Policy and Political Action

Policy & Political Action

RNAO continues to sound the alarm on changing models of nursing care

RNAO continues to speak out against actions being taken in some hospitals across Ontario. The association is gravely concerned about proposed nursing staffing models that – disguised under other names – take us back to “functional nursing.”

In our correspondence and meetings with health-care organizations, we have been sharing the importance of nursing staffing models that secure continuity of care and continuity of caregiver, using RNs for the total nursing care of unstable patients with unpredictable outcomes, RPNs for the total nursing care of stable patients with predictable outcomes, and PSWs for support with care provision where appropriate as delegated by a nurse.

At a time when hospitals are cash strapped, senior executives must use evidence to make decisions, not experiment with patients’ lives. The evidence on nursing models of care delivery conclusively shows that fragmentation leads to medical errors. The evidence also shows that using RNs results in improved clinical and financial outcomes. Indeed, the amount of direct patient care RNs provide is directly linked to mortality and morbidity rates. Higher levels of care from RNs result in fewer deaths, readmissions, pressure ulcers, pneumonia and other pulmonary events, post-operative infections, urinary tract infections, upper gastrointestinal bleeds, cardiac arrests and medication errors. A higher proportion of RNs is also linked to shorter lengths of stay and improvements in failure to rescue, as well as superior organizational effectiveness and budgetary outcomes. Recent evidence also demonstrates that client outcomes improve when RNs provide direct care instead of assuming a supervisory role in functional nursing.

Is your workplace being affected by staffing model changes? Tell us about your experience.

Resource Type Link
Report Mind the Safety Gap in Health System Transformation: Reclaiming the Role of the RN

Mind the Safety Gap in Health System Transformation: Reclaiming the Role of the RN

Mind the Safety Gap in Health System Transformation: Reclaiming the Role of the RN

Media Reports about Changing Models of Care

Nurses face job cuts across Ontario, Toronto Star

Ontario health budget rises, but by much less than last year, Toronto Star

Health-care advocates worry Ontario budget will lead to cuts, CTV News

Windsor Regional Hospital nursing change will save money, won’t boost care, expert says, CBC

St. Joe’s backs down on replacing neonatal RNs with RPNs, Hamilton Spectator

Acute care infant unit no place for experimenting with care, Hamilton Spectator

St. Joe’s cutting 136 jobs, up to 40 from layoffs, CBC Hamilton

Hospital’s cost-saving plan risky for patients, Assoc. says, Northern Life

Letter to the Editor: Reconsider decision, The Record

Cambridge Hospital to cut 33 nurses, try new care model, CBC.ca

Related Best Practice Guidelines

Client Centred Care

Developing and Sustaining Effective Staffing and Workload Practices

Intra-professional Collaborative Practice among Nurses

Position statement

Strengthening Client Centred Care Position in Hospitals

Strengthening Client Centred Care in Long-Term Care

Strengthening Client Centred Care in Home Care

Action Alerts

Tell Minister Hoskins to Stop RN Replacement

Mind the Safety Gap in Health System Transformation: Reclaiming the Role of the RN

Changing Models of Nursing Care with References109.77 KB
Resource Type: 
Political Action