination and swift actions. 

Doris Grinspun, RN,MSN, PhD, LLD(hon), Dr(hc), FAAN, O.ONT
Chief Executive Officer, RNAO

RECENT RNAO POLICY CORNER ITEMS:

3 June   - Adapting harm reduction during a pandemic – go here.

29 May - Foot care nurses – go here.

29 May - Update on pandemic pay; pandemic pay in consumption and treatment sites – go here.

28 May - RNAO Calls for Immediate Action in Response to the Canadian Armed Forces’ LTC report – go here.

26 May - Update on VIANurse – go here.

26 May - Ending homelessness: Will you join us to build a COVID-19 recovery for all? – go here.

24 May - Technology as a solution: Opportunities and pitfalls of COVID contact-tracing apps – go here.

21 May - Debunking PPE myths with Dr. Jeff Powis: Which masks should health care workers wear during COVID-19? – go here.

20 May - RNAO response to announcement of an independent commission into Ontario's long-term care system – go here.

19 May - With the pandemic curve flattening, VIANurse program will focus its effort on outbreaks – go here.

14 May - Nursing Week update – go here.

14 May - Pandemic puts health system to the test: Nurses have answers for shortfalls – go here.

14 May - Disappointment for not being included in pandemic pay – go here.

13 May - RNAO saddened by the loss RN Brian Beattie to COVID-19 – go here.

13 May - End racism and prejudice – go here.

12 May – Enhancing Community Care for Ontarians (ECCO 3.0) – go here

11 May - Nurses share their successes and challenges during National Nursing Week – go here.

10 May - A story of hope, ingenuity, support and genuine care for an LTC resident – go here.

7 May    - Counting the missing deaths: Tracking the toll of the coronavirus outbreak – go here.

5 May    - Life on the front lines of the pandemic: Profile of RNAO member NP Daria Gefrerer – go here.

5 May    - Addressing differential access to virtual care due to technology inequities – go here.

3 May    - Being person-and-family-centred during COVID-19 – go here.

1 May    - Migrant agricultural workers and the COVID-19 crisis – go here.

30 April - COVID-19 pandemic in provincial institutions and correctional centres – go here.

28 April - Supporting First Nation Communities during COVID-19 – go here.

27 April - Responses to COVID-19 for persons experiencing homelessness in Toronto: An update – go here.

25 April - Lessons learned through a COVID-19 nursing home outbreak – go here.

25 April - Letter from a retired RN to Premier Ford: The problems with LTC were evident long before COVID – go here.

23 April - Working with seniors in long-term care requires specialized knowledge – go here.

22 April - Shaking the stigma: We need a proactive COVID-19 response for mental health and addiction – go here.

21 April - We Require Expanded and Accessible COVID-19 Data in Ontario – go here.

20 April - Can Loss of Smell and Taste Help Screen for COVID-19? – go here.

18 April - COVID, Trump and the World Health Organization – go here.

16 April - A Home Based Model To Confront COVID-19 – The Case Of The Balearic Islands – go here.

15 April - COVID-19 and the Challenges in Homecare – go here.

14 April - Reprocessing Of N95 – An Update – go here.

14 April - A New COVID-19 Facility For Persons Experiencing Homelessness In Toronto – go here. 

13 April - Practical Tips for Safe Use of Masks – go here.

10 April - Ontario’s Tragedy in Long Term Care Homes and Retirement Homes – go here.

10 April - RNAO Action – Supporting Long-Term Care – go here.

10 April - Update For Nursing Students – NCLEX Exam – go here.

9 April - Celebrating Passover, Good Friday, Holy Saturday, Easter Sunday and the start of Ramadan during a pandemic – go here.

9 April - Guidance on use of N95 mask – go here.

7 April - Sentinel surveillance and on-site testing in the homeless service sector – go here.

7 April - Reprocessing of n95 – safe? – go here.

5 April - We must change the way we do testing and case definition – go here.

5 April - Ringing the alarm bells on critical care beds – go here.

4 April - COVID-19, stay at home and domestic violence – go here.

We have posted earlier ones in my blog here. Please go and take a look.

Information Resources

Public Health Ontario maintains an excellent resource site on materials on COVID-19. This is an essential resource for Ontario health providers. 

Ontario’s health provider website is updated regularly with useful resources here.

Ontario’s public website on the COVID-19 is there to inform the general public – encourage your family and friends to access this public website. The WHO has provided an excellent link for you to share with members of the public here.

Please promote the use of Ontario’s COVID-19 self-assessment tool: It also has a guide where to seek care, if necessary. Its use will provide the province with real-time data on the number and geography of users who are told to seek care, self-isolate or to monitor for symptoms. Data will inform Ontario's ongoing response to keep individuals and families safe.

Health Canada's website provides the best information capturing all of Canada. It contains an outbreak update, Canada's response to the virus, travel advice, symptoms and treatment, and resources for health professionals.

The World Health Organization plays a central role in addressing the COVID-19 pandemic. See here and here.

You can find up-to-date global numbers in Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.

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