Dear Colleagues: Welcome to our Thursday, June 18 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.

Annual General Meeting – an exhilarating week!

We are still under the spell of an exhilarating week of events around RNAO’s Annual General Meeting (AGM) – you can see all that happened here.

Early last week we released our dynamic Annual Report – let me brag a little bit because I know you haven’t seen an Annual Report like this before. It reflects the collective work of the association. Take a look here!

The efforts and achievements of RNs, NPs and nursing students, many of whom have been working day and night caring for people during the COVID-19 outbreak, was celebrated during the 95th Annual General Meeting (AGM) of RNAO, June 11 –June 13. The event, which is normally in-person and live-streamed, was held virtually this year in light of the pandemic.

COVID-19 has challenged nurses everywhere in ways we never anticipated or imagined. They’re nursing people with knowledge, compassion and courage while risking their lives. It is fitting that 2020 is the Year of the Nurse because people have always respected and trusted nurses and yet, this pandemic has highlighted the work of nurses and the central role we play in improving health, in building healthier communities, and in caring for the ill and suffering. 

RNAO has been front-and-centre during COVID-19, supporting our members, deploying health-care workers through VIANurse, providing updates for thousands of health-care workers at home and in many countries, publishing a prominent blog, profiling a massive presence in the media, organizing weekly webinars, participating in government decision-making tables, partnering with advocates for vulnerable populations, and engaging in direct policy discussions with officials. To top it off, we also launched a campaign to cheer up health workers and show that #TogetherWeCanDoIt. 

Our AGM was an exciting opportunity for the 43,408 members of our association ‒ RNs, NPs and nursing students ‒ to come together as a profession and to reflect on our successes in policy advocacy and our clinical work. Our voice and expertise has shaped the health system and provided direction on what more we must do to ensure it better reflects the needs of Ontarians. 

Despite RNAO’s enormous effort addressing the pandemic, we continued our work on evidence-based guidelines and evidence-based policy. We launched Enhancing Community Care for Ontarians (ECCO 3.0), released two major reports on long-term care, engaged support for struggling congregate homes, launched three new BPGs, continued our innovative work with Best Practice Spotlight Organization Ontario Health Teams (BPSO-OHT) and with all other BPSOs at home and around the world, and had a fulsome and remarkable Nursing Week in May. This is the type of association we are – an association that always thinks outwards and is always ahead of the curve on how to serve Ontarians and serve nurses and other health professionals. “You can say I am a very proud outgoing president. Yes, extremely proud,” lauded a joyful outgoing president Dr. Angela Cooper Brathwaite.   

One area where RNAO’s voice was and still is loud-and-clear is long-term care, a sector long neglected by successive governments and where the rapid fire spread of COVID-19 resulted in the untimely deaths of far too many residents. Last week, RNAO sent a submission to a government advisory group looking into staffing. The association says more funding is necessary to address a shortfall of regulated health professionals, along with a Basic Care Guarantee for all residents living in Ontario’s 626 nursing homes.

As we looked back during the AGM on the accomplishments of the past year and set new priorities for the coming year, RNAO’s AGM also welcomed incoming president Morgan Hoffarth. Hoffarth is a co-ordinator in the Medically Complex Service at St. Joseph’s Health Care in London. In addition to her experience in acute care, she has also worked in primary care.

“I look forward to being president of a united force of nursing leaders who have chosen to belong to their professional association because they know that RNAO’s voice is heard and that collectively we are making a difference in nursing, health and health care. In the midst of a pandemic and a flurry of other activity, we are now heading into a full virtual AGM,” said Morgan Hoffarth. “As difficult as these times are, nurses and RNAO have a lot to celebrate – and it is the right time to honour our members.” 

The three-day event kicked off with speeches from various politicians and honoured guests. 

Four Ontario long-term organizations received their designation as cohort D of RNAO’s Long-Term Care Best Practice Spotlight Organizations (LTC-BPSO) for their commitment to implementing the association’s evidence-based best practice guidelines to improve resident care. They include: Fiddick’s Nursing Home, Holland Christian Home Inc - Faith Manor, Markhaven Home for Seniors and Nipigon District Memorial Hospital.

In addition to hearing from political and stakeholder leaders, the association presented its annual Recognition Awards to 13 individual winners and three groups to honour the nursing contributions they have made in areas as practice, policy, research, administration and education. Journalists receiving awards for excellence in health-care reporting were recognized as RNAO handed out its annual Media Awards.

Visit our AGM portal for the full record of the events.

You can watch the video recordings of the Opening Ceremony (Day 1) here, the full Day 2 here, and the Closing Keynote Panel (Day 3) here. If you only have time to watch one segment, I suggest you watch the Closing Keynote with Dr. Barbara Stillwell and Dr. Mary Wakefield (see bios here) – it was electrical.

Connection: Voices, responses and opportunities to engage

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 on my blog, where you can catch up with earlier issues. The COVID-19 Portal is here.

Upcoming COVID-19 Webinar: Celebrating National Indigenous People’s Day

This coming Monday, June 22, 6:45-8:00 pm, in our Together We Can Do It! Webinar (Part 12), we will be celebrating National Indigenous People's Day. Our guest speakers will be Chief RoseAnne Archibald (Ontario Regional Chief), Mae Katt (Nurse Practitioner, Temagami First Nation), and Marilee Nowsegic (CEO, Canadian Indigenous Nurses Association). We encourage you to attend by Zoom and celebrate with us! The registration link is here.

Together we can do it

MOH EOC Situational Report #144 for Wednesday, June 17

Situation:

The full EOC Situational Report #144 for Wednesday, June 17 can be found here.

For a more detailed Ontario epidemiological summary from Public Health Ontario, go here.

EOC report #139 for June 12 informs of the following actions taken:

• Emergency Orders have been updated to reflect Stage 2 opening in parts of the province.
• People throughout Ontario are being encouraged to establish a social "circle" of no more than 10 people who can interact and come into close contact with one another without physical distancing. Dr. David Williams, Ontario's Chief Medical Officer of Health, updated public health advice to come into effect immediately province-wide to allow social circles of up to 10 members, including those outside the immediate household. Social circles will support the mental health and well-being of Ontarians and help reduce social isolation.
• The Ministry of Health has updated the Patient Screening Guidance document and it is here.
• A new Guidance for Workplace Outbreaks has been created to support public health case investigations and outbreak management in workplaces. It is here.
• The revised CMOH Directive #3 and guidance documents for resuming visits in Long-Term Care Homes, Retirement Homes and certain Congregate Living Settings have been uploaded to the Ministry’s website.
• Today, the Ministry for Seniors and Accessibility (MSAA) and Ontario Health released details of the testing strategy for retirement homes.  The following documents are available on the Ministry of Health’s website:

• Memo: COVID-19 Testing for Retirement Homes
• COVID-19 Surveillance Testing – Guidance Regarding Retirement Homes Staff and Resident Testing
• COVID-19 Test Requisition

EOC report #140 for June 13 informs of the following actions taken:

• The Ontario government announced it is providing more flexibility on the number of attendees permitted at an indoor and outdoor wedding and funeral ceremonies. Based on positive public health trends the government is extending the number of people allowed to attend an indoor wedding or funeral ceremony to a maximum of 30 per cent capacity of the ceremony venue.  

EOC report #141 for June 14 informs of the following actions taken:

• None.

EOC report #142 for June 15 informs of the following actions taken:

• More people will be able to get back to work as additional businesses and services in certain regions across Ontario can begin reopening this Friday. The Ontario government in consultation with the Chief Medical Officer of Health and local medical officers of health is enabling more regions of the province to enter Stage 2 of the government's reopening framework. These regions are able to reopen due to positive trends of key public health indicators at the local level including lower transmission of COVID-19 sufficient hospital health system capacity local public health capacity to assist with rapid case and contact management and a significant increase in testing provincially.
• The Chief Medical Officer of Health issued a memo (here) to hospitals regarding resumption of visitors in acute care settings. The “COVID-19 Acute Care Guidance” and “Operational Requirements for Health Sector Restart” have been updated to support resumption of visitors in acute care settings. Memo and updated guidance documents are here and here.

EOC report #143 for June 16 informs of the following actions taken:

• Guidance for Workplace Outbreaks has been posted to the ministry’s website.
• The Ontario government is providing employers with a new general workplace guide, which will help them develop a safety plan to better protect workers, customers and clients. The new downloadable toolkit offers tips on how to help prevent the spread of COVID-19 as more people get back on the job during Stage 2 of the reopening of the province.

EOC report #144 for June 17 informs of the following actions taken:

• Advice for Religious Services, Rites or Ceremonies has been posted on the ministry’s website.
• The Ontario government has extended all emergency orders currently in force under s.7.0.2 (4) of the Emergency Management and Civil Protection Act. This extension will be in effect until June 30, 2020, to ensure the government continues to have the necessary tools to safely and gradually reopen the province, while continuing to support frontline health care workers and protect vulnerable populations from COVID-19.
• The government has a dedicated PPE supplier directory providing a list of companies that sell personal protective equipment (PPE) and other supplies.
• PPE can still be accessed, depending on available supply, on an emergency basis through the established escalation process which is as follows:
• • Once you have ascertained that, despite stewardship and conservation efforts, you have a critical supply shortage, we would ask that you do the following:
  • • Work with your regular supplier to determine when you will get regular shipments of PPE and equipment.
    • Submit a request via the appropriate Personal Protective Equipment Intake Form to work with your region/regional table and with other local health care providers to determine if others in your local area have supplies they can provide to you.

• If none of these actions are successful, your appropriate regional PPE lead* will escalate your request to the Ministry’s Emergency Operation Centre (MEOC).
• The ministry is allocating supplies according to critical needs and working with regional partners to support all requests.
• *Regional PPE lead contacts:  Central Region: Susan Gibb: Susan.Gibb@lhins.on.ca  East Region: Paul McAuley: Paul.McAuley@3so.ca Leslie Motz: lmotz@lh.ca  North Region: Matthew Saj: sajm@tbh.net Michael Giardetti: giardetm@tbh.net  Toronto Region: Rob Burgess: Robert.Burgess@sunnybrook.ca Nancy Kraetschmer: Nancy.Kraetschmer@tc.lhins.on.ca   West Region: Toby O’Hara: Toby.OHara@hmms.on.ca

Staying in touch          

Please continue to keep in touch and share questions, comments and challenges. Send these to me at dgrinspun@rnao.ca and copy my executive assistant, Peta-Gay (PG) Batten <pgbatten@rnao.ca>. Due to the volume of comments and questions, we are responding as fast as we can. 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:

12 June - Petition on masks for Canada – go here.

12 June - LTC: RNAO releases list of 35 reports and recommendations dating back 20 years – go here.

6 June   - Statement – RNAO stands together with our Black sisters and brothers – go here.

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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