The next provincial election will take place against the backdrop of a pandemic that has exacted a toll on people’s physical and mental health, the nursing profession and Ontario’s health system.
To help steer the province through the effects of a devastating pandemic, the Registered Nurses’ Association of Ontario (RNAO) released a provincial election platform Thursday during its annual Queen’s Park Day. Ontario’s nursing crisis: Your health, your health system outlines recommendations it wants all political parties to adopt ahead of the June 2 election. The recommendations cover five key areas that shape people’s ability to be healthy: the environment, social determinants of health, nursing, care delivery and fiscal capacity.
“This election comes at a pivotal time in our province’s history. The COVID-19 pandemic has exposed environmental, social and economic inequities. The most vulnerable and racialized groups in society were especially affected,” says RNAO’s CEO Dr. Doris Grinspun. RNAO recommends that all political parties commit to reducing greenhouse gas emissions and ensuring universal access to clean water. Guaranteeing 10 paid sick days for all employees, raising the minimum wage to $17 per hour and building more affordable and supportive housing units are a must to help those affected disproportionately by the pandemic. Simply stated “environmental and social poverty results in ill-health,” says Grinspun, adding the opioid overdose crisis is a repercussion of the social deprivation exacerbated by COVID-19.
“Central to our platform is the nursing crisis. We entered the pandemic with a shortfall of 22,000 RNs. Two years later, the profession is bleeding and needs an infusion of RNs because of the exhaustion and burnout COVID-19 has dealt,” says Grinspun. “Our collapsing health system is a direct result of the RN shortage,” Grinspun adds. To improve access to care for Ontarians we need at a minimum 22,000 additional RNs in the next four years. And we need 50 per cent more NPs in the next four years. And, they must all be working at full scope of practice.
Retaining RNs remains a challenge in Ontario. This is primarily because of Bill 124. That’s why “RNAO’s platform insists on the immediate repeal of Bill 124 and substantially increasing compensation to keep RNs in Ontario,” says Grinspun. Building up the supply of RNs, once retention is in progress, is achievable by continuing to increase nursing school enrolments and creating multiple pathways so personal support workers can become RPNs, RPNs can become RNs, and RNs can become NPs – allowing all to build their careers in Ontario. “RNAO’s platform also calls for expediting the applications of more than 20,000 internationally educated nurses already living in Ontario and who are eager to join the workforce,” adds Grinspun.
RNAO’s platform also outlines broad health system changes to better meet people’s health-care needs. “We must learn from the tragic losses in long-term care (LTC) so it never happens again,” says RNAO president Morgan Hoffarth. That’s why RNAO’s platform recommends implementing a comprehensive seniors’ care strategy that would assist seniors to remain at home as long as possible by investing in home care. And, to have faster access to LTC if and when such care is needed. RNAO also believes that access to home care and LTC must be universally available to all those who need it. “Safe and dignified care in LTC requires more than additional beds. It necessitates enshrining RNAO’s Nursing Home Basic Care Guarantee in legislation so that every resident receives four worked hours of nursing and personal care per day,” adds Hoffarth. RNAO also urges parties to embed its world-renowned evidence-based best practice guidelines in the electronic medical records (EMRs) of LTC homes, so that residents receive up-to-date optimal care.
We must understand the importance of funding all sectors. This is why RNAO’s platform calls for a well funded public health sector so it can respond effectively in good times and in a health crisis. It also calls for mandating RN-to-patient ratios in ICUs and ICU transfer units to prevent future attrition and ensure we can keep RNs to tackle the catastrophic backlogs for surgical and diagnostic procedures. The pandemic also showed the benefits of integrated health systems of care such as Ontario Health Teams (OHT). This is why RNAO is calling for the expansion of OHTs and anchoring them in primary care – a hallmark of a well-functioning health system. RNAO says measures to improve access to primary care such as increasing the number of NP-led clinics and relocating the 4,500 RN care coordinators in primary care settings and OHTs are necessary for effective system integration.
At a time when Canadians have been asked to examine the country’s history, RNAO says that political parties must commit to addressing the needs of Indigenous Peoples. This means working with Ottawa to respond to the 94 calls to action in the Truth and Reconciliation Commission’s report, and helping First Nations communities search for unmarked graves on the sites of former residential schools in Ontario. Permanently funding 50 community wellness nurses and increasing funding and resources to ensure First Nations communities can meet their public health needs are also essential.
Ontario has the fiscal capacity to pay for the recommendations included in RNAO’s platform. Currently, the province spends less on health programs on a per capita basis than other jurisdictions and it collects less tax revenue than most other provinces as a measure of gross domestic product. “Investments in our health and health system will pay off now and in the future. It’s good public policy that will benefit all of us years down the road,” says Hoffarth.
“Nurses were at the forefront of the pandemic and know what changes are needed to help Ontarians and the province now and post pandemic,” says Hoffarth. “Without adequate and equitable health care, people suffer. Without sufficient health human resources across every sector, our province’s nurses face the brunt and access to care is compromised. RNAO’s platform is a clear blueprint and the only way forward to improve the health of Ontarians, build up our profession, and make our health system better integrated and more responsive to people’s needs.”
RNAO has shared its platform with all of the party leaders and will post each political party’s responses to its recommendations on its website as they’re received.
The Registered Nurses’ Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses’ contribution to shaping the health system, and influenced decisions that affect nurses and the public we serve. For more information about RNAO, visit RNAO.ca or follow us on Twitter, Facebook and Instagram.
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