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Registered Nurses' Association of Ontario      

Dear Colleagues: Welcome to our Friday, November 6 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.

 

Elections in the US: A path to healing and respect for science

As we all wait anxiously for the final tally of votes in the United States, I sit to finalize my blog while remaining glued to the media updates and elections maps. It has been a long wait – four years – of deepening inequalities, growing anti-Black discrimination, homophobia, Islamophobia, and as of late, mask-phobia. I don’t recall a time in recent history where nurses – and most health professionals – shared so widely a political preference. This US election is not necessarily about a political party but about someone who personifies everything that is abhorrent and contrary to the health of a nation. The end is now in-sight, and the work to rebuild for our friends south of the border will be hardened and a lengthy one. We will be cheering and learning from their successes.

But the United States cannot simply go back to the time before President Trump. Trump did not create a plutocracy, entrenched inequality, gaping race discrimination, lack of access to health and other basic services, growing disenchantment among working people who face a bleak future, destruction of the environment, militarism and far-right extremism – these are long-established trends in the country that he exploited and exacerbated. What needs to happen next is that those root causes of division, hatred and Trumpism must be seriously addressed. The soon to be (I hope) President-elect Biden and Kamala Harris – the first ever Black woman to serve as Vice President – must place first priority in restoring respect for science and scientists to curve the unimaginable suffering caused by the illness and death toll resulting from the purposeful and irresponsible rejection of public health advice. The new administration must also tackle the erosion in social and environmental determinants of health, exacerbated by the pandemic. And, the multiple race, religion, sexual orientation, gender identity, migratory status, and other forms of discrimination and marginalization must be addressed with care, sensitivity and determination. These are the kind of actions that will create a better future for the United States, its people, and the people around the world who are influenced by developments in that powerful country.

 

RNAO statement in response to the government’s announcement on increasing direct care for long-term care resident to four hours per day

RNAO is shocked by the lack of urgency in Monday’s announcement from the provincial government that they intend to meet minimum quality care standards in Ontario’s nursing homes by 2025. Urgent action and not an election promise is needed to protect the lives of nursing home residents as the province is now in the grips of a ferocious resurgence of COVID-19. As of Nov. 1, nearly 10 months into the pandemic, 74 nursing homes across the province are again battling COVID-19 outbreaks with insufficient staffing and resources.

With more than 2,000 residents and eight staff of the province’s 626 nursing homes already dead from COVID-19-related illnesses and their families and staff in anguish, RNAO says it is negligent and disingenuous for the government to announce that it will achieve minimum standards of quality care in Ontario’s nursing homes only five years from now. Delayed timelines for minimum, evidence-based standards of care will result in more preventable lives lost during COVID-19 and afterwards.

See the full statement from RNAO here. Sign the action alert here.

 

Fall 2020 provincial budget once again leaves vulnerable populations to fend for themselves

The Ontario government released on Wednesday the Fall 2020 Budget. RNAO participated in the “lockdown” prior to the release and has subsequently been heavily involved with the media coverage of the budget and its ramifications. As you can see below, the budget received low scores from RNAO. See our October 16 pre-budget submission here and our November 5 press release, in response to the budget, is provided in full next.    


RNAO is deeply concerned with a Fall 2020 budget that shows signs of a government tiring of fighting the COVID-19 pandemic. In the midst of a ferocious resurgence, what is needed is a budget that reflects the urgency of our circumstances and the need to protect the health, economic and social well-being of Ontarians – especially those who are most vulnerable to the devastating impacts of this virus.

RNAO points to the government's decision to delay the implementation of four hours of direct care for nursing home residents until 2024-2025 as a failure to take proper care of the province's most vulnerable population. "There is no excuse for postponing the urgently needed staffing increase in the province's nursing homes," says RNAO President Morgan Hoffarth. "The evidence is well-known, confirmed in report after report over more than two decades, and captured in RNAO's Nursing Home Basic Care Guarantee. More than 2,000 seniors and eight staff have already died from COVID-19-related illnesses in Ontario's nursing homes, leaving families and staff in anguish. The government says it supports a minimum of four worked hours per resident, per day as necessary for the health and well-being of nursing home residents, but its timetable to act on this promise will only lead to more preventable deaths. We can't – and shouldn't have to – wait more than four years to meet minimum safety standards for this province's most vulnerable seniors," says Hoffarth.

RNAO CEO Dr. Doris Grinspun called on the provincial government to negotiate national long-term care standards with First Ministers and use the consequent federal transfers to invest in the care of Ontario's nursing home residents: "Without question, federal health transfers to Ontario have been slipping to unacceptable and harmful levels. RNAO accurately predicted this would be the case from the moment the federal government, under Stephen Harper, decided not to renew the Accord. The recent openness by the federal government to tie transfers to negotiated long-term care standards is something the Ontario government should jump on, if they are serious about the commitment to four worked hours of hands-on, direct nursing and support care." As of Nov. 4, as many as 89 long-term homes in Ontario were experiencing COVID-19 outbreaks.

While the necessary funding and minimum care standards for dignified and safe care in the long-term care sector have been put off until after the next provincial election, the budget's details on home care were also inadequate. RNAO called for a 20 per cent boost to home care funding in order to relieve pressure on both the hospital and long-term care sectors and enable Ontarians to receive healthy and safe care in their own home and community. "We regret that significant investments in the hospital sector and the trend to place nursing homes under the administration of hospitals is taking us away from building a robust community care sector," says Grinspun. "The real promise of this government's health system transformation plans – a plan RNAO fully supported and one that now seems to be fading away – centred around Ontario Health Teams (OHT) that would strengthen community care and be anchored in primary care," added Grinspun. RNAO's Best Practice Spotlight Organization (BPSO) OHT program has been working with fledgling OHTs to ensure they provide evidence-based, seamless care across all sectors, including person- and family-centred care and transitions in care, using RNAO's world-renowned best practice guidelines.

RNAO notes that the COVID-19 pandemic has disproportionately affected seniors, in addition to racialized and lower-income populations. "We expected provisions in this budget to address the profoundly unequal effects of the virus. People experiencing homelessness need safe shelter and housing, as well as protection from eviction," says Grinspun. "Long before this pandemic struck, we had an affordable housing crisis across this province. This budget does not make the investments needed to get us to a more resilient and caring place."

While more than 3,000 Ontarians have lost their lives to COVID-19-related illnesses over the last 10 months, the pandemic has exacerbated the province's other public health crisis: the growing number of opioid overdoses. RNAO is disappointed that the budget offers no response to this crisis, which is claiming more than five lives each day. "Our government committed to fund 21 consumption and treatment service sites two years ago. While the need for these sites far outstrips the 21 promised, the government has yet to deliver even on this modest promise," says Hoffarth. "These are preventable deaths, and modest investment in harm reduction services across the province would save hundreds of lives."

 

RNAO organizing a Cross Country Meeting – Collective Action for Long-Term Care Reform in Canada

RNAO invites everyone to a special Health System Transformation & COVID-19 Webinar on Monday, November 9, 6:45-8:30 pm ET.  

In this Cross Country Meeting we will discuss Mobilizing Collective Action for Long-Term Care Reform in Canada.

The webinar will be moderated by The Globe and Mail columnist André Picard, the author of Neglected No More: The Urgent Need to Improve the Lives of Canada's Elders in the Wake of a Pandemic.

Panelists include:

  • Nathan Stall, staff geriatrician at Sinai Health System;
  • Doris Grinspun, RNAO CEO;
  • Shirlee Sharkey, president and CEO of SE Health;
  • Miranda Ferrier, national president of the Canadian Support Workers Association;
  • Linda Silas, president of the Canadian Federation of Nurses Unions and president of the Ontario Personal Support Workers Association; and
  • Laura Tamblyn Watts, president and CEO of CanAge. 

COVID-19 has swept through long-term care homes, taking the lives of more than 5,000 residents in Canada with most deaths happening in Ontario and Quebec. 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. 

RNAO recognizes 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. 

Everyone is invited to attend including anyone across Canada who cares about seniors and wants to join forces to inspire our provincial, territorial and the federal governments to establish national standards for LTC and to take additional action to support people staying in their homes longer. 

See the press release here. Find info here and register here.

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

 

Other upcoming webinars and events for November – Open to all

~~~~~~

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

The next webinar in the series will be on November 16, 6:45-8:15 pm. Details available here and 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 October 26 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.

The October 26 presenters were:

  • 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.

                                                                   ~~~~~~

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.

                                                                     ~~~~~~

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 and documents online. 

Register online today to secure your spot. 

 

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 #286 for 6 November: 

Case count as of 10:00 am November 6, 2020 / Nombre de cas à 10h00 le 6 novembre 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

49 304 181

+ 670 243

1 243 418

+ 9 665

Canada*

252 341

+ 4 123

10 395

+  59

Ontario**

81 693

+ 1 003

3 209

+  14

Update:

Ontario Moves Public Health Unit Regions into COVID-19 Response Framework to Keep Ontario Safe and Open. In consultation with the Chief Medical Officer of Health, local medical officers of health, and other health experts, the province intends to move Ontario's public health unit regions to the Keeping Ontario Safe and Open Framework. The framework categorizes public health regions into five levels: Green-Prevent, Yellow-Protect, Orange-Restrict, Red-Control, and Lockdown being a measure of last and urgent resort.

 

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:

30 Oct - 2S-LGBTQ+ Seniors: Our Existence is Our Resistance!go here.

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

16 Oct - RNAO advocates for national long-term care standards in Canadago 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, actiongo here.

9 Oct - Patient-centred-care – the dream and the realitygo 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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