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Registered Nurses' Association of Ontario      

Dear Colleagues: Welcome to our Saturday, March 27 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.

 

Government's reopening plan threatens the health of Ontarians

RNAO issued today the following media release.


The government's reopening framework is threatening people's lives, the collapse of the province's health system and the closing of schools.

The government's latest announcement Friday (March 26) that Hamilton is moving into the grey-lockdown zone and the regions of Timiskaming and Eastern Ontario are moving into the red zone provide further proof that a third wave of COVID-19 could engulf vast sections of the province.

Yet, on Friday, March 19, the government announced it was increasing capacity limits for indoor dining in selected regions designated in the red and orange zones. It also gave the go-ahead for outdoor dining in regions that have been placed in the grey-lockdown zone. Large numbers of people have been gathering since.

"The minister of health has said the next few weeks are critical and she is correct. However, at the same time Minister Elliott is warning Ontarians about the dangers variants of the virus pose, the government is issuing contradictory messages by relaxing public health measures designed to protect people's health. That's why we are urging Premier Ford to scale back reopening plans," says RNAO CEO Dr. Doris Grinspun, including the latest plan to reopen personal care services such as hair salons and barber shops on April 12.

RNAO says public health measures are being eased at the same time Chief Medical Officer of Health Dr. David Williams has confirmed that Ontario is in the midst of a third wave. "We need to act now to prevent this third wave from being more catastrophic than the second wave. We know with certainty that the virus variants spread mush faster. We also fear it makes people far sicker and can result in much higher rates of death," adds Grinspun.

The government's own modeling projections indicate the highly contagious variants could see daily case counts balloon anywhere from 2,500 cases to a worst-case scenario of up to 4,000 new infections by the end of March. For the past three days, they have been well over 2,000 cases and fast approaching the 2,500 mark.

Equally alarming says RNAO are hospital ICU levels that, according to Critical Care Services Ontario, show COVID-19 patients occupied 401 beds as of March 26, well above the threshold at which hospitals say they can cope. 

Rather than opening up parts of the province, Grinspun says the government should strengthen restriction of movement to enable the health system to cope. "Our focus should be on containing the spread of the virus, keeping our health system functioning, our schools open and safe, and redoubling the efforts to rollout vaccines."

RNAO president Morgan Hoffarth wants the government to ensure nurses; particularly those who work in primary care and home care – close to 20,000 – are fully utilized in the province's vaccine rollout. "As more and more vaccines arrive, we urge the government to enlist the 7,500 nurses who work in home care." This is something RNAO has been advocating for and outlined in a letter sent to the premier and health minister in February, imploring the government to act. "Nurses are providing care for seniors and others who are homebound on a regular basis. This will ensure the pace of the rollout speeds up and is carried out more safely and efficiently." Hoffarth says this is especially important given the evidence that people 60 years of age and older are at a much greater risk of dying from COVID-19.

Hoffarth also says continuing to relax public health measures at a time that the spread of the virus is increasing will likely result in the closing of schools in various regions of the province, which she points out would be devastating for children. "We know the best place for children is to be in class, learning from their teachers and interacting with their peers. If we continue to put business interests ahead of the education, mental health and wellbeing of children, schools will inevitably be forced to close," says Hoffarth.

"Nurses know small businesses are suffering and call on government to help by providing funding to get them through the next few months. We will all go back to patronizing our local businesses when the pandemic is under control. However, we will never get back the lives lost to COVID-19," says Hoffarth, adding "we also renew our plea to Premier Ford to announce paid sick days for people who don't have that employment benefit. This is a critical measure to help workers and slow down the spread of COVID-19."

 

Provincial budget fails to deliver urgent nursing investments to care for Ontarians and to sustain the profession through the pandemic and beyond

RNAO’s media release on March 24 responded to the presentation of the Ontario budget in the legislature. Here it is.


The Registered Nurses’ Association of Ontario (RNAO) is disappointed the government is failing to make the investments desperately needed to help nurses in the fight against COVID-19 and to sustain the nursing workforce after the pandemic.

“The length and intensity of the pandemic has hit nurses especially hard. They are exhausted, feel let down and unsupported by the government and yet, are soldiering on during a third wave of COVID-19,” says Dr. Doris Grinspun, RNAO’s CEO. A recent survey conducted by the association shows nurses, particularly those early in their career, are seriously considering leaving the profession and this budget offers little indication that help is on the way, adds Grinspun.

This includes a commitment to hire thousands of additional registered nurses (RN) and nurse practitioners (NP), measures to retain nurses currently working in the system and redoubling our efforts to recruit future nurses.

The budget, which was unveiled by Finance Minister Peter Bethlenfalvy, titled Ontario’s Action Plan: Protecting People’s Health and Our Economy, provides details on the government’s ongoing response to the pandemic.   

While RNAO fully supports the government’s substantial investments in the hospital sector including adding thousands of hospital beds, the association is perplexed that there is no plan or investments in the budget for the nurses needed to provide care.

The $933 million in funding to create additional spaces in the long-term care sector (LTC) and modernize existing ones for residents who call LTC home addresses only one aspect of life in the sector. Missing again are details about the $4.9 billion the government says it will invest over four years to increase nursing and personal care. More RNs, NPs and registered practical nurses (RPN) are needed in addition to the thousands of personal support workers (PSW) that Minister Bethlenfalvy cited in his budget address in the legislature. “Nurses work alongside PSWs and we respect their commitment and work, however, we regret that the minister failed both to praise and outline exactly how many RNs and RPNs will be hired to deliver the four worked hours of nursing and personal care it says it is committed to delivering,” says Grinspun.

The LTC sector was essentially abandoned during COVID-19, leaving staff, residents and their families reeling as the virus swept through nursing homes, resulting in a devastating loss of life and 3,753 resident deaths to date. “Residents should not have to wait until 2024-25 to receive the care they deserve today,” says Grinspun. She says the association’s Nursing Home Basic Care Guarantee is a ready-made evidence-based staffing formula that provides four worked hours of nursing and personal care for each resident with 48 minutes of RN care, 60 minutes of RPN care and 132 minutes of PSW care on a daily basis. The guarantee also calls for a nurse dedicated to infection prevention and control in each home, and an NP in each nursing home in Ontario. On the latter, we asked that this budget invest a minimum of $15 million to hire at least 100 Attending NPs in nursing homes, which would reduce unnecessary transfers to hospital, resulting in better quality of life for residents and their loved ones, and lower health system costs.

When it comes to the work of NPs, this budget contains no funding to increase their numbers, despite Premier Ford’s commitment at the association’s Feb. 25 Queen’s Park Day, where he said he was open to boosting the number of NPs in Ontario. Not only are NPs urgently needed in LTC, the need for them in primary care is also dire, especially in regions where Ontarians have no access to primary care – a key reason why RNAO calls for immediately funding at least three additional NP-led clinics.

RNAO says the government also missed an opportunity to shore up future care needs of Ontarians by committing to increase the number of seats in RN nursing education programs by 10 per cent this year and further increases of 10 per cent in subsequent years. “This is surprising given the government’s awareness of attrition from the profession,” says Grinspun.

Given the pandemic, the importance of public health cannot be emphasized enough. RNAO was also looking for a commitment that would see the 625 RN positions dedicated to schools funded permanently, along with funding for an additional 50 community wellness nurses in First Nations communities. “The needs in school will continue to be heightened for years to come,” says Grinspun.

The budget falls short when it comes to the delivery of home care. A tax credit without accompanying home and community care supports will do little to allow seniors to remain in their homes longer. RNAO called for a 20 per cent boost in funding to give Ontarians a choice to receive healthy and safe care in their own homes and to relieve pressure on both the hospital and long-term care sectors. “People should be allowed to choose whether they want to live in LTC or remain in their homes. And when nursing and other support services are offered through home care, aging in place is preferred by the public. It is also safer and ultimately a less expensive alternative,” says Morgan Hoffarth, RNAO’s president.

While the government touted its success in its vaccine rollout, RNAO says more than 20,000 nurses working in primary care and home care are eager to be brought onboard to speed up the government’s program by getting vaccines to seniors and others who are homebound.

When it comes to the social determinants of health, RNAO is concerned the budget does not address the need for paid sick days to protect essential workers. “There is overwhelming evidence that providing paid sick days would reduce workplace infections for those who lack access to this employee benefit,” says Hoffarth. And, “as long as COVID-19 remains a threat and employment is precarious, the province has an obligation to protect tenants who are unable to pay rent by re-instituting a moratorium on evictions and deploying funding for rent payment support,” adds Hoffarth.

While much of the province’s attention has been focused on the pandemic and a vaccination rollout to help end it, there is no vaccine to combat the deadly effects of the opioid crisis. More than 2,200 people died from overdose last year and recent figures show the crisis claims an average of six lives each day. The government needs to confront this public health epidemic with harm reduction. It can do so by funding urgent public health needs sites (UPHNS), which essentially function as overdose prevention sites. It also needs to fulfill its promise to approve and fund the 21 consumption and treatment services sites that it announced in 2018. “Addiction is an illness and we can prevent more unnecessary deaths by offering the supportive services and dignified care that people struggling with substance use need,” says Hoffarth.

“We understand the need to support small businesses and other aspects of our economy affected by COVID-19, however, nurses expected that the budget would also address the nursing  shortfalls that exist in our health system so we can provide the best care that Ontarians need now and after the pandemic ends,” says Hoffarth.

 

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

 

 

Action alert: An urgent call for more nurse practitioners (NP)

Increased utilization of nurse practitioners (NP) in Ontario’s health system is long overdue. Join us in our urgent call for the government to deliver immediately on long-standing promises of:

  • funding and adding new nurse practitioner-led clinics (NPLC) to the province’s existing roster of 26
  • funding and adding more attending NPs to long-term care (LTC) in the attending NP role.

In February, RNAO released its NP Task Force Vision for Tomorrow report. It calls for:

  • increasing NP supply
  • optimizing NP utilization
  • expanding NP scope of practice
  • aligning the NP curriculum to changes in scope of practice and care needs
  • harmonizing compensation to adequately remunerate NPs across all sectors
  • investing in research that demonstrates NP impact
  • broadening insurance coverage to consistently include NPs
  • showcasing NP impact within the health system and to the public

RNAO’s Vision for Tomorrow is a big and bold plan to increase health equity and access to health care in Ontario’s post-pandemic health system. Implementation of its recommendations must be implemented immediately. Please support RNAO’s call for:

  • three additional NPLCs in 2021
  • funding and hiring of 100 attending NPs within the next six months

Sign here and let Premier Ford know that there is an urgent need for more NPs in our health system.

 

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 with LTC Commissioner Frank Marrocco and other notable speakers

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, and much more!

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.

 


Hospice Palliative Care Ontario Presents: Virtual Compassion Care Community Centre

 

Please help spread the word about this valuable service: Hospice Palliative Care Ontario strives to provide quality education and support and is excited to be able to do so through the Virtual Compassion Care Community Centre. These activities take place virtually and are intended for seniors, people isolated at home, caregivers, and hospice volunteers. Each of the programs is run by facilitators in a comfortable and interactive group setting to increase social connection and supports. All of the programs are free to access. Join today to learn and connect!

 

Hospice Palliative Care Ontario understands that because of the COVID-19 pandemic, many people are finding it more difficult to gather with family, friends, and peers for support in dealing with grief or loss. HPCO is continuing to explore options for expanding access to virtual support groups to address this need.

 

Please click here for the complete list of programming.

 

If you have any questions, please email Nav.Dhillon@hpco.ca

 

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 #395 for March 26 (no report on March 27):

Case count as of March 26, 2021 / Nombre de cas le 26 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*

951 562

+ 5 192

22 790

+  31

Ontario**

338 239

+ 2 169

7 292

+  12

Update:

  • See here Recommendations on Exceptions to Extended Dose Intervals for COVID-19 vaccines from the province’s Vaccine Clinical Advisory Group (VCAG). The document will be available shortly in French and English

 

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:

20 Mar - Preliminary results of RNAO‘s Work and Wellbeing Surveygo here.

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.

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