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Registered Nurses' Association of Ontario      

Dear Colleagues: Welcome to our Friday, October 30 report – now in the ninth month of COVID-19 in Ontario. Visit the COVID-19 Portal for the many resources RNAO offers on COVID-19. Find earlier update reports here, including thematic pieces in Doris’ COVID-19 Blog. RNAO media hits and releases on the pandemic can be found here. Daily Situational Reports from Ontario's MOH EOC can be found here. As always, feel free to share this report and links with anyone interested.

 

RNAO statement in support of Bill 13: Time to Care Act

RNAO applauds members of the Ontario legislature for acting unanimously and in the best interests of residents in long-term care (LTC) homes by voting in favour of Bill 13 on Oct. 29, 2020. RNAO fully supports Bill 13 and urges the government to move this bill quickly through the legislative process so it becomes law.

The private member’s bill, introduced by London-Fanshawe NDP MPP Teresa Armstrong in 2018, passed second reading and now goes to committee. It calls for amendments to the Long-Term Care Homes Act to establish a minimum of four worked hours of nursing and personal support services per resident, per day – in all Ontario nursing homes. Bill 13 takes us one step closer to RNAO’s vision of safer, higher quality and evidence-based care as laid out in its 
Nursing Home Basic Care Guarantee. If passed, this bill will help improve the safety and quality of care for residents and will address long-standing, severe staffing shortfalls resulting from decades of policy and funding inaction.  

Please sign our Action Alert urging the government to move fast with #TimeToCareAct #BasicCareGuarantee


2S-LGBTQ+ Seniors: Our Existence is Our Resistance!

We are grateful to the Senior Pride Network Toronto for their tremendously important contribution – below – calling to recognize the human rights of older 2-spirit, lesbian, gay, bisexual, transgender, transsexual, queer and intersex (2S-LGBTQ+) people in the City of Toronto, in particular those who reside in a long-term care home. We hear the call of the authors that the first step is to acknowledge the existence of people who have been discriminated and ignored and consequently have suffered the health impacts of that neglect. We hope this article makes a small contribution to that goal. The surveys mentioned in the article can be found here and here.


For our 2S-LGBTQ+ seniors, the COVID-19 pandemic is a cruel reminder that the long-term care (LTC) system in Ontario is neglectful of, or unresponsive to, our particular health issues, needs and concerns. Sadly, 2S-LGBTQ+ seniors are mostly invisible in LTC homes. Many homes claim to not have any 2S-LGBTQ+ residents. And data are unavailable on the number of 2S-LGBTQ+ residents, the number who contracted COVID-19 or those who died after contracting it. The measures and care protocols adopted to respond to COVID-19 generally do not acknowledge the existence of 2S-LGBTQ+ residents and do not consider the particular vulnerabilities, inter-related health issues and particular care needs of 2S-LGBTQ+ seniors.

As older persons and those with chronic health conditions or weakened immune systems, 2S-LGBTQ+ seniors who contract COVID-19 are at higher risk of developing more severe illness and complications, and of dying from it. Recent national surveys have found that 2S-LGBTQ+ people are more vulnerable to COVID-19 than other persons. Specifically, 

  • 29% are living with a chronic health condition, compared with 15% of other people;
  • 21% who identify as Black, Indigenous and People of Colour (BIPOC) have been admitted to the hospital for COVID-19 compared to 9% of both 2S-LGBTQ+ people in general and the national population;
  • those who identify as BIPOC are more likely than the general population to know somebody who has died from COVID-19 (Egale and INNOVATIVE Research Group, 2020).

Research studies have shown that our 2S-LGBTQ+ populations are at greater risk of developing cardiovascular disease, cancers, kidney and liver diseases, HIV/AIDS and related co-morbidities, and respiratory diseases such as asthma. Caregivers in LTC homes need to be knowledgeable about underlying medical conditions and co-morbidities, their causes and their effects on 2S-LGBTQ+ seniors, and in particular on those who contracted COVID-19.

In addition, 2S-LGBTQ+ residents experience anxiety and worry about LTC staff. The staff, with few exceptions, are untrained, little-trained or ill-trained in these residents’ specific care issues and needs. 2S-LGBTQ+ residents also often experience, or have a fear of experiencing, discrimination, harassment and abuse (physical or verbal) in LTC homes. LTC staff may be uncomfortable with 2S-LGBTQ+ people or have biases or negative attitudes (including homophobia, transphobia and biphobia). These fears and concerns are intensified during COVID-19 outbreaks.

Many 2S-LGBTQ+ seniors are already socially isolated before moving into LTC homes. We have experienced rejection or denial by our biological families and are less likely to be in a spousal relationship or to have children or other “blood relatives” on whom we may rely for social and emotional support and care. Our biggest fear is dying alone and forgotten once we become residents of LTC.

In order to reduce social isolation and build personal support networks, 2S-LGBTQ+ seniors increasingly rely on our chosen families (surrogate, non-biological) or a circle of friends (e.g. partners, close friends, caregivers). However, we often discover that our relationships and chosen families are not recognized or respected by their LTC home.

Strict social distancing protocols and restrictions on visitors imposed during outbreaks of COVID-19 in LTC homes cause even greater social isolation for 2S-LGBTQ+ residents. As a result, we experience greater loneliness, depression, despair and a deterioration in our physical health and general well-being. To mitigate social isolation and provide emotional and social support for us, LTC homes must be required to recognize and respect 2S-LGBTQ+ spousal relationships, chosen family members and support networks for visitation and for providing essential care.

Critical improvements are required urgently to ensure that LTC homes are sensitive to and inclusive of the needs, care preferences, and life experiences of 2S-LGBTQ+ seniors. There is a pressing need to integrate awareness and inclusivity of 2S-LGBTQ+ seniors, and respect for them, in the LTC system and in the system’s response to COVID-19.

Ontario Senior Pride, an ad hoc coalition of The Senior Pride Network Toronto and six other Ontario groups, has made a submission to Ontario’s Long-Term Care COVID-19 Commission that addresses the many problems confronting 2S-LGBTQ+ seniors.  It makes 14 recommendations to the Commission and the Ontario Government that when implemented would help to make the LTC system more inclusive of 2S-LGBTQ+ seniors and more responsive to our needs.

We expect ALL LTC homes, service providers and levels of government in Ontario and Canada to acknowledge our existence. This simple action will improve and save our lives. We want and expect the basic human rights of kindness, caring, compassion, dignity, safety and RESPECT!


Upcoming webinars and events for November – Open to all

Health System Transformation & COVID-19 Webinars (monthly) - On Monday, November 9, 6:45-8:00 pm we will be holding a

Cross Country Meeting: Collective Action for Long-Term Care Reform in Canada.

COVID-19 has swept through long-term care (LTC) homes, taking the lives of over 5,000 residents in Canada with most deaths happening in Ontario and Quebec. The Canadian Institute for Health Information reported that Canada had almost double the proportion of COVID-19 deaths within LTC settings than other OECD countries -- 81% of the total as compared to 42%.

Thousands of families and loved ones are devastated with their loss. Others, including residents and staff, are exhausted, distressed and fearful of what is to come on this second wave.

Canadians across the country are yearning for action. We recognize the need and opportunity to turn tragedy into action, to secure a brighter future for our seniors. This is where we can come together and inspire all jurisdictions to build on the federal government’s Speech from the Throne that includes a commitment to work with provinces and territories to establish national standards for LTC and to take additional action to support people stay in their homes longer.

RNAO's voice is 46,000 members strong and thousands have shown their support for reform by signing our action alerts. We must build the momentum to affect change by mobilizing in partnership with other associations, unions, seniors, families and the media to further our voices together and inspire the nation’s political will to do what is right for seniors. Join us on Nov. 9 at a virtual town-hall style meeting focused on ensuring national standards become a reality.

Who is invited? Anyone across Canada who cares about seniors and wants to join forces to inspire our provinces, territories and the federal government to establish national standards for LTC and to take additional action to support people stay in their homes longer.

We call on: Residents, families, nurses, interprofessional colleagues, PSWs, students, concerned Canadians, and other association leaders to come and join in creating a social movement like no one has seen before. Let’s talk action and let’s drive it! 

Find info here and register here.

Information on past webinars, including videos and presentation slides, can also be found here.

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Landscape and Emerging Issues with E- Cigarettes: Webinar Series

Webinar 3 of a 3 part series - Tuesday, November 17, 12:00 - 13:00 pm

Preventing E-Cigarette Use Amongst Youth

This three-part webinar is in partnership with the RNAO, Community Health Nurses’ Initiatives group (CHNIG) and Community Health Nurses of Canada (CHNC).

Objectives:

  • understand the prevalence of vaping in Ontario and across Canada
  • understand the mechanism of vaping (primary focus: nicotine)
  • articulate health impacts of vaping
  • discuss how nurses and other health-care providers can provide clients with prevention, protection and cessation support

Guest speakers:

  • Rosemary Lamont, RN, York Region Public Health, Community and Health Services           
  • Dr. Andrew Pipe, CM, MD, LLD(Hon), DSc(Hon), FRCPSC(Hon), University of Ottawa Heart Institute

Register here.

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NP Knowledge Exchange Annual Symposium (this year virtual)

NPs who are members of RNAO are invited at no cost to our NP Knowledge Exchange Virtual Symposium on Monday, November 23, 9 am to 4 pm.

Explore the theme “Moving from Strength to Greater Strength: NPs in Ontario, Canada, and around the Globe” at our seventh-annual NP Knowledge Exchange Symposium.

We will have a chance to network, collaborate and learn more about the NP Task Force and its compelling history, progress and promise to drive successful health transformation. In addition, we will discuss how the clinical, policy and governance roles of NPs during COVID-19 impacted the system and can be leveraged in the vision for tomorrow. 

Speakers include Dr. Barbara Stilwell, executive director of Nursing Now; Helen Angus, Ontario’s deputy ministers of health and many more fantastic speakers. Co-chairs for the day are NPIG Chair Sally Baerg and RNAO CEO Dr. Doris Grinspun.

This event is open at no cost to all NPs in Ontario who are RNAO members.

See the agenda and other info online. 

Register online today to secure your spot. 

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Let’s Talk about Anti-Black Racism and Discrimination in Nursing

The next webinar in the series will be on November 26, 6:45-8:15 pm. Details forthcoming. You can register here.

Our monthly webinar series is open to RNs, NPs and RPNs interested in receiving updates on RNAO’s Black Nurses Task Force and to engage in meaningful conversations that are already influencing the work of the Task Force. 

The Black Nurses Task Force has a mandate to tackle anti-Black racism and discrimination within the nursing profession. Media is welcome. Please RT a powerful piece by bxavier@thestar.ca (Twitter: @breanna_xcarter) in the Toronto Star

The most recent webinar was on Monday, October 26. This webinar dealt with Systemic Racial Discrimination and Micro aggressions in the Workplace: From Recognition to Action. Please RT   

The objectives were:

  • Explore manifestations of systemic racial discrimination and microaggressions experienced by Black nurses in the workplace.
  • Discuss how complaints of anti-Black racism and discrimination are raised and addressed in the workplaces of Black nurses across the health system.
  • Generate awareness about the mental and physical health impacts of anti-Black racism and discrimination and identify trauma-informed supports for Black nurses in the workplace.
  • Describe types of and effectiveness of training and orientation programs around cultural competence/safety, diversity, and anti-oppression from the perspective of Black nurses.
  • Share and discuss approaches for responding to and coping with systemic racial discrimination and microaggressions in the workplace—experienced personally or witnessed.

Presenters:

  • LaRon Nelson, PhD, RN, FNP, FNAP, FAAN
    Independent Foundation Professor and Associate Professor of Nursing and Associate Dean of Global Affairs & Planetary Health at Yale University, Scientist with MAP Centre for Urban Health Solutions in the Li Ka Shing Knowledge Institute at St. Michael’s Hospital
  • Jackie Williamson, RN, BScN, MEd, PhD
    Professor, Durham College
    Staff Nurse, Centre for Addiction and Mental Health (CAMH)
  • Crystal Garvey, RN BScN MScN PhD (student)
    Professor Collaborative BScN Program, Durham College/ Ontario Tech University

The presentations and details for this and earlier webinars can be found here.

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#Togetherwecandoit

Today is day #226 of RNAO’s #TogetherWeCanDoIt campaign. RNAO began this campaign on March 19 to cheer up health care workers and others in essential services. A central pillar of our campaign is #Maskathon to help spread the message and the actions of masks-for-all!

In the thick of the second wave and with a modified Stage 2 in Ontario, Premier Ford is facing substantive pressure by some in his caucus to loosen restrictions, and his remarks today were most concerning. This will be once again a test on the Premier’s capacity to withstand pressure and follow sound public health advice, or sacrifice people’s health and lives.

Let us do what we are supposed to do – without letting our guard down. So, here is how it goes: 1) work from home, if you can; 2) Use a mask anytime you are out and cover well your mouth, nose and chin; 3) Use sanitizer or wash your hands every time before you put your mask on and upon taking it off, and don’t touch your face while outside your home; 4) Keep your bubble to those in your household; 5) Remind your friends, family members, colleagues, neighbors and just about anyone you know to protect themselves and others. And, let’s keep active and virtually connected, so no one feels lonely.   

To our members who continue working hard through these most challenging times: We are here for you. We are extending the deadline for registration for the 2020-2021 membership year to Friday, Nov. 6, 2020, without any penalty. This means you have until 11:59 p.m. on Nov. 6 to renew your RNAO membership or to join, without a gap in PLP or LAP between Nov. 1 and Nov. 6, 2020.  Don’t wait again till the last day, please!

If you are a nursing student – BScN or bridging program: Join for FREE! For those who are already RNs or NPs: check this out -- there is RNAO fever -- and it is a good fever to have as we have now almost reached 46,000 members! #TogetherWeCanDoIt.

  

HAPPY HALLOWEEN EVERYONEhttps://encrypted-tbn0.gstatic.com/images?q=tbn%3AANd9GcRUwT9jaL_f77A-7--3sJunLmtQAdnZntHM8URjKsya1c-QN203&usqp=CAU !!!!!!!!!!!!!!!!!!!!!https://encrypted-tbn0.gstatic.com/images?q=tbn%3AANd9GcRUwT9jaL_f77A-7--3sJunLmtQAdnZntHM8URjKsya1c-QN203&usqp=CAU!!!!!!!!!!!!!!!!!!!!!!https://encrypted-tbn0.gstatic.com/images?q=tbn%3AANd9GcRUwT9jaL_f77A-7--3sJunLmtQAdnZntHM8URjKsya1c-QN203&usqp=CAU !!!!!!!!!!!

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MOH EOC Situational Report

We are posting each day the Daily Situational Reports from Ontario's MOH EOC at RNAO’s website. That way, you can access the Ministry’s guidance at any time.

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

Here is a segment from the latest Situation Report #279 for 30 October: 

Case count as of 10:00 am October 30, 2020 / Nombre de cas à 10h00 le 30 octobre 2020

Area / Région

Case count / Nombre de cas

Change from yesterday / Changement par rapport à hier

Deaths / Décès

Change from yesterday / Changement par rapport à hier

Worldwide total /
Total mondial

45 498 873

+ 573 502

1 188 473

+ 7 171

Canada*

228 542

+ 2 956

10 074

+  42

Ontario**

74 715

+  896

3 127

+  9

No updates for today.

 

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>. RNAO’s Board of Directors and our entire staff want you to know: WE ARE HERE FOR YOU!

Thank you all for being there for our communities – everywhere and in all roles! Together, in solidarity, we are stronger and more resilient. These will continue to be tough times for a while for everyone and most especially our colleagues working in the front lines here at home and in countries around the world hit hard by evil COVID-19!

As we have said before, the silver lining of COVID-19:  Coming together and working as one people – for the good of all!

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

 

RECENT BLOG ITEMS:

23 Oct - Responding to the second wave of COVID-19: RNAO continues to speak out – go here.

16 Oct - RNAO advocates for national long-term care standards in Canada – go here.

16 Oct - Reta’s Story  (a contribution of Judy Smith, Reta’s daughter-in-law) – go here.

9 Oct - RNAO relieved that Premier Ford engages late, but essential, action – go here.

9 Oct - Patient-centred-care – the dream and the reality – go here.

2 Oct - RNAO urges stricter measures to combat rapidly rising number of COVID-19 infectionsgo here.

25 Sept - Nurses say throne speech advances A Just Recovery for Allgo here.

18 Sept - Is Your Hospital Using Blood Wisely?go here.

18 Sept - RNAO calls to Delay Action on CNO Council Decision to Expand RPN Scopego here.

11 Sept - International Overdose Awareness Day: Statement from RNAOgo here.

11 Sept - RNAO joins global movement: A Just Recovery for Allgo here.

28 August - RNAO letter to Prime Minister Justin Trudeau regarding Speech from the Thronego here.

21 August - Black August and an update on RNAO’s Anti-Black Nursing Task Forcego here.

21 August - Winter Surge Planning: How one Ontario Health Team is Preparinggo here.

14 August - Insights from Cuba: Primary care as the focus of COVID-19 preventiongo here.

7 August - School reopening: Ontario government can still do the right thing on class sizesgo here.

31 July - Preparing for the second wave of COVID-19: Discussiongo here.

31 July - Important announcement regarding the VIANurse programgo here.

31 July - Government must immediately mandate hiring to avert second tragedy in LTCgo here.

24 July - Preparing for the second wave of COVID-19: What is the plan?go here.

17 July - RNAO launches new social media campaign #Maskathongo here.

17 July - RNAO calls on government to reunite families in LTC homes in Ontariogo here.

10 July - Nurses’ mental health, leave of absence and return to work experiencesgo here.

10 July - RNAO continues to pursue family reunification in LTCgo here.

10 July - Support Zimbabwean nurses arrested and fired for protesting deteriorating pay and working conditions during pandemicgo here.

3 July -   RNAO launches task force to tackle anti-Black racism within the nursing professiongo here.

3 July -   Rather than praise, let’s protect our nursesgo here.

3 July -   Nurses celebrated diversity during Pride monthgo here.

26 June - Nursing Home Basic Care Guaranteego here.

26 June - Masks for all – the policy imperative in Canadago here.

18 June - Annual General Meeting – an exhilarating week!go here.

12 June - Petition on masks for Canadago here.

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

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

3 June   - Adapting harm reduction during a pandemicgo here.

We have posted earlier ones in my blog here. I invite you to 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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