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Registered Nurses' Association of Ontario      

Dear Colleagues: Welcome to our Saturday, February 27 report during this thirteenth 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. 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. Scroll down for information on several webinars.

We are inviting our readers to support the St. James Town Emergency Food Relief program, which serves a very vulnerable population and has had to pause due to lack of funds. You can watch the CBC story, link to a petition and go to the GoFundMe page if you wish to donate money. We will update regarding this local initiative in future blogs.

 

RNAO celebrates Black History Month 2021

February marks Black History Month – a month dedicated to honouring our Black sisters and brothers, their past and the steps toward allyship.

RNAO recognizes the continued importance of sharing Black stories and perspectives, encouraged by and eager to contribute to the invigorated movement to end anti-Black racism and discrimination. In the past year, RNAO launched a task force dedicated to tackling anti-Black racism within the nursing profession, as well as an internal task force to ensure the association practices protect applicants and staff from discrimination and racism, and advance inclusivity and diversity in all aspects of our work.

During Black History Month, RNAO has been celebrating with leaders in our community and we invite you to see a few of their messages here. We have also taken the opportunity to update the nursing community on the work of its Black Nurses Task Force.

To read more, link to resources and watch videos, please go to RNAO’s Black History Month page here.

 

RNAO’s 21st annual Queen’s Park Day goes virtual

My deepest thanks to RNAO’s Communications Assistant, Alicia Saunders, and our Director of Communications Marion Zych, for the excellent recap of our 21st Queen’s Park Day (QPD). Close to 200 registered nurses, nurse practitioners, nursing students, politicians and members of the public joined RNAO on Feb. 25.

As one of RNAO’s annual signature political action events, this year’s iteration looked a bit different due to the ongoing COVID-19 pandemic. Participants joined our President Morgan Hoffarth and our CEO Dr. Doris Grinspun for a four-hours afternoon event that included remarks from the premier, minister of health and leaders of the NDP, Liberal and Green parties, as well as NDP and Liberal party health critics. As a non-partisan association, RNAO has built solid partnerships with all parties to ensure nurses’ perspectives are shared around the decision-making tables of government, and that the issues and challenges of nurses, and the solutions we offer are always considered a priority.

At the beginning of the event, Grinspun told attendees they would leave “feeling energized and armed with new knowledge.” She and Hoffarth shared information on some of the key health issues RNAO has advocated for this year, specifically measures needed to combat COVID-19, the opioid overdose crisis, the funding and staffing crisis in long-term care (LTC) and health system transformation. Participants were encouraged to speak up and use their voices to ask Ontario’s politicians the tough questions that will ultimately lead to an improvement of the health and well-being of individuals and communities across the province. “What’s good for Ontarians is good for nursing,” Grinspun said.

After each party’s presentation, RNAO members were able to ask the political leaders and critics questions through the virtual chat function. Question topics included the measures to help end the COVID-19 pandemic, the need for more consumption and treatment services sites, increased staffing in LTC, pharmacare, housing and environmental determinants of health.

Deputy Premier and Minister of Health Christine Elliott was first to speak and focused on the work the Ontario government is doing to address the COVID-19 pandemic and the second phase of its vaccination program. She also acknowledged that RNs and NPs who want to help administer vaccinations will be able to do so soon through Ontario’s matching portal. She announced that the Ontario government is increasing funding by $2.1 million per year for the next two years to support the RNAO-administered Nursing Education Initiative program.

During her presentation, Minister Elliott acknowledged the need to work together to improve the health-care system and to combat COVID-19. “There is still a lot of important work ahead of us to ensure we beat COVID-19 and to build a more patient-centred health-care system. I know together we will achieve both goals,” she said. Grinspun pleaded with the minister to vaccinate all health professionals fronting patient care, ahead of firefighters and others. Our CEO shared that agency nurses working in ICUs are yet to be vaccinated, and only seven percent of nurses working in home care have received the vaccine. The minister committed to remedy the situation.

Andrea Horwath, leader of the Official Opposition – NDP – was joined by her party’s long-time health critic, France Gélinas. Horwath took time to highlight the important work of nurses in Ontario during this past year. She also commented on how Ontario is not only dealing with the pandemic, but several other ongoing crises, including issues with the LTC system, opioid poisoning, lack of mental health supports and homelessness. She noted the health-care system is crucial and something everyone values. “The delivery of health services is one of the most important priorities of Ontarians and Canadians when asked what their taxes should be spent on,” she said. Gélinas echoed this statement and voiced her concern that nurses were not included in the province’s initial response to COVID-19. “RNAO was vocal from the start. Why weren’t nurses at the table? Why weren’t they listened to?” she asked. “We should listen to you and to everyone on the frontline, guided by public health.”

Liberal Leader Steven Del Duca and health critic John Fraser emphasized the importance of RNAO’s ongoing advocacy work. The liberal party has heard RNAO ‘loud and clear’ on the opioid crisis, Del Duca said. He also shared that his party is conducting public consultations as it begins to shape its platform. He encouraged RNAO members to participate and share their views. When it comes to pharmacare, Del Duca says that getting a national plan in place is vital. “I agree that filling this missing piece in our national health-care system is essential.” Fraser said that RNAO has worked to put pressure on the government to make the right decisions. “Sometimes what you need to do is ask the really tough questions and point people in the right direction, and that’s what you’ve done,” he said.

Mike Schreiner, leader of Ontario’s Green Party, was also at the event to share his gratitude for the work nurses have done over this past year while highlighting the need to make sure nurses have a safe work environment and the support and pay they deserve. He also noted that COVID-19 has shone a light on the long-standing issues in LTC that predate the pandemic, something RNAO has been outspoken about for a long time. “COVID has highlighted that we have to prioritize care over profits. We need to make these investments now to hire the staff to care for our elders,” Schreiner said. RNAO will continue to advocate for a Nursing Home Basic Care Guarantee to be implemented in all homes across the province and country to give residents the care they deserve and the staff the supports they need.

Premier Doug Ford joined the session to provide closing remarks. He recalled an experience he had when his brother Rob – former Toronto mayor – was receiving cancer treatment. Rob wanted to get out of bed but fell while the premier was helping him. It was late at night and when Ford went for help, he noticed there were only a few nurses on the floor. He had to get help from security in the hospital, but says the experience stuck with him and he vowed that never again would there not be enough nurses. The premier commented on the important role nurses have played and that the government needs to be there to continue to lift up the nursing workforce. “You’re absolute heroes,” he said. “We need to make sure moving forward that we’re there financially to support.” The Premier commended RNAO’s work and thanked our CEO for always providing him with advise.   

Thanking the Premier for being a good partner, Grinspun took a moment to remind him of what needs to be done to suffocate the pandemic. She also insisted on the need to urgently hire more RNs in all sectors and ensuring there is one NP per LTC home. She also pressed him on administering the COVID-19 vaccine 24-hours-a-day, seven-days-a-week when the supply arrives and to engage nurses, along with physicians and pharmacists in such a rollout. The premier told Grinspun: “We’ll make sure we ramp up and have enough people to have our health-care system moving forward.”

Although participants at this year’s event missed the opportunity to interact one-on-one with their MPPs, the gathering was an evident success in that it provided an opportunity for nurses to be heard and respected by decision-makers at Queen’s Park.

The latter portion of this year’s virtual meeting featured the release of the RNAO Nurse Practitioner Task Force report, Vision for Tomorrow. An engaging panel discussion with members of the task force, joined by task force co-chairs Dr. Doris Grinspun and Dr. Elissa Ladd, rounded out the day (see next article). Anyone who was unable to attend is invited to read more about the report and its eight recommendations and actions for building a stronger NP workforce as part of Ontario’s health system transformation agenda. The premier shared that he was open to boosting the number NPs in Ontario. “We’ve put a commitment together over the next four years to hire 10,800 RNs, close to 5,000 RPNs, and then with the nurse practitioners, by all means… let’s get a number on the table because we need you, we really do,” says Ford.

The saved livestream of this year’s virtual event is now available. Members can also read the live Twitter coverage.

 

RNAO’s NP Task Force releases groundbreaking report – Vision for Tomorrow

On Feb. 25, RNAO’s NP Task Force released the groundbreaking report, Vision for Tomorrow, which brings to life not only the evidence on why NPs are crucial in our health-care system, but also the lived experiences of those NPs who are already making a difference to patient outcomes in their day-to-day practice. It is a comprehensive blueprint that calls for the NP role to be expanded and to fully utilize NPs to advance the health of Ontarians and strengthen the health system. Overall, it calls for the supply of NPs in Ontario to increase by 1,875 (or more than 50 per cent) by 2030. This increase is necessary just to address the specific needs of vulnerable and underserved populations.

Vision for Tomorrow includes eight recommendations, and each comes with specific calls to action aimed at the government and other partners. The recommendations include:

  1. Increase the supply of NPs across all sectors and settings.
  2. Optimize the utilization of NPs within current scope.
  3. Expand the scope of practice for NPs.
  4. Align NP curriculum with expanding scope of practice.
  5. Harmonize NP compensation across all sectors and settings.
  6. Invest in research to support NP practice and improved health outcomes.
  7. Optimize access and continuity of care by ensuring all insurance benefit carriers, and other such payers, accept NP services analogous to physician counterparts.
  8. Showcase impact of NPs through public education campaigns to advance full utilization of NPs across all sectors and settings.

“NPs are a resource for our health system and their role has evolved thanks to our advocacy. However, if we are serious about health-system transformation and integration, there is much more we must do so more Ontarians benefit from their expert care,” says task force co-chair and RNAO CEO Dr. Doris Grinspun. “NPs are key to delivering on the Quadruple Aim, which seeks to improve the patient care experience, improve health outcomes, improve the care provider’s experience, and reduce health costs. This is front-and-centre in our report and our recommendations.”

The significance of the Vision for Tomorrow report is that its impact extends beyond Ontario and even beyond Canadian borders.

“With a framework grounded in the Quadruple Aim concept and the report’s attention to the United Nations’ Sustainable Development Goals, which strive to end poverty, protect the planet and ensure people’s well-being, I am confident the report will have far-reaching impact,” says Dr. Elissa Ladd, co-chair of the task force and director of Global Health Equity and Innovations at the MGH Institute of Health Professions in Boston. Ladd also serves as a deputy director of the International Council of Nurses’ Nurse Practitioner/Advanced Practice Nurse Network Global Research Academy.

For the release of this report, RNAO invited NPs and task force members to be part of an informative panel discussion. Each spoke of their respective work and impact in primary care, long-term care (LTC), acute care and Indigenous communities.

COVID-19 has underlined the need for the Ontario government to ensure NPs are utilized to their full potential for the benefit of patients and overall population health. The pandemic has compounded the health impacts of poverty and growing inequities in communities across the province. NPs who are already making a difference in this sector include task force member Tara Leach, who is an NP and founder of an Ottawa clinic that provides trauma-informed care to those who experience sexual exploitation, coercion and/or human trafficking. She spoke on behalf of primary care NPs during the Feb. 25 panel discussion, sharing details of how she and her NP colleagues in this sector are a safety net, ensuring timely assessment, diagnosis, treatment, prescriptions, referrals and follow-up for marginalized, vulnerable and underserved populations.

The impact of COVID-19 on the province’s LTC sector is staggering. A record number of residents have died. They are victims of long-standing severe staffing shortages and systemic issues that could be addressed with better utilization of the education, competencies and skills of NPs. Priya Shah, an NP and member of a nurse-led outreach team for the Hamilton Niagara Haldimand Brant Local Health Integration Network, represented LTC NPs during the panel discussion. She spoke about her role in preventing unnecessary emergency department visits and hospital admissions for the elderly population in LTC. She also addressed the vital working relationship she has with attending NPs in LTC who are most responsible provider for this population.

In acute care, NPs have legislative authority to: admit, diagnose, treat, transfer and discharge patients; order diagnostic tests; prescribe medications; and more. Yet, significant roadblocks still stand in their way, preventing them from unleashing their full potential to benefit Ontarians and health-system effectiveness.

Task force member Suzanne Robichaud, VP of clinical services and chief nursing executive for Hôpital Montfort, spoke to the role of NPs in acute care, and how more are required to adequately care for frequent users in hospitals and those with complex medical needs. Fully engaged NPs in acute care can be effective recruiters for the role, and preceptors for student NPs, she said.       

Such leadership is vital in all sectors, and it is particularly important in rural and remote Indigenous communities, according to task force member Dr. Victoria Smye, director and associate professor at the Arthur Labatt Family School of Nursing, Western University, London. She spoke about the need to align NP curriculum with expanding scope of practice, and securing more preceptors and more diverse placements available to NP students. Academic institutions have a lot of work to do to engage with Indigenous communities so NP students are better prepared to provide equity-oriented, trauma-informed, culturally safe care in these communities.

When it comes to the sheer number of NPs, Canada and Ontario also have a lot of catching up to do compared with the U.S., which boasts 61.1 NPs per 100,000 people. In contrast, Canada has 15.3 NPs per 100,000. Ontario is only slightly higher at 22.5 NPs per 100,000. Currently, there are 3,426 NPs practising in primary care, acute care and LTC in the province. As stated above, the report calls for an additional 1,875 NPs by 2030 – just to address the needs of vulnerable and underserved populations.

 “This Vision for Tomorrow report marks the end of one phase, but the beginning of a set of actions,” Grinspun says. “Task force members will now take on an advisory role, meeting once or twice a year as we advocate to see each of these recommendations come to fruition. NPs and their patients are waiting and they deserve to see each one of these recommendations and companion actions come to life.”

Read the full report for more detailed analysis and next steps.

 

POLICY UPDATES FOR ALL TO ACT ON & MUST JOIN EVENTS – OPEN TO ALL

 

Understanding wellness in Indigenous wisdom traditions for caregivers

Mar 2, 2021, 7:00pm - 9:00pm

This webinar is in partnership with the Registered Nurses’ Association of Ontario (RNAO), Nishnawbe Aski Nation(NAN), Chiefs of Ontario (COO), the Centre for Addiction and Mental Health (CAMH), Shkaabe Makwa and the Canadian Indigenous Nurses Association (CINA).

Target audience: registered nurses, nurse practitioners, registered practical nurses and nursing students across care settings, primary care providers, public health and health promotion professionals, allied health-care providers and policy makers. 

Note: this webinar will focus on nurses and health-care providers supporting First Nations communities and organizations; however, all are welcome to attend.

During this presentation, participants will:

  • share the importance of language and what your language says about being well;
  • discuss how your culture helps maintain being well;
  • discuss the vision of a healthy community/healthy peoples; and 
  • discuss the importance of the caregiver role and how much they are appreciated and valued by communities.

Presenters:

  • Theresa Redsky Fiddler (Elder)
  • Ka’nahsohon Kevin Deer (Elder)
  • Perry McLeod-Shabogesic (Elder)
  • Mary Deleary (Elder)

Click here for full bios.

Webinar program at-a-glance

 

Continuing the conversation – An open forum for nurses to share how they're feeling during COVID-19

Mar 3, 2021, 2:30pm - 4:00pm

RNAO is aware nurses across Ontario – especially those working on the frontlines of COVID-19 – are experiencing tremendous levels of physical and emotional stress and burnout. We know this can affect your mental health and well-being at this challenging time and that you may have less time to devote to your own self care.

RNAO hosts a biweekly virtual open forum series for nurses to share how they're feeling during COVID-19. During these forums, RNAO holds breakout sessions for participants to discuss themes identified in the previous forums, such as dealing with multiple losses, taking care of yourself and more.

All Ontario RNs, NPs, RPNs and nursing students – in all roles and sectors – are invited to take part and share or simply join in to listen to your nursing colleagues.

The next session is on March 3, 2021. Stay tuned for more details.

Register now.

You can find RNAO’s page on Psychosocial support during the COVID-19 pandemic here.

 

Webinar on nurse wellness survey results: RNAO's pulse on Ontario’s RNs, NPs and nursing students

March 8, 2021, 2 - 4 p.m. ET

RNAO’s work and wellbeing survey asked RNs, NPs and nursing students in Ontario how they’ve been impacted by COVID-19 and the best way RNAO can continue to support Ontario’s nursing community. The survey closed on Feb. 22, and the more than 2,100 responses have been analyzed.

Join our webinar on March 8 to hear and discuss how the pandemic has changed nurses’ work, their attitudes toward work and their future in nursing. Learn how the survey results will inform RNAO’s upcoming policy work and advocacy efforts.

Bring your questions and participate in the conversation with RNAO’s CEO, Dr. Doris Grinspun and Director of Nursing and Health Policy, Matthew Kellway.

REGISTER NOW to secure your spot in this critical discussion.

For more on the RNAO COVID-19 webinar series, go here.

 

Webinar: Impacts of racism on the mental health of Black nurses

Mar 15, 2021, 6:30pm - 8:00pm ET

Objectives:

  • generate awareness of the emotional toll overt and covert racism can have on Black nurses and nursing students;
  • explore how systemic anti-Black racism and discrimination affects the mental health and wellbeing of Black people;
  • discuss the ways in which Black nurses’ experiences of racism impacts their educational and career trajectories;
  • identify strategies to address, cope with and build resilience against racial microaggressions; and 
  • review opportunities for advocacy related to increasing mental health supports and services within academic institutions and workplaces of Black nurses.

Presenter:

  • Dr. Oluremi Adewale, RN, BScN, MScN, EdD, President, CEO and Founder of Women Focus Canada Inc. and Mental Health Consultant

REGISTER NOW

For more on the Let’s Talk about Anti-Black Racism and Discrimination in Nursing webinar series and RNAO’s Black Nurses Task Force, go here.  

 

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 #375 for February 26 (no report on February 27):

Case count as of February 26, 2021 / Nombre de cas le 26 fevrier 2021

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

Canada*

858 217

+ 3 091

21 865

+  58

Ontario**

298 569

+ 1 258

6 944

+  28

Update

 

Staying in touch          

Keeping in touch is now more important than ever. Feeling that you are part of a community and that we have your back will help you get through this challenging time. We are also eager to hear from you how we can best support you. Send to us your 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 reach out to one another in solidarity! Our government, the public and indeed all of us as health professionals – must also keep 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 take care of yourselves and know that RNAO always 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, FCAN, O.ONT
Chief Executive Officer, RNAO

 

RECENT BLOG ITEMS:

20 Feb - Are you struggling with substance use and/or mental illness?go here.

20 Feb - RNAO hears about COVID-19: A heart-to-heart dialogue for nursesgo here.

20 Feb - With new variants growing, concerns mount about the premature lifting of restrictionsgo here.

18 Feb - Anti-Black racism and discrimination in nursing: The power of mentorship in nursing educationgo here.

13 Feb - RNAO’s letter to the premier on the vaccine rollout and the current contextgo here.

6 Feb - Use community care providers to ramp up vaccinations!go here.

6 Feb - RNAO’s continuing media profile: The January reportgo here.

30 Jan - The PrOTCT plan for nurses: Counseling vaccine hesitant patients & colleaguesgo here.

30 Jan - Please sign action alert urging Premier Ford to suffocate COVID-19, NOW!go here.

23 Jan - Mitigating the spread in Toronto shelter settingsgo here.

23 Jan - Home care nurses are #ReadyToVaccinatego here.

23 Jan - Hurtful comments about law enforcementgo here.

15 Jan - The escalating catastrophe of the COVID-19 second wave in Ontariogo here.

15 Jan - Progress in vaccine distribution: Updates, issues and concernsgo here.

8 Jan - RNAO raises its voice in the media: Media coverage in December 2020go here.

8 Jan - A practicum experience at RNAOgo here.

8 Jan - RNCareers: Help during the holidays and help for next phases of this pandemicgo here.

29 Dec - Public health nurses in schoolsgo here.

29 Dec - Government failing Ontarians as virus runs rampant and endangers livesgo here.

29 Dec - We need your help in addressing urgent staffing needs in health facilitiesgo here.

29 Dec - Best wishes for the holidaygo here.

18 Dec - Providing compassionate nursing care in an age of artificial intelligencego here.

18 Dec - RNAO continues to express grave concern regarding the second wavego here.

18 Dec - Long-term care staffing plan lacks urgency and legislated actiongo here.

11 Dec - RNAO gravely concerned about the second pandemic wavego here.

11 Dec - Health organizations plead for Ontarians to celebrate holiday season safelygo here.

4 Dec - Continuing the conversation: Mobilizing collective action for LTC reformgo here.

4 Dec - Nurses urge dedicated funding for infection prevention and control in LTCgo here.

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

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

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

13 Nov - Mobilizing collective action for long-term care reform in Canadago 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 themselvesgo here.

6 Nov - Elections in the US: A path to healing and respect for sciencego 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 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.

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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