Dear Colleagues: Welcome to our Friday, January 8 report – and the first for 2021 – during this eleventh month of COVID-19 in Ontario. You can find earlier update reports here, including thematic pieces in Doris’ COVID-19 Blog. And, for the many resources RNAO offers on COVID-19, please visit the COVID-19 Portal where you will also find RNAO media hits and releases on the pandemic here. As always, feel free to share this report and links with anyone interested. Daily Situational Reports from Ontario's MOH EOC can be found here.

If you were working during the holidays, please know that you have the utmost gratitude from the RNAO family. We would like to thank our many colleagues who have reached out to us expressing a desire to help during the pandemic, including providing vaccination support. RNCareers.ca is RNAO’s official career site since 2005, and the largest in Ontario. See the article towards the end of this blog with details about new additions to RNCareers.ca.

RNAO continues to raise its voice in the media: Summary of media coverage in December 2020

Since our last update on November’s media activity, RNAO has continued its extraordinary and ongoing commitment to speaking out on pressing issues that impact the public during this pandemic. Leading into the holiday season in December, it became more critical than ever that Ontarians follow public health measures to suffocate COVID-19. On Dec. 21, the provincial government announced that it would be implementing a province-wide lockdown, but not until Dec. 26. The rationale for the five-day delay was to give businesses time to clear inventory. RNAO was shocked and said it was reckless to wait until Boxing Day to implement these vital and life-saving measures.

As we stated in our Dec. 21 media release “saving lives must be paramount. Saving one life is more important than shopping.” During an interview on 610 CKTB, I told host Matt Holmes that “the inventory of illness and resulting deaths we will see is not worth the inventory of any store.” We insisted the government needs to be consistent in its message to Ontarians. The premier says he is concerned about the health of Ontarians while concurrently delaying action until ICUs continue to fill up – and then delayed even further to allow businesses to stay open “to do their inventory.” This is an inconsistent public health message. On CBC Toronto, I said that waiting so long to implement the lockdown means we will need tougher and longer lockdowns in the go-forward.

RNAO was calling for aggressive action on the second wave already in early September. The association hosted a joint media conference with geriatrician Nathan Stall on Nov. 13, calling on the government to implement a full lockdown. We also re-issued a joint statement on Dec. 10 with the Ontario Hospital Association, the Ontario Medical Association, WeRPN and the Respiratory Society of Ontario urging government to implement tougher government restrictions and make sure Ontarians follow public health measures. CP24 shared our message that “the number of people in hospital with COVID-19 is rising and could have potentially devastating consequences for patients.”

Tragically, with over 4,200 new cases today, many ICUs at capacity, and health-care workers beyond exhaustion, RNAO’s concerns regarding the limitations of Ontario policy have been validated. And we have not yet seen the worst of this second wave. The lack of timely and stronger action is the reason we will see consistently over 4,000 new cases daily for the next two weeks, and a number possibly edging as high as 5,000 in February. This is why we continue to urge Premier Ford for immediate action – no time to wait:

1. An immediate and complete lockdown with curfew, similar to what Quebec has implemented.
2. No reopening of schools on January 11, as scheduled, and reassess the situation at the end of January (thankfully the government has already announced an extension of the closure until January 25).
3. Increased support for vulnerable populations.
4. Full speed ahead, 24x7, with vaccination in long-term care homes.

RNAO has been at the forefront of a drawn out and unacceptably delayed struggle to address the heartbreaking impact of COVID-19 on the long-term care (LTC) sector. At this point, we are facing negligence on a massive scale that has led to the decimation of a whole generation of Ontarians living in LTC homes.

To recap, on Dec. 17 the Ontario government released its staffing plan, A Better Place to Live, A Better Place to Work. While pleased to see the government make progress on the urgent needs in LTC, RNAO immediately vocalized the plan’s lack of urgency and legislated action to help residents, foreseeing tragic consequences. We were shocked that the promised four hours of direct care per resident per day will not come into full effect until 2024-2025. The announcement is, in effect, an election promise rather than acknowledgement of the need for urgent change. Under the government’s proposed plan, only 15 minutes of additional care per day, on average, will be provided to residents before the next provincial election.

As I told Dahlia Kurtz of Ottawa’s 580 CFRA on December 18, our concerns were not addressed, and the biggest one is that there is no commitment to legislate this additional care. RNAO has been advocating for two decades, and we are not going to ever give up on this push for four worked hours of direct care. Our focus is now to reach out to all political parties to ensure they commit to legislating these hours for every resident, every day. That way, when the election does happen – provincially and nationally – we will be asking nurses and the public to support political platforms that commit to the four worked hours of nursing and support care enshrined in legislation.

During the second wave of COVID-19, which started in early September, we have continued to see an increasing number of outbreaks and more deaths in our LTC homes. At Sunnycrest Nursing Home in Whitby, 162 residents contracted the virus, leading to provincial intervention. As I told the Toronto Star on December 9, the dire situation at Sunnycrest and other LTC homes will have a lasting impact not only on the residents but also the staff. “It’s impossible and it’s excruciating,” I said, suggesting that many nurses will suffer from post-traumatic stress disorder (PTSD) when the pandemic comes to an end. “They feel guilty, they feel distraught emotionally, and they feel afraid.”

Premiers and leaders from each province and territory met with Prime Minister Trudeau in early December. Ahead of this meeting, Dr. Carole Estabrooks from the University of Alberta and I, co-authored an op-ed. Published in the Toronto Star, it was about the urgent need for the federal government to develop national standards for LTC. National standards were promised by the federal government during its Speech from the Throne in September. These standards are crucial to help fix the LTC system. We need all levels of government to come together. As noted in another article about national standards, in which RNAO was sought out for its perspective, we told the Toronto Star: “We have all failed collectively, so now it’s time for national standards so this tragedy never happens again.” I urge you to sign our Action Alert calling for national standards here.

We all know the pressure is also mounting in Ontario hospitals as more COVID-19 patients are hospitalized and ICU admissions increase. Hospitals have been preparing for a surge in cases. “Unless we behave during the holidays, we will crumble the [health-care] system,” I told Global News on December 16.

After almost a year of this pandemic, we are finally starting to see a light at the end of the tunnel in the form of a vaccine. In early December, Health Canada approved the Pfizer-BioNTech COVID-19 vaccine for use in Canada, and inoculation began Dec. 14. A little more than one week later, on Dec. 23, the Moderna vaccine received approval as well. The government has set plans in motion to make sure those most vulnerable receive this vaccine first. Vaccinating health-care workers and LTC residents first is welcome news, and what we advocated for, but as we said on Global News, vulnerable communities, where many essential workers live, also need to be considered a priority group.

Much to our surprise and disappointment, Ontario’s COVID-19 vaccination clinics closed on Christmas Day and Boxing Day. The Ministry of Health says this modified scheduled was requested by hospitals, but RNAO believes this closure was unacceptable given we are in the middle of a pandemic with a virus that takes no breaks at all. Vaccinating our frontline health-care workers and LTC residents as quickly as possible is absolutely critical if we are to see that light at the end of the tunnel grow stronger. I told Craig Needles on 610 CKTB that, “there is no excuse. People are eager to take the vaccine. Residents and their essential caregivers desperately need the vaccine.” When it comes to vaccinating in general, Canada has been slow to implement vaccination programs. I told CTV News that this virus does not take a weekend and doesn’t take time to sleep at night. We must fight this virus 24/7.

While the news of a vaccine is something to be applauded, it does not address the current crisis. It will take several months for everyone who wants a vaccine to receive one, and no one should use the vaccine rollout to distract from the urgent needs today. We must continue to implement public health restrictions according to the needs at each juncture, and we must uphold all public health measures, including staying at home as much as possible, washing our hands frequently, wearing a face mask and keeping two metres apart from those outside of our household – as well as not traveling from one zone to another, let alone from one city or country to another.

Governments must address the needs of those essential workers who cannot stay at home or those whose conditions do not allow for physical distancing and isolation (e.g. multigenerational families in small living spaces and persons experiencing homelessness). The government must also institute a ban on evictions during COVID-19. On Dec. 27, I wrote an op-ed for the Hamilton Spectator about this issue. During a pandemic, we must protect people and allow them to continue to live in a safe environment. As I wrote, “preventing evictions is not just about providing desperate economic relief for tenants; it is also about their health.”

A practicum experience at RNAO: From evidence-based clinical care to evidence-based policy

Sarah Gallie recently completed her Master of Nursing degree at Ryerson University. In this article she recounts her practicum experience at RNAO’s policy department.

When I started the journey to complete my Master of Nursing at Ryerson University more than two years ago, I was looking for opportunities to expand my experiences of providing clinical care to patients and families at the bedside. Little did I know I would be completing my final practicum at RNAO amidst a global pandemic. 

When I enrolled at Ryerson, the courses I selected focused in leadership in health-care policy and education. I had previous experience working in nursing education and I had my mind set on continuing down that path. As I mapped out my program of study, I picked classes that mentioned education in the course description. To meet the program requirements, I also had to complete a course about health policy. Although I had previous experience participating in RNAO’s signature policy events such as Queen’s Park Day, and I had also responded to many of the association’s political action alerts, I could not have predicted how this course would flip my world upside-down. 

I found myself sitting on the edge of my seat, engaged and passionate about the topics discussed in this course. I was able to share with my peers the details of my experiences with RNAO. I found that they too became more intrigued when hearing about a nurse’s experience engaging in health policy. I quickly started to question the courses I had left in my program of study. Perhaps I needed to rethink my path.

When I began thinking about securing a practicum experience, I met with my faculty advisor to discuss my options. I shared with her my plans to pursue a career in education, but also spoke about the experiences I had during the health policy course. She could sense the excitement in my voice and her advice was to push myself to explore a practicum experience that was outside of my comfort zone. 

Following her guidance, I connected with the policy department of RNAO about the possibility of a practicum opportunity. After a few email exchanges, I was heading down another fork in the road that I never imagined I would take. 

My practicum experience at RNAO afforded me opportunities I would never have had if I had not pushed myself outside the silo I had put myself in at the start of my Master of Nursing program. It is a decision I will never regret. Being immersed in the world of health and nursing policy on the macro level during COVID-19, I was able to witness policy priorities shift quickly towards a focus on advocacy for the health of all Ontarians during a crisis. 

The project I focused on during my practicum centred around engaging nurses to feel empowered as influential leaders in the political arena while leveraging the competencies and skills that are engrained in us as nurses. In reflecting back upon this experience, I have come to the realization that my passion for health policy emerged while sitting in a classroom and was further brought to life at RNAO.

Having come to the end of my practicum and ultimately my Master of Nursing, I am thankful to my Ryerson University professors, my faculty advisor, and to RNAO for all they have taught me about what it means to be a nurse and political advocate with a passion for health and nursing policy.

Webinar on COVID-19 vaccine distribution: Progress to date

The latest in RNAO’s Health System Transformation and COVID-19 Webinar Series

Monday, Jan. 11, 2021, 2:00 to 4:00 pm

All Ontario health-care providers are invited to join the upcoming webinar, COVID -19 vaccine distribution: Progress to date, featuring Dr. Dirk Huyer, member, Lead Clinical Guidance and Surveillance Work-Stream, COVID-19 Vaccine Distribution Task Force. The event will also feature colleagues from Ontario’s Ministry of Health.

Dr. Dirk Huyer was appointed as the Chief Coroner for the Province of Ontario in 2014. He has been involved in the provincial response to the COVID 19 pandemic most recently as a member of the COVID 19 Vaccine Distribution Task Force as well as leading the Clinical Guidance and Surveillance workstream reporting to the Task Force.

RNAO CEO Dr. Doris Grinspun will open the webinar and set the stage for the discussion with some overall updates on COVID-19 in Ontario. Following this, Dr. Dirk Huyer and colleagues from the Ministry of Health will provide critical updates on the approach and progress of COVID-19 vaccination. A question and answer period with webinar participants will follow.

Due to high demand, participation in this webinar is limited to health providers in Ontario only. Registration is available on a first come, first served basis.

REGISTER NOW to secure your spot for this critical update.

*Please note the time change from previous webinars in this series. This Monday’s webinar is from 2:00 to 4:00 pm.

Sign petition to stop MPP Randy Hillier from flouting public health measures

RNAO urges all its members to sign Dr. Jeanette Dietrich's Change.org petition to stop Independent MPP Randy Hillier from flouting COVID-19-related public health measures and disseminating misinformation about COVID-19. In November 2020, Independent MPP Randy Hillier was charged under the Reopening Ontario Act after organizing an anti-COVID-19 lockdown rally at Queen's Park. This was the second anti-lockdown rally organized by Hillier. Since then, Hillier has continued to defy public health orders and the science that informs them. In late December, Hillier posted a picture of himself gathered with more than a dozen other people around a table, all without masks, subsequently threatening more "parties" and inviting more charges.

RNCareers: Help during the holidays and help for next phases of this pandemic

RNCareers.ca, RNAO’s official career site since 2005, is the largest in Ontario. The site hosts positions for nurse practitioners (NPs), registered nurses (RNs), registered practical nurses (RPNs), personal support workers (PSWs), and other health professionals in clinical and non-clinical roles across all health-care sectors. There are position listings for all levels of nursing including frontline, administrative, management, and executive nursing positions.

Jobseekers:

RNCareers.ca is a key resource for those searching for new career opportunities. Make use of features such as job alerts to be notified of positions posted based on criteria such as employer name or title, and upload your resume/CV to our resume database so that employers can contact you directly.

Please CLICK HERE to create an account on the site and complete these fields so employers can more easily identify those who are willing to assist during these crucial periods.

We also encourage you to upload your resume to the site so that employers can reach out to you directly if you meet qualifications for their positions. You can also set up JOB ALERTS on the site so you are notified of new opportunities based on terms you specify (e.g., 'vaccination', 'COVID-19', 'ICU’ ‘LTC’, etc.), or names of specific organizations you are seeking opportunities at.

Go to https://www.rncareers.ca/register/ to create your account today, and find your next opportunity! When creating your account, please indicate if you are willing to work in facilities undergoing COVID-19 outbreaks, and if you are available to provide COVID-19 vaccinations. This information will be crucial for employers seeking staff during the ongoing pandemic.

Employers:

Please go to https://employers.rncareers.ca/ to start posting positions and hiring qualified nursing professionals.

We have various job packages. Most of the available packages include access to our resume database, which includes resumes from over 11,000 candidates! Employers can search the resume database based on relevant key terms (e.g., location, sector, CNO class, etc.), as well as jobseekers' responses to questions related to their willingness to work in facilities that are undergoing COVID-19 outbreaks and availability to provide COVID-19 vaccinations.

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 Situation Report #341 for January 8:

Update:

COVID-19 Vaccination Recommendations for Special Populations is available on the Ontario government website.

Please find here the Guidance for Prioritizing Health Care Workers for COVID-19 Vaccination.

Staying in touch          

Please continue to keep in touch and share questions, comments, and challenges. Feel free to also recommend ideas for future webinars. Send these to me at dgrinspun@rnao.ca and copy my executive assistant, Peta-Gay (PG) Batten email: 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 continue to be tough times and we have to keep strong and focused! While the vaccine is hugely important, the immediate target is fighting the spread of the virus to preserve lives. To 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 – THANK YOU, and please know we stand by you!

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:

29 Dec - Public health nurses in schools – go here.

29 Dec - Government failing Ontarians as virus runs rampant and endangers lives – go here.

29 Dec - We need your help in addressing urgent staffing needs in health facilities – go here.

29 Dec - Best wishes for the holiday – go here.

18 Dec - Providing compassionate nursing care in an age of artificial intelligence – go here.

18 Dec - RNAO continues to express grave concern regarding the second wave – go here.

18 Dec - Long-term care staffing plan lacks urgency and legislated action – go here.

11 Dec - RNAO gravely concerned about the second pandemic wave – go here.

11 Dec - Health organizations plead for Ontarians to celebrate holiday season safely – go here.

4 Dec - Continuing the conversation: Mobilizing collective action for LTC reform – go here.

4 Dec - Nurses urge dedicated funding for infection prevention and control in LTC – go here.

27 Nov - RNAO, once again, plays major role in the media during November – go here.

27 Nov - COVID-19 in long-term care: A nurse’s witness statement – go here.

20 Nov - Government’s measures too late and insufficient; calling for a COVID-Zero strategy – go here.

13 Nov - Mobilizing collective action for long-term care reform in Canada – go here.

13 Nov - RNAO’s media conference to address the crisis in long-term care – go here.

6 Nov - Fall 2020 provincial budget once again leaves vulnerable populations to fend for themselves – go here.

6 Nov - Elections in the US: A path to healing and respect for science – go here.

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 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 infections – go here.

25 Sept - Nurses say throne speech advances A Just Recovery for All – go 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 Scope – go here.

11 Sept - International Overdose Awareness Day: Statement from RNAO – go here.

11 Sept - RNAO joins global movement: A Just Recovery for All – go 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.

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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