Dear Colleagues: Welcome to our Saturday, May 1 report during this fifteenth 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 in the next few weeks.
COVID-19 VIANurse – Critical care nurses
As updated last week, RNAO has activated VIANurse to augment nursing HR in critical care.
As of April 30, 469 RNs and NPs have indicated their availability to help in critical care. 30 hospitals have requested critical care RNs/NPs from VIANurse. We are aware that 97 RNs/NPs have applied to the postings sent to them. About half of the hospitals have hired or are in the process of hiring these nurses.
Critical Care Nurses: Please CLICK HERE to complete our critical care survey if you are:
How does it work? When employers in your area need critical care nurses we will let you know. You will discuss directly with the employer regarding application, hours of work, compensation, etc.
Employers: Employers who need critical care nurses can fill out this FORM. RNs and NPs in your geographical area will be connected to your hiring personnel via email.
Please note that VIANurse is only focused on critical care. For other staffing needs, nurses and employers should access RNCareers.ca, RNAO’s job board since 2005. If there are questions, please contact Daniel Lau, Director of Membership & Service at email@example.com.
Long-Term Care COVID-19 Commission report receives thumbs up from RNAO; will government act?
On April 30, the Ontario’s Long-Term Care COVID-19 Commission released its final report. RNAO has followed the work of the Commission, met more than once with the commissioners and contributed substantially to their work (see here and here and here and here and here). Here is RNAO’s media release today in response to the Commission’s final report.
The Ontario government owes an apology to the families of the 3,758 long-term care (LTC) residents lost to COVID-19 and to the staff that valiantly cared for them under deplorable conditions – including 11who lost their own lives in the line of duty.
Residents of LTC homes deserve the dignity of safe and quality care. The recommendations released Friday by the Long-Term Care COVID-19 Commission provide pointed directions for the government to meet its obligations. Nurses call on the government to enshrine in legislation and immediately implement the urgent staffing and skill mix recommendations; Infection Prevention and Control imperatives, and the needs of residents and their essential care partners.
Those are the overarching messages from the Registered Nurses’ Association of Ontario (RNAO). The failings outlined in the commission’s report echo systemic issues the association has raised for over two decades, including since 2018 with the Ford government.
RNAO issued early warnings in February 2020 in view of the unfolding catastrophe in Italy. It called on the government to adopt the precautionary principle and to take measures to protect residents in LTC. Despite these warnings, the virus swept through hundreds of homes claiming 3,758 lives, most of them during the first and second waves of the pandemic.
The independent commission, led by Associate Chief Justice Frank Marrocco, outlines recommendations on chronic underfunding of the sector, severe staffing shortfalls and infection control deficiencies. These priorities must be addressed to prevent another horrific tragedy.
Among the commission’s recommendations:
While the government has already pledged to introduce four worked hours of direct nursing and personal care for residents, it is not taking meaningful action. The commission’s report reinforces RNAO’s call for an accelerated process to increase staffing and achieve the required skill mix endorsed by the commission for safe and dignified care. There has been plenty of time to plan and implement. The same demand for staffing and skill mix urged by the commission was outlined in RNAO’s Mind the Safety Gap report in 2016 and consistently thereafter including in the association’s Nursing Home Basic Care Guarantee submitted to Minister Merrilee Fullerton in 2020.
The commission endorsed a recommendation made by Justice Eileen Gillese in her 2019 public inquiry report into LTC. It called on the Ministry of Long-Term Care to “encourage, recognize, and financially reward long-term care homes that have demonstrated improvements in the wellness and quality of life of their residents” (Recommendation 57). RNAO has communicated this concern repeatedly to governments, past and present. Ministry funding is cut when best practices are implemented that improve resident outcomes and lower acuity, since funding is only tied to resident acuity levels measured by CMI. “Homes that implement RNAO’s best practice guidelines and are designated as Best Practice Spotlight Organizations should not be penalized for raising the quality of care among residents and improving health and clinical outcomes, which in turn reduce their acuity,” says Dr. Doris Grinspun, RNAO’s CEO.
RNAO applauds the commission’s recommendation that 70 per cent of staff be full-time (Recommendation 49), a call made by RNAO two decades ago. “Precarious work has plagued the LTC sector. Full-time work contributes to better health outcomes as staff get to know their residents and develop meaningful relationships that result in resident-centred care. Providing full-time, stable work means staff members also have security and are not forced to work multiple part-time or casual jobs, moving between homes and increasing risk of infections,” says Grinspun.
RNAO is delighted with the recommendation to increase funding for home care services to enable aging at home, as well as for long-term care homes to be included in Ontario Health Teams. RNAO raised these issues in its Enhancing Community Care for Ontarians (ECCO 3.0) report released in 2020 decrying that community care and LTC have been left out of consecutive governments’ health transformation agendas – a reality exacerbated during the pandemic.
“The catastrophe in LTC began in the first wave. In a move that prioritized hospitals, the needs of residents were ignored and ultimately sacrificed by the government. LTC homes didn’t have personal protective equipment, severe staffing issues were not addressed and the government delayed measures to control the spread of the virus,” says Grinspun. She adds this was “a tragedy that will haunt us for years to come. It was shameful, reckless, and completely preventable had this government acted in time – as advised by RNAO and other experts. Ultimately, when the government finally followed that expert advice, we stopped the devastation in nursing homes.”
“We will watch to see how serious the government will regard the commission’s report. The government called for this commission and should act on it immediately. Although Premier Ford and his team did not start the fire in nursing homes, they allowed it to engulf them. They now have an enormous opportunity to change course and bring about transformational change in LTC. The government can carve a new path for the sector and create a better future for residents,” says Morgan Hoffarth, RNAO’s president.
“We thank Justice Marrocco and his co-commissioners for their in-depth work and for highlighting critical issues and urging government to act. They recognized the ferocity of the pandemic and issued two sets of interim recommendations in advance of their final report. We thank them for listening to residents, families, LTC staff, stakeholders and experts. It’s clear they were deeply affected by what they heard and learned and we are indebted to them,” says Hoffarth.
RNAO’s continuing media profile: The April report
As we battle a relentless and stubborn third wave of COVID-19 driven by dangerous variants, RNAO continues to speak out on the pandemic and its impact on nurses, other health-care workers and Ontarians.
Ontario’s health system is on the precipice of collapse and nothing short of a complete lockdown and stay-at-home order are needed to combat a fast and furious third wave of COVID-19. That’s the message that RNAO put out to Ontarians on April 1. It was a response to the tepid public health measures announced that day by the premier of Ontario. The premier announced a 28-day province-wide shutdown that wasn’t strict enough as it allowed non-essential businesses to operate. RNAO said the announcement did not go far enough to confront the biggest health crisis facing Ontarians and the province, since the outset of this pandemic.
In an April 5 QP Briefing article, I said that a stay-at-home order is crucial to saving lives and our health system. “This situation is serious, serious with [outbreaks in] warehouses, serious with [outbreaks in] food packing plants…and the only thing that it seems the government now is waiting (for) is that the P1 [more dangerous Brazil] variant starts to spread like the B.1.1.7. [UK variant which has already spread], and that will be the end of us,” I explained. I also told CFRA Ottawa on April 6 that it was negligent to not lockdown the province: “It’s lack of action for political reasons, not evidence[-based driven decisions].” This RNAO theme has recurred for the whole month of April. In a letter to the editor in the Toronto Star (April 27) we insisted on the urgency of implementing a minimum of 10 paid sick days, keeping only essential businesses open (such as food and medication) and accelerating the vaccine rollout especially in vulnerable workplaces and communities . In short: “Nurses demand swift action and we demand it now.”
On April 16, Premier Ford announced new measures to officially lockdown the province. These measures included extending the stay-at-home order and provincial declaration of emergency. The premier also announced Ontario would implement border restrictions and limit people’s movement into the province from Manitoba and Quebec. However, as we said in our RNAO response, the premier opted to again choose ideology over science. He did not close all essential businesses. Some of his new measures such as closing playgrounds and giving new powers to police caused an uproar from many, including RNAO. The Science Table has clearly indicated the source of transmission is in indoor congregate places, not outside in playgrounds. Also, granting police the authority to stop individuals and question them on their whereabouts is highly troubling given the history of carding in the province (“carding” refers to stopping and questioning individuals with no particular reason). After much backlash and resistance from regional police chiefs, this particular power was scaled back with the premier apologizing for moving too fast on closing playgrounds and adding to police powers, especially how that power would affect essential workers on their way to work.
In an interview with 980 CFPL about the RNAO’s reaction to the expansion of hospital beds, I told host Mike Stubbs that the solution to the influx of ICU and ER admissions is not to expand the number of beds, but to stop the spread of the virus. I also expressed deep concern for workers in factories. “Those people coming to those factories are working in precarious situations. They work minimum wage and don’t have sick days…They are paying the price of this pandemic.” Inequities have been front and centre throughout the Ontario pandemic, but the third wave is particularly notorious in this regard. The hot zones of the third wave are in congregate blue-collar workplaces and in racialized and marginalized communities with crowded housing, multigenerational families and many workers who cannot afford to stay at home even when they are unwell.
On April 20, RNAO issued a statement on paid sick days. In the statement, RNAO said “any delay will cause undue hardship and cost more lives. We must allow essential workers to stay home if they are sick in order to beat this virus.” On April 22, the premier mentioned that a sick leave plan was in the works but provided no further details. As I told the Canadian Press that same day, the time for emotional pleas is over and inaction results in more lives lost. On April 28, the minister of labour announced the province’s temporary paid sick days plan, which would provide employees three paid days of leave if they miss work due to illness, have COVID-19 symptoms or need time off to get vaccinated. The government will reimburse employers up to $200 per day per employee, for a total of $600. I told the Canadian Press that three days is insufficient to protect workers and to stop the third wave and that we will continue to see further illness and outbreaks if they’re not given at least 10 paid sick days. On April 29 in CityNews Ottawa’s The Rob Snow Show, I said that when a person is sick or isolating they don’t have the time to fill in forms and that it needs to be a permanent employer-based program. Simply put, “Everyone should have the right to stay home when they’re sick.”
This spring, RNAO released the results of our Work and Wellbeing Survey. The primary finding of the survey was that at least 13 per cent of RNs ages 26-35 reported that they were very likely to leave the profession after the pandemic. I told the Toronto Star that this would have a huge negative impact on our health-care system. “Losing so many RNs at an early stage in their careers would have a profound and lasting effect on how our health system functions.” An April 13 Sudbury.com article quoted RNAO President Morgan Hoffarth on nurses’ concerns: “Our colleagues are exhausted, some are even at a breaking point and what they want is a government that gives them the help they need: more staffing and more supports.” On April 24, Birgit Umaigba, one of our RNAO members who has been awesome at sharing her experience as an ICU RN during COVID-19, told Global News about the impact the pandemic is having on her and her colleagues: “the amount of dead people we see… The Code Blues, the chaos is really affecting a lot of people.” In response to the crunch in ICUs, the province recently gave hospitals the power to transfer patients to long-term care (LTC) homes without their consent. On April 28, I told QP Briefing that’s disastrous as LTC homes do not have the proper staffing to take care of their own residents, much less of transferred hospital patients. I said such a situation can only happen when there is no functioning government in the province.
The third wave has had a devastating impact on our ICUs and raised a dramatic need for more critical care nurses. The problem has long roots as we didn’t have enough RNs even before the pandemic. On April 21, I told Global News, “we have the lowest RN-to-population ratio in Canada, so of course you won’t have [enough] ICU nurses [when you need them,] and now you layer on that a [COVID] crisis of mega proportions.” With the record-high daily COVID-19 cases pushing towards 5,000, RNAO activated VIANurse to augment nursing human resources in critical care on April 14, 2021. "Nurses know how desperate the situation is," I told QP Briefing (April 12). I was addressing the plans for new ICU beds, and asking: Where will the nurses to staff them come from? The health minister promised that ICU beds would be properly staffed but extra training for ICU nurses is often required. I provided my response to that in Toronto Star on April 12: “We can move certain nurses from the recovery room, from the operation rooms… [but] even they need training.” The lesson for Ontarians is that RN human resources are central to a well-functioning healthcare system, and cost-cutting that diminishes their numbers has negative impacts both in the short and the long run .
On vaccine rollout, President Morgan Hoffarth said in an April 16 RNAO media release that "an all-hands-on-deck approach to vaccinate people must be implemented immediately. It is the only way to ensure those in essential workplaces and living in communities identified by public health authorities as hot zones are vaccinated quickly." To achieve this, she said "nurses, physicians, pharmacists, dentists, paramedics and others who are willing and able to vaccinate should be deployed. And mobile units – including home care nurses – should be sent to essential workplaces and hot spots, en masse." RNAO continues to insist on vaccination at warehouses and factories where essential workers are and at highly-impacted communities facing multi-pronged challenges. On April 11, I told the Toronto Sun “many people cannot take time off work to go get vaccinated. And when their shift ends, the vaccine clinics are closed.” “We must fully engage nurses and doctors in primary care and home care to accelerate the vaccine rollout and get us through this dark, dark tunnel.”
RNAO’s advocacy and media outreach led to 433 hits in April. We will continue to speak out for our members and for the health of Ontarians. To keep up with RNAO’s media coverage visit the COVID-19 Portal press room.
POLICY UPDATES FOR ALL TO ACT ON & MUST JOIN EVENTS – OPEN TO ALL
Vaccination & pop-up clinic for the Black, African & Caribbean communities
In an earlier report we updated on a campaign to vaccinate members of the Black, Caribbean and African communities in Toronto. This is an impressive grassroots effort to address barriers to acceptance and increase uptake of COVID-19 vaccines in communities most negatively impacted by the virus. Here is the information on the next pop-up vaccination clinics:
May 8 and May 9, 10 am to 6 pm – first come, first served.
18+ years of age. OHIP not required, bring ID.
Location: Jamaican Canadian Centre, 995 Arrow Road (Finch and Hwy 400).
Overview of RNCareers.ca and tips on cover letters and resumes
One-to-One Resume Review Sessions (two dates)
9 a.m.-12 p.m. ET (by appointment only)
Resume review is a virtual one-to-one 20-minute virtual session where you will receive feedback on your resume. Various RNAO staff and community partners will be involved in this event.
During your consultation, you will receive tailored feedback to improve the format, content, functionality and readability of your resume.
REGISTER NOW for May 13
Participants will receive a Zoom link with login instructions two days prior to their session.
Webinar: COVID-19 Webinar Series
May 10, 2021, 2:00pm - 4:00pm
RNAO's CEO Doris Grinspun hosts the COVID-19 webinars for health providers.
Health providers from Ontario, Canada, and anywhere in the world are welcome to join.
You can watch our April 12, 2021 webinar on Wave three: Update, advocacy and what's next?:
Ontario is now in the third wave of the COVID-19 pandemic. During this webinar, Dr. Doris. Grinspun, RNAO's CEO, and colleagues provided an update on how the third wave is affecting nurses and Ontarians. Hear how RNAO, together with members and allies, are advocating for immediate actions to save lives, and long-term actions to right wrongs and establish justice for all. Learn about the next steps and how you can help shape the trajectory of this devastating virus and its variants.
Watch and read about earlier webinars here.
Nursing Now Ontario Awards Ceremony
May 12, 2021, 2:00pm - 3:00pm
The Nursing Now Ontario Awards celebrate the contribution of nurses who improve the health outcomes of Ontarians and who contribute to nursing practice. Awards are presented to one winner in three categories: registered practical nurse (RPN), registered nurse (RN) and nurse practitioner (NP).
The awards ceremony takes place during Nursing Week 2021 (May 10 – 16).
After receiving 213 nominations, the Ontario Nurses’ Association (ONA), RNAO and the Registered Practical Nurses Association of Ontario (WeRPN) will recognize the award recipients during a special ceremony on May 12, 2021 at 2 p.m. (ET). The event will be held virtually on Zoom. The awards fall on the same day as the anniversary of Florence Nightingale’s birth. Nightingale is considered the founder of modern nursing.
This awards program builds on the goals of the Nursing Now campaign, a global initiative aimed at raising the profile of the profession and improving health around the world through nursing. The campaign calls on governments, health professionals and service users to champion the role of nurses in clinical practice, policy and political leadership.
Host: Dr. Doris Grinspun, RN, Ph LLD(hon), Dr(hc), FAAN, O.ONT, Chief Executive Officer, RNAO
Morgan Hoffarth, RN, BScN, MN, President, RNAO
Vicki McKenna, RN, President, ONA
Dianne Martin, RPN, Chief Executive Officer, WeRPN
Please register to join us for this celebration.
Webinar: Continuing the Conversation - An Open Forum for Nurses
May 12, 2021, 3:00pm - 4:30pm
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 wellbeing at this challenging time and that you may have less time to devote to your own self care.
During these biweekly open forums, RNAO facilitates discussions and holds breakout sessions for participants to discuss themes identified in the previous forums, such as dealing with multiple losses, taking care of yourself, burnout and more.
All RNs, NPs, RPNs and nursing students – in all roles and sectors – are invited to participate. You may wish to share how things are going for you or you can simply join and listen in.
May 12, 2021, 3 – 4:30 p.m. ET
International Nurses Day
Stay tuned for details and registration.
Webinar: Let’s Talk about Anti-Black Racism and Discrimination in Nursing
May 17, 2021, 2:30 - 4 p.m. ET
Topic: An intergenerational conversation: Addressing anti-Black racism
This is a monthly webinar series designed for nurses interested in receiving updates on RNAO’s Black Nurses Task Force and to engage them in meaningful conversations that will inform the work of the Task Force. The Black Nurses Task Force has a mandate to tackle anti-Black racism and discrimination within the nursing profession. Read more here.
Register for the May 17 webinar here.
Watch on YouTube here
Mark your calendar: 96th Annual General Meeting (AGM)
Jun 24, 2021, 2:00pm - Jun 26, 2021, 1:00pm
RNAO’s 96th AGM will be held virtually on June 24 - 26, 2021. Details on how to join the live streamed events will be posted in early June.
For a recap on last year's virtual AGM, please visit our AGM portal.
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 #420 for April 30 (no report on May 1):
No updates today.
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 firstname.lastname@example.org and copy my executive assistant, Peta-Gay (PG) Batten email: email@example.com. 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
RECENT BLOG ITEMS:
24 April - RNAO launches new policy webpages – go here
– go here
17 April - Vaccine engagement as a tool to address marginalization and exclusion – go here
17 April - Here's how the COVID-19 pandemic could play out in 2021 and beyond – go here
17 April - Reacting to the latest Ontario government public health measures – go here
10 April - RNAO and NAN sign Relationship Accord to improve health across NAN Territory – go here
10 April - RNAO media release on public health measures and vaccination rollout – go here
10 April - 3 ways to vaccinate the world and make sure everyone benefits, rich and poor – go here
3 April - Government’s “shutdown” announcement doesn’t go far enough – go here
– go here
27 Mar - Provincial budget fails to deliver urgent nursing investments to care for Ontarians – go here
27 Mar - Government's reopening plan threatens the health of Ontarians – go here
20 Mar - Preliminary results of RNAO‘s Work and Wellbeing Survey – go here
13 Mar - Getting it right – go here
– go here
6 Mar - RNAO’s continuing media profile: The February report – go here
– go here
6 Mar - Webinar: Understanding wellness in Indigenous wisdom traditions for caregivers – go here
27 Feb - RNAO celebrates Black History Month 2021 – go here
27 Feb - RNAO’s 21st annual Queen’s Park Day goes virtual – go here
27 Feb - RNAO’s NP Task Force releases groundbreaking report – Vision for Tomorrow – go 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 nurses – go here
20 Feb - With new variants growing, concerns mount about the premature lifting of restrictions – go here
18 Feb - Anti-Black racism and discrimination in nursing: The power of mentorship in nursing education – go here
13 Feb - RNAO’s letter to the premier on the vaccine rollout and the current context – go here
6 Feb - Use community care providers to ramp up vaccinations! – go here
6 Feb - RNAO’s continuing media profile: The January report – go here
30 Jan - The PrOTCT plan for nurses: Counseling vaccine hesitant patients & colleagues – go here
– go here
23 Jan - Mitigating the spread in Toronto shelter settings – go here
23 Jan - Home care nurses are #ReadyToVaccinate – go here
23 Jan - Hurtful comments about law enforcement – go here
15 Jan - The escalating catastrophe of the COVID-19 second wave in Ontario – go here
15 Jan - Progress in vaccine distribution: Updates, issues and concerns – go here
8 Jan - RNAO raises its voice in the media: Media coverage in December 2020 – go here
– go here
8 Jan - RNCareers: Help during the holidays and help for next phases of this pandemic – go here
We have posted earlier ones in my blog here. I invite you to look.
Public Health Ontario maintains an excellent resource site on COVID-19 materials.
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.
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.
You can find up-to-date global numbers in Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE.
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