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Registered Nurses' Association of Ontario      

Dear Colleagues: Welcome to our Saturday, March 20 report during this fourteenth 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.

RNs and NPs, take advantage of a limited offer starting Wednesday, March 24th: 

Join here

 

Preliminary results of RNAO‘s Work and Wellbeing Survey

On March 8, Matthew Kellway, RNAO’s director of nursing and health policy, Kim Jarvi, RNAO’s senior health economist, and I presented preliminary results from our Work and Wellbeing Survey at our biweekly COVID-19 webinar (watch webinar here and see the slides here).

We launched the survey at the end of January. We knew nurses were shocked by the news that an RN, Stefanie Van Nyugen, died by suicide. She was young – just a few years into her career. Throughout this brutal pandemic we have heard directly from many of you. You have also written to us about your challenges and struggles with COVID-19. Yet, given the shocking news of Stephanie, we felt compelled to formally check the pulse of nurses across all sectors and to more deeply understand how you are coping.

The survey was open for three weeks and we received more than 2,100 responses from RNAO members and non-members. The target population was RNs, NPs and nursing students. The reaction to the survey confirmed why it was so important. We learned about nurses’ working conditions, attitudes towards work, stress levels, how nurses were coping as well as their future in nursing. The results will inform RNAO’s ongoing policy and advocacy efforts, as well as our programs to support Ontario’s nursing community.

Who responded?

  • 91% were RNs, 4% were NPs and 5% were nursing students. 
  • 82% of those who responded were members of RNAO while 18% were non-members.
  • Staff nurses accounted for almost 75% of respondents. 
  • Just over 50% of respondents worked in the hospital sector.
  • 15% worked in long-term care (LTC).
  • The remaining worked in primary care, home care, community care and academia.
  • The distribution of respondents was relatively even across age groups.
  • 70% of respondents reported working full-time while 23% worked part-time.

Impact of the pandemic

We asked nurses how their work had been impacted by the pandemic. While this may be an obvious question, we didn’t want to pre-judge the outcome. In response, 96% reported yes while 4% said no. We asked how concerned nurses were about work-related risks to their personal health due to COVID-19, and 60% reported being moderately or extremely concerned. Early on, the lack of personal protective equipment was a key concern and weighed heavily on nurses, particularly those working in hospitals and long-term care homes.

Almost half of the respondents reported that their work-life balance was affected to a great extent. Some reported working seven days a week, working mandatory overtime and having to forgo days off and vacation. The never-ending length of the pandemic weighs heavily, now surpassing one year. We have lived through two waves already and have now entered wave three in Ontario.

In terms of stress, 60% of nurses reported high or very high levels, while 32% reported moderate levels. We asked how are they coping with the stress they experienced. More than half (56%) ranked their coping score a 6 out of 10, or higher. A key finding is that older nurses reported being better able to cope with stress than younger nurses who indicated they weren’t coping as well.

Pandemic responses

We asked nurses if they had taken time off to manage stress, anxiety or other mental health issues. In response, 74% reported no time off while 26% did take some time off. This is remarkable given the intensity and the length of the pandemic. Regarding sources of support for mental health and wellbeing, more than half reported seeking the help of family and friends. 

We asked how they rate the level of support they received from RNAO, their employer and the government. Most respondents rated RNAO as providing good to excellent support, while rating their employer as fair to good, and the government as poor.

RNAO’s mandate is to speak out for nursing and to speak out for health. We are encouraged that 44% of respondents never felt discouraged by their employer from discussing their work experiences outside the workplace. This is significant, as nurses must continue to share their perspectives about what it is like to work during a pandemic. This must be welcomed and encouraged.

Future at work

We are still studying the results about how much nurses are working and their future intentions. Here are preliminary observations. Of the total, 31% reported working more than 40 hours per week. We received numerous comments about nurses working more than the 50-hour threshold. The burden of that work fell on nurses in some sectors (e.g., public health, acute care and LTC) more heavily than others (e.g., primary care).

We asked about intentions to retire. In terms of being eligible to retire at the time of the survey, 22% reported they are, while the remaining 78% were not. 52% of respondents said they planned to continue working for at least another 10 years and 22% said they plan to work another five to 10 years. That leaves about a quarter of respondents who said they plan to retire within four years, which represents a huge human resource challenge.

We have yet to compare the responses on likelihood to leave nursing (and the extent to which stress plays a role in that decision) with normal rates of attrition. Nurses in the sectors that faced a higher burden of work and stress (again, public health, acute care and LTC) indicated higher likelihood that they would leave the profession after the pandemic.

One bright spot: Respondents who are RNAO members are less likely to leave the profession after the pandemic than non-RNAO members. We are so pleased you feel supported by your professional association.

Takeaways

The impact of the pandemic is universal but the experiences of nurses are as unique as the nurses themselves. Each RN, NP and nursing student has lived through this differently.

The pandemic is jeopardizing the tenure of nursing colleagues in the profession with younger nurses experiencing more challenges coping and experienced nurses considering when they will retire. Those departures threaten the health system, which is why we must ensure we have strong retention plans in place. This is true at any time and with any employer. It is especially important now given the pandemic and its length’s impact on the nursing workforce.

Also critical is planning adequately for the future by increasing the capacity of nursing school programs. We need more RNs and NPs to meet the growing demand for their expertise. RNAO has already included this ask in our provincial budget submission.

A few lessons

The findings underline that hospitals were the only sector that fared well during the initial stage of the pandemic. The lessons learned from SARS meant they were ready – except for the insufficient stocks of PPE. However, that readiness didn’t translate across other sectors. Consider the tragedy in LTC as the worse prepared sector.  

Employers that improve working conditions for RNs and NPs in ICUs and LTC will have satisfied and supported staff. Staff shines when you have models of care with clear accountability, adequate resources and support. Nurses have choices about where to work and they will make those choices based on working conditions, leadership support, education support, and so on.  De-skilling is a poor practice – avoid replacing RNs with RPNs, RPNs with PSWs, PSWs with lesser trained personnel.

When considering retention efforts, ensure the ability of nurses to thrive…not just to survive. That‘s what will keep the nursing profession going.

Webinar participant comments

After presenting the early findings, we asked the 160 participants in our webinar if the findings reflect their own experiences. An overwhelming majority said yes. Here is a sample of the comments in the meeting’s chat box:

“Very interesting results, which should help in {health} human resource planning for the near future.”

“I respect what the nurses have gone through during this pandemic.”

“Yay to RNAO for leading this research.”

“Thank you so much for all the good information.”

Next steps

We thanked participants for the thoughtful comments. Our work isn’t complete. We are now conducting a deep dive into the results. Numerous narrative comments will help inform the analysis. We will finalize a comprehensive report to be released on March 31. You can watch the webinar here and see the presentation slides here.

 

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

 

Careers in Nursing webinar – An NP shares her journey in a rural indigenous community

Mar 26, 2021, 12:00pm - 1:00pm (ET)

Join us as Connie Foster shares her journey on becoming a nurse practitioner (NP) in a rural indigenous community.

You will gain insight on rural practice within Indigenous communities through a focus on an NP working in a Nurse Practitioner Led Clinic (NPLC).  

This webinar will showcase how the role of the nurse practitioner and the NPLC model has promoted better health outcomes for clients related to mental health and substance use.

Session objectives:

  • Participants will gain insight into the daily life of a primary care practitioner with a specialty in substance use management.
  • Participants will learn about career opportunities in primary care and substance use management.
  • Participants will gain an understanding of the advocacy role of nurse practitioners.

Presenter: Connie Foster, NP-PHC, MSc

RNAO’s Work & Wellbeing Survey: Media release and open forum for nurses to share how they're feeling during COVID-19

Wednesday, Mar 31, 2021:

  • 2:00pm to 3:00 – Press conference open to the media
  • 3:00pm to 4:00pm – Webinar with nurses

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 affects your mental health and well-being and that you 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 will serve to release the results of our report to the media, and continue our conversation with nurses.

Wednesday, March 31, 2021, 2:00pm - 4:00pm. Register here.

Learn more about the open forums here.

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

 

NP Virtual Institute on April 21

April 21, 2021, 9 am - 4:30 p. (ET)

Nurse practitioners from all sectors and settings across the province are welcome to RNAO’s Second-Annual Nurse Practitioner Institute – Nurse practitioners shaping the health system of the future.

The one-day virtual event provides NPs with an opportunity to network, engage and explore topics related to policy, clinical practice, quality improvement and patient safety, leadership and research. Top speakers this year include Matt Anderson, President & CEO, Ontario Health; Frank Marrocco, Associate Chief Justice and LTC Chief Commissioner; Dr. Jennifer Zelmer, President & CEO Canadian Foundation for Healthcare Improvement; and Greg Tofner, President & CEO from the Ontario Association of Medical Radiation Sciences delivering a clinical session of CT Scans & MRIs.

Participants will also discuss and debate key lessons and learnings from COVID-19 relevant to their practice and health system performance as well as build leadership and advocacy skills to drive meaningful policy and practice changes.

The NP Institute will close with an update about RNAO’s NP Task Force report Vision for Tomorrow, including the advisory role task force members will take on to ensure progress is made on each of the eight recommendations. 

These awesome speakers and much more are at NO cost for RNAO’s 1,800+ NPs. Register online today.

If you are an NP and not yet a member of RNAO, you can join as of this Wednesday for ONLY $100 with PLP and all taxes included! And, then join the NP Institute for free! Join here  

To learn more, please see the agenda. Register online today.

 

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 #390 for March 19 (no report on March 20):

Case count as of March 19, 2021 / Nombre de cas le 19 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*

922 848

+ 3 609

22 590

+  36

Ontario**

325 254

+ 1 745

7 212

+  10

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:

13 Mar - Getting it rightgo here.

13 Mar - RNAO leads dozens of organizations in candlelight vigilgo here.

6 Mar - RNAO’s continuing media profile: The February reportgo here.

6 Mar - Communication during a Pandemic: How we can endure the pandemic togethergo here.

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.

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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