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Registered Nurses' Association of Ontario      

Dear Colleagues: Welcome to our Saturday, March 6 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.

 

Candlelight vigil to commemorate one year of the pandemic – Thursday at 7 pm

This coming Thursday, March 11, marks the one year anniversary of the pandemic declaration by the World Health Organization. It is sobering to reflect on all that has happened to people around the world since then. And yet there is a long road ahead before we reach the end of the COVID-19 ordeal. To share in this reflection, RNAO invites you to commemorate the anniversary with us.

Given the enormity of what has transpired over the past year, the tragic loss of life and the incredible efforts of our hardworking nurses, physicians, personal support workers and other valued healthcare workers fighting the virus, RNAO invites you to recognize the occasion with a candlelight vigil ceremony – live and online.

We plan to issue a media advisory to encourage members of the public, along with healthcare providers, to step outside of their homes or workplaces at 7 p.m. (ET) on Thursday, March 11 and to light a candle to remember those who have died and to reflect on the hope that lies ahead. We also encourage you to profile your online presence on March 11 with the image of a lighted candle – in the homepage of your website, in your Facebook page and everywhere else.

Join our effort to help spread the word. If you are an organization and want to join as such – email Marion Zych mzych@RNAO.ca with your desire to join our effort, along with your organizational name and logo. Please let us know by Tuesday, March 9 at noon. We, in turn, will provide you with an image you can use to help promote this on your websites and social media channels.

For those who want to join as individuals, simply step out on Thursday at 7 pm with your candle lightened. If you need to know more, email Susan McNeill  Stay tuned for the announcements from RNAO.

 

RNAO’s continuing media profile: The February report

We’re nearing the one-year mark since the World Health Organization declared COVID-19 a pandemic and RNAO continues its unstoppable efforts to address the challenges we face in Ontario. We are proud of the central role we play in the media, and here is a summary of the issues we raised during February.

As more COVID-19 vaccines arrive in Ontario, RNAO has insisted that the rollout be in the hands of community providers. In a Feb. 12 letter to the editor in the Toronto Sun, I stated Ontario needs to move away from hospital-delivered vaccinations and accelerate vaccine distribution by relying on nurses working in public health, primary care and home care, as well as physicians and pharmacists through established networks. I also urged to quickly vaccinate vulnerable populations, including persons who are homeless and individuals over the age of 60 who are most at risk. I urged the premier to ensure a plan was set to have vaccinations administered 24-hours-a-day, seven-days-a-week. On Feb. 5, in the National Post, I said: “We absolutely need to never have a vaccine in a fridge. We get the vaccine and we put it in [people’s] arms.” On March 5, Health Canada approved the Johnson & Johnson COVID-19 vaccine for use in Canada making it the fourth approved so far.

I also raised concerns about how Ontarians will know it’s their turn for the vaccine. “Where will they be going?” I asked on Feb. 17 in CTV News Ottawa. “If they’re not technology savvy, how will they make an appointment?” The same day, RNAO released an Action Alert to sound the alarm on the urgent need for a clear plan, and we continue to encourage members and the public to put the question to the premier. All of RNAO’s recommendations regarding the path forward were outlined in our letter sent to Premier Ford and Deputy Premier and Minister of Health Christine Elliott on Feb. 10. Our health is at stake, and we need a successful vaccine plan so we can finally see the light at the end of this long, dark tunnel.

RNAO continued to speak about the urgent need for self-isolation pay. Many nurses in Ontario were not being paid to self-isolate after being in contact with a potential COVID-19 patient. Hospitals in Hamilton, Niagara, Brant, Haldimand and Norfolk counties though are now providing staff with temporary self-isolation pay. RNAO hopes that every organization in Ontario will follow suit. I told CBC News on Feb. 17 that “it was never right to put the burden of sick time or isolation time on the back of the nurses that are putting themselves on the line to care and to protect and save lives.” In a Feb. 25 interview with CHCH news in Hamilton, I told them “I’m glad that...the entire region has decided to reconsider the approach.”

After less than a month since the province-wide stay-at-home order commenced, the premier announced on Feb. 8 most regions in Ontario would return to the colour-coded response framework. RNAO published a media release on the same day calling the easing of restrictions premature for many regions of the province in the absence of measures to restrict travel between regions. With the presence and spread of new variant strains, our message to the government and public remained clear: “Now is not the time to soften it up. Now is the time to sit tight” (Canadian Press, Feb. 9). RNAO expressed particular concern about the impact on our already strained health-care system. I told CTV News on Feb. 9: “Let’s not gamble on overwhelming the health system even more… the health-care professionals, doctors and nurses are absolutely exhausted.” On Feb. 19 the government announced that Toronto, Peel and North Bay-Parry Sound would have their stay-at-home order extended to March 8. However, York Region was able to move into the ‘red’ zone, which I told that same day to the Toronto Star was entirely a political decision rather than a public health one. On Feb. 26, the government announced that Thunder Bay and Simcoe Muskoka will be moving back into lockdown because of rising case counts, partly because variants of the virus spread more quickly. On March 5, the government announced that the stay-at-home order in Toronto and Peel will end and they will move into the grey-lockdown level of the colour-coded framework and North Bay-Parry Sound will move into the red-control level.

Even in the middle of a pandemic, when nurses are often called heroes, nursing vacancies across Canada remain prevalent. But as I told CBC News’ Canada Tonight on Feb. 8, it’s not that there is a shortage of RNs but rather a shortage of hiring RNs. On the bright side, the pandemic is inspiring many – high school graduates and second-career seekers – to aspire to enter our profession. A new report by the Ontario Universities Application Centre shows that they have received a substantial increase in applications for nursing programs. We need to secure our health human resources by expanding nursing programs as well hiring more registered nurses and nurse practitioners on a sustained basis. Let’s also remember we have 2,500 nurses ready and able to work right now in RNAO’s RNCareers.

We keep encouraging members to use your informed, credible voices. Burnout is pervasive among frontline providers and we are proud of our members speaking out in the media. RNAO member Birgit Umaigba told CBC News’ Metro Morning on Feb. 3 that the pandemic is taking its toll on her. “We’re constantly surrounded by death, trauma and grief,” she says. “You walk into the ICU not knowing what to expect.” But she says she continues to show up to work because: “If I don’t show up, who’s going to?” RN Sara Fung also voiced her concern for her family: “It’s very stressful, and we’re living with this constant fear of catching COVID-19 ourselves and passing it on to our loved ones.” RNAO is here for you, that’s why we encouraged nurses in Ontario to complete our survey on their work and wellbeing. The results of that survey and the next steps in RNAO addressing the concerns will be discussed at our next COVID-19 Webinar Series event this coming Monday -- March 8 -- Register now.

On Feb. 25, RNAO held its annual Queen’s Park Day. An extensive Feb. 26 article by Queen’s Park Briefing, mentioning RNAO in the headline, provided rich detail on the event. It quotes discussions with Premier Doug Ford, Health Minister Christine Elliott, NDP Leader Andrea Horwath, Liberal Leader Steven Del Duca and Green Party Leader Mike Schreiner. During the closing remarks from Premier Ford, he referred to the value of nurses saying "I'm just very, very grateful, because it is the toughest job out there." The premier recounted an evening at the hospital with his late brother Rob who slipped and fell while getting out of the bed. When the discussion turned to health measures, I urged him to impose stricter regulations for reopening. “Lock it down, the sooner the better,” I told him. Even though this year’s event took place virtually, the invigorating energy from members was present all the same.

Much of the discussion in Queen’s Park Day focused on the need for more investment in nurse practitioners (NP) in Ontario, with the premier responding “by all means ... let's get a number on the table because we need you, we really do.” He mentioned commitments the government has made to hiring ovr 10,000 RNs and 5,000 RPNs. Queen’s Park Day also included the launch of RNAO’s NP Task Force’s new report, Vision for Tomorrow, which provides recommendations to expand and enhance the role of NPs in Ontario’s health system.

RNAO’s media outreach resulted in 269 media hits during February. We continue to take media calls to discuss ongoing issues and concerns. For more information, you can read our latest media interviews in our COVID-19 Press Room.

 

 

Communication during a Pandemic: How we can endure the pandemic together

COVID-19 has impacted enormously on mental health and our ability to communicate with others. We are hugely grateful for the contribution of the following article written by Teresa Valenzano and Patty Matsuo on behalf of the Ontario Association of Speech-Language Pathologists and Audiologists (OSLA). Teresa Valenzano, M.HSc. (S-LP), Reg. CASLPO, is research manager of the Interprofessional Practice Based Research program at St. Michael’s Hospital. Patty Matsuo, M.A., SLP(C), M.H.Sc., CHE, brings 24 years of experience as a hospital-based clinician and 16 years as a professional practice leader. She currently works at Trillium Health Partners in Mississauga/Toronto. They are, respectively, member and past president of the OSLA Board of Directors.


It’s been over a year since COVID-19 has been on Canadian soil – a tumultuous year requiring adaptation to guidelines, restrictions, and policies, all in a concerted effort in the battle against COVID-19.  While the impact is varied for each of us, every citizen of the world has been affected by our ability to communicate.

Communication, both verbal and non-verbal, underlies most of our daily actions. Whether it’s the first “good morning” we say to our roommate as we hand them a cup of coffee, or a nod to the TTC driver as we step onto the bus, we send communicative signals all the time, often consciously and subconsciously. And as frequently as we send those signals, we receive them and interpret them just as often – if not more! While some signals are the simple relaying of information, others encompass the social interaction between human beings – emotional responses given and received through all our senses.

Whatever the content, these connections are hindered by masking and distancing because of COVID-19. These day-to-day limitations with whom we can gather, the two-metre distance we hold between each other, physical barriers that keep us apart and how we must cover our faces in public cannot overstate the impact on quality of life for all individuals, some more than others.

In October 2020, it became mandatory to wear face coverings in public indoor spaces across Ontario. With this came sales of medical and cloth masks and signs posted outside of the TTC advertising how to make your own mask from a T-shirt. It has been proven in the scientific literature that face coverings help in the fight against the spread of COVID-19 – that is not up for debate. But what we often dismiss is the impact of wearing these face coverings on communication. With over 50% of Canadians 40 years and older with hearing impairment and over 90% of those over the age of 70 with hearing loss, masks hinder their ability to understand conversation, obscuring both the sound and the visual cues from lip movements and facial expressions.

For individuals with dementia and other cognitive challenges who rely on non-verbal communication through touch, physical guidance, facial expression, body language and tone of voice, with less face-to-face interaction, they have lost essential communication opportunities.  Not only has the frequency of contact been restricted, but communication is also shrouded by gowns, gloves, masks and shields.  Familiar faces are less recognizable. Confusion and anxiety are increased. Emotional well-being and ability to cope are compromised.

Physical distancing requirements have changed our communication style. No longer do we shake hands when we meet someone new or share a high five to celebrate successes. Physical distancing not only limits communication but lack of affective touch impacts our relationships, socioemotional health and even physical well-being. Connectedness is key to communication, and physical closeness and touch play a large part. For those who have experienced having a loved one hospitalized during the pandemic, not being able to hold their hand due to visiting restrictions or isolation room guidelines can feel staggering. The inability to provide comfort through touch, to communicate our caring, can be devastating for the person needing comfort while leaving the other feeling guilty for not being able to do more.

Humans are social beings who rely on one another for survival. While some adapted to using technology to maintain contact with their social circle, this is not possible for all, nor did it replace in person gatherings. Many have felt socially isolated during the past year leading to loneliness, and depression.

There are things we can do to help one another weather the impacts of communication challenges as we endure the remainder of this pandemic. As we speak through our masks, we can remember to speak louder, speak slower, and check in to ensure our conversation partner understands what we are saying. To facilitate communication with individuals with cognitive challenges, allow extra time for information processing, keep using facial expressions (real smiles are read in your eyes), and show your emotion through your voice. Mostly take the time and use simple phrases to support their comprehension and ability to express their wants and needs. Using personal protective equipment and infection control practices safely, make physical contact and provide that essential touch when needed. Take the time to make social contacts in other ways – by phone, by mail or visual call when you can.

Defeating this virus requires us all to work together. How we endure the battle requires us to remain mentally and physically strong. Persevere through the pandemic guidelines and restrictions using communication strategies to connect to each other. It’s a message we should all take to heart. 

 

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

 

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
  • Aaliyah Hoo Kim, RN, BScN, Clinical Nurse Educator at S.R.T. MedStaff

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.  

 

 

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

Mar 17, 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 17, 2021, 2:30pm - 4:00pm. Stay tuned for details and registration.

Learn more about the open forums here.

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

 

Watch webinar: Understanding wellness in Indigenous wisdom traditions for caregivers

This webinar was held on March 2, 2012 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

Watch various recorded segments of the webinar here (scroll down the page).

 

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 #380 for March 5 (no report on March 6):

Case count as of March 5, 2021 / Nombre de cas le 5 mars 2021

Area / Région

Area / Région

Change from yesterday / Changement par rapport à hier

Deaths / Décès

Change from yesterday / Changement par rapport à hier

Canada*

+ 878 391

+ 2 832

+ 22 151

+  46

Ontario**

+ 306 007

+ 1 250

+ 7 046

+  22

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 health professionals – must keep focused. There is hope at the end of this long tunnel. Vaccines are being delivered in large quantities and now we need to fasten the rollout! Hugely important is to continue 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 stands 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:

6 Mar - Webinar: Understanding wellness in Indigenous wisdom traditions for caregiversgo here.

27 Feb - RNAO celebrates Black History Month 2021go here.

27 Feb - RNAO’s 21st annual Queen’s Park Day goes virtualgo here.

27 Feb - RNAO’s NP Task Force releases groundbreaking report – Vision for Tomorrowgo here.

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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