Behind the Front Lines A recap /critical look at health care news and the reality behind the reporting from the viewpoint of front-line Ontario registered nurses
Three Things You’ll Learn in This Issue:
Volume 2, No. 5 June 2010
Health Coalition Report Urges an End to ER Closures
1. Why ERs should be kept open
2. Public health cuts impact infant health – go 3. Number of home care nurses declining – go
Nurses, Hospital Battle for Public Support A war of words is occurring in St. Paul, Minnesota where 12,000 nurses are telling horror stories of what happens to patients when there are too few nurses on staff (source). Nurses are traditionally very reluctant to speak about specific cases where low staffing levels have impacted patients’ health outcomes. Fear of retribution by their employers and respecting patient confidentiality are just two of the roadblocks to speaking out. The Minnesota nurses are in a legal strike position and one of the major issues is lack of staffing. The nurses have subsequently been accused of “fear-mongering” by their hospitals.
As officials call for the overnight closure of the emergency department at St. Mary’s Memorial Hospital (source) a new report from the Ontario Health Coalition is calling for a functioning ER in every hospital in the province (source). The call to close the St. Mary’s ER each night is coming from the Huron Perth Healthcare Alliance. St. Mary’s Mayor Jamie Hahn is accusing officials of ignoring the considerable input of the community to keep the ER open overnight. The Mayor has pointed out that that the South West LHIN’s own statistics show that St. Mary’s has a high rate of ER visits during the hours between midnight and 8 am, precisely the hours being proposed for closure. According to the LHIN’s website, 90 per cent of those visiting the ER during the night require care within 30 minutes. The Ontario Health Coalition’s report says that a provincial standard must be set to more meaningfully measure access and assess capacity. The report – written by a panel of health-care experts who travelled the continued on page 2
Behind the Front Lines page 2
ER Closures cont’d province hearing from communities – also recommends that the LHINs be directed to stop ER closures. Many patients told horror stories of their experiences in hospitals, including premature death of loved ones due to early discharge and long waits for medical attention. Many of these stories are in the OHC report.
What is ONA? The Ontario Nurses’ Association (ONA) is the union representing 55,000 registered nurses and allied health professionals and more than 12,000 nursing student affiliates providing care in hospitals, longterm care facilities, public health, the community, clinics and industry.
Who is Linda Haslam-Stroud, RN? ONA President Linda HaslamStroud, RN (pictured), is a veteran renal transplant nurse who is an expert spokesperson on a range of issues. Linda is available to comment on everything from workplace violence, patient care, health care policy in Ontario, the flu pandemic, nursing cuts, public health and much more. Simply contact ONA’s media relations officer, Sheree Bond, at (416) 964-8833, ext. 2430 if you would like to interview Linda on a health-related issue.
How to reach us: Ontario Nurses’ Association 85 Grenville Street, Suite 400 Toronto, ON M5S 3A2 (416) 964-8833 www.ona.org
Editorial Decries Cuts to Infant Health Cuts to Public Health budgets haven’t received a lot of media attention in Ontario, but cuts and their subsequent impact on infant health was the subject of an opinion editorial in the Waterloo Region Record (source). The piece notes the irony of the Canadian government “championing the health needs of mothers and children in developing countries around the world” while allowing a provincial funding freeze to cut care for new mothers and babies. Hospital RN cuts have received a fair share of media attention recently, but public health nursing cuts continue to go largely unreported. The editorial notes that this year’s RN reduction follows a more drastic reduction last year and leaves the Public Health Unit unable to come close to the provincial target of a home visit by an RN to at least 75 per cent of new mothers and their babies. Healthy Babies, Healthy Children is a mandatory provincial program; however, with the latest round of RN cuts, the region will now be able to provide the service to just 30 per cent of new mothers. Public Health RN cuts have occurred provincially for the past year, despite the high demand for them and their role during the H1N1 flu pandemic last fall.
Behind the Front Lines page 3
Ontario Has Fewer Home Care Nurses Ontario Minister of Health and Long-Term Care Deb Matthews has dismissed Opposition party questions about hospital RN cuts by saying these nurses will simply go to work in the community as home care nurses. However, a new report from the Nursing Health Services Research Unit (NHSRU) – a collaborative project of the University of Toronto and McMaster nursing schools – has found that there has been a steady decline in the number of RNs working as visiting nurses (source). The NHSRU analyzed the College of Nurses of Ontario Membership Statistics Report and found that while the number of RNs in the sector had increased overall, the actual number of visiting nurses has steadily decreased. In Ontario in 1999, there were 7,546 visiting nurses who were employed. In 2009, that number had declined to just 5,007. In addition, the workforce is aging – in 2009, almost 32 per cent of visiting nurses were aged 55 to 64, compared with just 12.2 per cent in 1999. The NHSRU concludes that the consequences of fewer visiting nurses on quality of care and wait times for home care services “warrants further investigation.”
UNDER THE RADAR News the Media is Missing
The Changing Statistics of Hospitalized Patients A new study from the Canadian Institute for Health Information (CIHI) has found that hospitalization rates in this country have dropped considerably over a 13-year period. The study also found that the length of stay – likely due to the complex nature of the illness/injuries suffered by hospitalized patients – has increased during this period (source). Comparing the number of acute-care hospitalized patients in 1995/96 to the rates in 2008/09, Ontario hospitalized 31.6-per-cent fewer patients. The average length of stay increased by 4.5 per cent. The study raises interesting issues around staffing levels in Ontario hospitals. If the patients admitted to hospital are suffering from more acute and complex conditions but hospitals are cutting staff, is the quality of care being maintained?
Behind the Front Lines page 4
Postscript to the Toronto Grace saga:
RNs Join ONA In a postscript to the saga of the Toronto Grace Health Centre (source), on June 15 the 60 registered nurses at the facility became members of the Ontario Nurses’ Association (ONA). As reported by Tanya Talaga and Robert Benzie last February, the Salvation Army and Ontario Health Minister Deb Matthews came to a last-minute agreement over the fate of the 119-bed hospital. The Health Ministry had been aware of the possible closure of Toronto Grace for almost a year, but came through with the $15-million in infrastructure funding that the Salvation Army said it needed to keep the hospital open. Now, the RNs have opted to join Canada’s largest nurses’ union.
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Volume 2, No. 5- A recap of/critical look at health-care news and the reality behind the reporting from the viewpoint of front-line Ontario...