OCHU

Pressure yields win for Montfort Hospital workers

Jan 12, 2012 10:10 AM

CUPE members at Montfort Hospital have won a substantial wage adjustment for registered practical nurses (RPNs) who went from being amongst the lowest paid (56th on the list), to among the top ten in Ontario. Members of CUPE 4721 had been attempting to bargain for almost two years and were working without a contract.

“Despite the long process, we're happy with the way things turned out. The employees showed tremendous patience,” says CUPE 4721 President Marc LaFrance. “Over the past two years, the frustration felt by members was palpable. During a membership meeting, they voted unanimously in favor of holding a protest to voice their discontent.”

The workers expressed their frustration and unfair treatment through video.

In the end, an arbitrator issued an award that gives CUPE 4721 members the same improvements to their collective agreement as were reached by hospital workers throughout Ontario.

Members learned the details of their new contract which includes a wage adjustment for RPNs; two per cent wage increase in each of the four years; paid medical certificates when required by the Hospital; improved vacation; higher shift and weekend premiums; and improvements to insured benefits.

“I really hope that our employer realizes that central bargaining (OCHU) is a model established in Ontario that arbitrators use when issuing their decision,” says LaFrance. “There is no reason why the next time around we should be forced to wait two years after our Ontario counterparts settle before starting to negotiate.”

CUPE Local 4721 represents almost 850 members who work as orderlies, registered practical nurses, technologists and technicians, respiratory therapists, clerks, porters, dietary aides, pharmacy technicians, physiotherapy assistants, as well as in housekeeping, trades, and sterilization.

November 4, 2011

Dear Premier McGuinty and Minister Matthews,

On behalf of the members of the Canadian Union of Public Employees (CUPE) Ontario and CUPE’s Ontario Council of Hospital Unions (OCHU) please accept our congratulations on your re-election.
There are several important issues that our members are looking to us to pursue with your government. Specifically in the areas of Long Term Care, Hospitals and Home Care, we are very concerned about [a] compulsory contracting out of home care services, [b] the privatization of health care delivery, [c] the lack of minimum care standards in long term care homes, [d] cuts to hospital services, [e] infection control in health care facilities, and [f] fresh local food in our health care facilities. We look forward to the opportunity to sit down with you in the near future to discuss our concerns and share our recommendations for improvement.
However, there is one particular issue we need to raise today as a very pressing concern for CUPE/OCHU and especially for our more than our 25,000 members who are Personal Support Workers (PSW’s) and Healthcare Aids (HCA’s) in Ontario. That issue, of course, is the PSW Registry.
We have recently read Minister Matthews’ September 02, 2011 letter on this matter, addressed to the President of the Ontario Council of Hospital Unions (OCHU), and we both appreciate your outreach to us.
As we trust you are both aware, CUPE did not agree with the creation of a registry and we warned that it would detract attention and resources away from more pressing concerns in healthcare. (A copy of our August 2011 brief is attached) It is most unfortunate that despite our recommendations and expertise you have moved forward with the creation of the Registry.
The focus of our concern today is the Minister’s September 02, 2011 letter where it refers to the process to design and establish a PSW Registry as being “led by OCSA” the Ontario Community Support Association.
Let us be very direct. To make this an employer led process is highly inappropriate. Our concern is not due to some anti-employer animus. Rather it is inappropriate for the government to contract out public policy development to a third party -- in particular, a third party which has an interest in the outcome.
1
The public policy process should avoid conflicts of interest and the appearance of a conflict of interest if it is to be credible. A process that is widely accepted as balanced and impartial is needed.
Given this flawed process it is perhaps not surprising that some unsettling choices have been made. OCSA has apparently set up a committee to manage this task with only two organizations out of twenty representing workers and only one of those actually having PSW’s as direct members. This shows a complete lack of respect for PSWs and will inevitably not reflect the needs of the very PSW’s it is supposed to represent.
How can it be only one of the five or more unions in Ontario that have PSW’s as members will be at the table in this important process? How can it be that Ontario’s largest trade union, CUPE, an organization with more PSW members (25,000) than any other organization, is not invited?
In order for this process to be meaningful and credible it must take into account a broad range of view points and voices.
We remind you that when the province of British Columbia set out to design a similar registry, that government engaged all the concerned health care unions in extensive consultations on the registry design.
We are calling on the government to immediately organize consultation sessions that will allow you to hear from community groups, workers and the public at large.
As well, extensive consultation with all unions representing PSW’s must be a part of this process.
Premier and Minister, CUPE and OCHU members who are PSW’s and Healthcare Aids (HCA’s) work in hospitals, homecare and long term care in virtually every riding and every community in our province. Our members work hard and they care deeply about the quality of services they provide each day and they have much to contribute in this process.
The unbalanced leadership and representation in the registry design process is offensive, unacceptable and must be corrected. We understand that the current process is moving forward very quickly. So we would request a response to our concerns before November 16.
Thank you very much for your serious and timely attention to this important matter. We look forward to your response and we are sure that if we work together we will find a constructive solution.
Yours Sincerely,
Fred Hahn President CUPE Ontario
Michael Hurley President
Ontario Council of Hospital Unions

Response to the Proposed Ontario Personal Support Worker (PSW) Registry for Health Care

Submitted to the Ministry of Health and Long Term Care (MOHLTC) Ontario
by the Canadian Union of Public Employees (CUPE) Ontario
and Ontario Council of Hospital Unions (OCHU)
August 2011
Response Submitted to the Ministry of Health and Long Term Care (MOHLTC) Ontario
Introduction
The Canadian Union of Public Employees (CUPE) Ontario and the Ontario Council of Hospital Unions (OCHU), a CUPE bargaining council, represent approximately 65,000 health care workers among our 210,000 members which include approximately 25,000 Personal Support Workers (PSWs) and Health Care Aides (HCA). CUPE nationally represents more than 615,000 workers making it the largest union in Canada. CUPE members work throughout the public sector including health, community care, social services, municipalities, school boards and universities.
The union welcomes the opportunity to further respond to the Ministry of Health and Long Term Care (Ministry) following the June 2011 consultations held in Toronto with key stakeholders, including CUPE Ontario and OCHU1. Our response takes into account our forty year commitment to support and enhance quality public healthcare that is part of the work of our union through advocating for a regulatory minimum standard of 3.5 hours of direct care for long term care residents, an end to the compulsory contracting out in home care that has created waiting lists of over 10,000 people, and proper funding for non‐profit and public hospital care. As presented at the consultation in June 2011, the union has serious concerns about the purpose, reason and the need for a Registry of PSWs.
A PSW Registry causes “double jeopardy”. The double jeopardy principle means being disciplined twice for the same alleged infraction – once by the employer or supervisor and again by being removed from the Registry list. Double jeopardy is unfair and unneeded and causes unnecessary extra expenses. Duplicate discipline systems and processes are costly. The funding of public health care delivery needs to be a priority.
It is our contention that the proposal for a Registry is premised on the wrong conclusions, focusing solely on the workers instead of the underlying problems facing our health care system. We would argue that it is the lack of meaningful regulations and government policies such as compulsory contracting out of services that are creating the systemic problems, such as:
• Under funding of hospitals, long term care and home care; • Inadequate accountability and transparency; • Health and safety risks for both recipients and health care workers; • Increasing workload; • Low staffing levels; • Wait lists 2 ; • Lack of a legislated direct care standard for long term care residents; and, • In‐attention to investment for skills development and core competencies for PSWs throughout
the health care system.
1 From here on the term “union” will be used to mean CUPE Ontario and OCHU. 2 For more information, click on CUPE’s Solutions to Health Care Waiting Lists http://cupe.ca/wait‐ times/Backgrounder_Solutio
Canadian Union of Public Employees (CUPE) Ontario / Ontario Council of Hospital Workers Union OCHU)
Response Submitted to the Ministry of Health and Long Term Care (MOHLTC) Ontario
CONSULTATION QUESTIONS – PERSONAL SUPPORT WORKER REGISTRY
Purpose
On May 19, 2011, the Ministry issued a news release stating that a Registry for PSWs was going to be created that would better recognize PSWs’ work and help to further meet the needs of the people they care for. The union supports efforts by the Ministry to recognize the work of PSWs. We also support policies that ensure that Ontarians whether in hospitals, their own homes or in long‐term care homes receive the care they need. As stated, we believe current government policies are failing to do that. Based on our front‐line hands‐on experience and knowledge of the health care sector, we believe that the PSW Registry will contribute little, if anything, to broad public policy objectives to provide quality public health care.
It is unclear to the union, why the Ministry is creating a Registry after the 2006 recommendations from the Health Professions Regulatory Advisory Council (HPRAC) did not support this. A comprehensive and extensive review was undertaken by HPRAC and the recommendation was that PSWs should not be regulated under the Regulated Health Professions Act (RHPA). The union was part of that review and we note that our submission argued against the regulation of PSWs. HPRAC also came forward with the recommendation that a Registry should not be implemented as an alternative to regulation.
HPRAC recommendations from 2006 on the issue of PSW regulation stated the following:
1. HPRAC recommends that Personal Support Workers not be regulated under the Regulated Health Professions Act, 1991 as they do not meet the requirements for regulation.
2. HPRAC recommends that a Registry for Personal Support Workers not be required as an alternate to the regulation under the Regulated Health Professions Act, 1991.
HPRAC did not recommend a PSW Registry since, among other reasons, it required legislation, a thorough examination of confidentiality issues, and that a Registry would not address issues in retirement homes or in private for‐profit care that are currently unregulated. HPRAC also deemed a PSW Registry to be a high‐cost item.
If the Ministry is concerned about the level and quality of care for Ontarians, whether recipients of home care, or who reside in long term care homes or hospitals, it should not focus on unnecessary and costly structures such as a Registry but instead provide adequate funding to ensure the level of care and staffing is maintained to meet the needs of patients.
Funding should not be increased, however, to envelopes from which profit can be taken in the absence of a complete opening of the books. High profit levels for private for‐profit long term care, private for‐ profit home care providers and for‐profit hospital contract companies, reduce resources that should be available for front line care. Funding increases to for‐profit health care providers have not been
Canadian Union of Public Employees (CUPE) Ontario / Ontario Council of Hospital Workers Union OCHU)
Response Submitted to the Ministry of Health and Long Term Care (MOHLTC) Ontario
accompanied by enhancements in levels of service. The Ministry needs to impose an accountability mechanism on operators that can be enforced by other stakeholders. As well there needs to be greater transparency so that the public can become informed what the current situation is in relation to care levels and care needs and how funding resources are being allocated.
At the consultation meeting in June, it was also suggested that a PSW Registry in Ontario could be utilized to track the PSW workforce for training and labour force planning purposes. The major challenge of ensuring we have a sufficient supply of trained and competent PSWs to meet the care needs of the people of this province is not the absence of a Registry but rather government policies which clearly undermine the terms and conditions of employment, create excessive workloads for existing staff which act as a deterrent for individuals considering entering the field.
Recruitment and retention can be improved through more competitive wages and working conditions. Currently, compensation for the PSW health care occupation is one of the lowest health care compensations in Ontario. Underfunding of health care organizations and a lack of effective accountability and transparency ‐ and the resulting inadequate staffing levels, heavier workloads ‐ and privatization, have caused horrendous working conditions. These problems also act as a deterrent for individuals considering entering the field as a career choice.
The current demographic of the PSW workforce show that the work force is predominantly women and in urban centres where the majority of work is undertaken, also predominantly racialized women. It is concerning for the union that a workforce with this demographic continues to face poor working conditions and now through a potential Registry may have to bear this additional burden.
Any proposed PSW Registry list must be without fees. PSWs cannot afford extra fees. As mentioned above, PSW compensation is often small. Any extra burden for PSWs would have serious negative consequences affecting both PSW recruitment and retention, not to mention morale.
The matter of minimum required core competencies was raised by the Ministry at the June consultation and it was advised that this work was still in process. A PSW Registry may be positive if it helps create more certified courses that allow PSWs to graduate with a PSW certificate. In 2006, HPRAC made the link between standard core competencies and any possible Registry:
A prerequisite to launching a certification Registry would be to establish uniform minimum entry‐ to‐practice standards for PSWs. This would need to address the treatment of equivalent credentials and competencies in order to avoid the exclusion of a significant part of the current workforce. There was little discussion or agreement on who should accredit and or implement this process.
The role of employment/labour relations law should be a part of a certified PSW course curriculum. In education programs for other health care occupations, such as Registered Nurse education, there have been educational components in this area. Learning about the laws setting out workplace rights and
Canadian Union of Public Employees (CUPE) Ontario / Ontario Council of Hospital Workers Union OCHU)
Response Submitted to the Ministry of Health and Long Term Care (MOHLTC) Ontario
responsibilities including the obligation to act as “patient advocates” and the restrictions on the right of employers to interfere with these rights, is an important part of PSW education. The union is eager to be an integral part of this training program.
We suggest the focus and priority for the government should not be a Registry but to ensure that there is regulatory standardization of the core curriculum and standards for PSW certificate programs. The union also has serious concerns about the increasing role of for‐profit, private vocational colleges and remains committed to strengthening and advocating for properly funding our public education system at both the secondary and post‐secondary level. Any effort in the direction of certification or accreditation of the educational programs for PSWs should focus on the public education system with public non‐ profit delivery. Finally current employees in the sector need financial incentives in terms of tuition and book costs as well as paid time, to upgrade their formal qualifications. Many current employees have the motivation but lack the financial wherewithal to take the time to do this on their own.
ACCESS TO INFORMATION Proposed Registry Privacy
Based on the information provided to us currently, there are potentially serious issues around the privacy rights of PSWs and this of the utmost importance to the union. In British Columbia (BC), only employers can check the PSW Registry. It seems that an Ontario Registry may be open to public viewing which would undermine privacy rights of individuals. The only information BC employers can see is if a PSW is included on the list (or Registry). The Registry is not a reference‐checking system for employers in BC. After an individual PSW is added to the list, their contact information is destroyed. Consequently we are perturbed that while Ontario Privacy’s Commissioner has been asked to comment on issues of privacy relating to the Registry the fact that this report will not be made public is extremely disconcerting. The union will be in contact with the Privacy Commissioner to ensure the privacy rights of PSWs are protected.
MAINTENANCE and ELIGIBILTY Governance of a Proposed PSW Registry
If a PSW Registry is created, a committee comprised of PSW unions should monitor the Registry and the Registry process. In BC, the Registry is housed within a non‐profit entity supervised by the Ministry of Health. The union affiliate in BC called the Hospital Employees Union (HEU) sits on one of the Registry Advisory Boards.
Proposed Registry Inclusion
If being included on a PSW Registry entitles a PSW to work for a publicly funded or regulated health care organization, any PSW Registry must include “grandparenting”. Grandparenting means that experienced health care workers working as PSWs and who may not have certificates to prove their qualifications, be allowed to join the Registry.
Canadian Union of Public Employees (CUPE) Ontario / Ontario Council of Hospital Workers Union OCHU)
Response Submitted to the Ministry of Health and Long Term Care (MOHLTC) Ontario
If a PSW Registry list is created, PSWs should have at least a one (1) year window to apply for “grandparenting” into a Registry. In BC, the Employer sent in the names of the PSWs, and individual PSWs checked that their name was on the Registry list by a certain date regardless of whether they had any certificates. As long as you were currently working, or had ever worked as a Health Care Aide (HCA) or PSW, you could be added to the list. There is a toll‐free 1‐800 number, mailing address, and web site in order to check to see if your name is on the Registry list. A “receipt” is issued to all eligible and interested health care workers once they are placed on the Registry list.
There should be consideration made about other health care workers who contribute to the health care team and their inclusion in any proposed PSW Registry list. Those individuals who have previously worked in health care but who are not currently working, should also be considered in any proposed PSW Registry list if they so choose.
If a voluntary PSW health care Registry is to be created, similar to the social worker Registry list in Ontario, only health care workers who want to use the title or are classified as “Personal Support Workers” by employers should be included. Health care workers who use alternate titles, need not join the list, if they so choose.
Proposed Registry Exclusion
If a proposed PSW health care Registry is created, the Registry exclusion process must be transparent, fair and follow due process. The negotiated grievance arbitration process already established in collective agreements needs to be examined as an appropriate Registry list exclusion tool.
In BC, only abuse allegations (physical, emotional, financial, sexual, neglect and deprivation of food or fluids as a form of punishment) can trigger a Registry investigation. The unions are involved in creating a list of fair investigators in BC.
In BC, the Registry process introduces intermediary steps, such as education rather than termination, whereby the accused member may enter into an anger management course or work in non‐direct care, similar to the process currently in place for doctors and registered nurses.
In BC, the Registry will not keep a record of abuse allegations: • if they do not result in a termination, or • where a special investigator, or arbitrator, determines that the accused individual should not be
removed temporarily or permanently from the Registry.
The union should not bear the cost of any investigation. Processes for non‐unionized PSWs should also be fair and follow due process.
Canadian Union of Public Employees (CUPE) Ontario / Ontario Council of Hospital Workers Union OCHU)
Response Submitted to the Ministry of Health and Long Term Care (MOHLTC) Ontario
In Summary
While the union supports the objectives of ensuring Ontarians receive the care they need, it is our contention that the proposal for a PSW Health care Registry is premised on the wrong conclusions, focusing solely on the workers instead of the underlying health care sector problems.
Again we want to stress that the government policies around regulation, levels of care and the instability of the workforce need to be addressed before the government gives any consideration to a Registry. In review, these include the following:
• Under funding of hospitals, long term care and home care; • Inadequate accountability and transparency;
• Health and safety risks for both recipients and health care workers; • Increasing workload; • Low staffing levels; • Wait lists;
• Lack of a legislated direct care standard for long term care residents; and, • In‐attention to investment for skills development and core competencies for PSWs throughout
the health care system.
We urge the Ministry to take the bold step of re‐allocating the resources and energy directed towards the creation of a Registry to, instead, addressing the longstanding problems that are the underlying causes of the serious challenges undermining the quality of care in all facets of the health care system. A PSW Registry is not the “fix” that is needed.
If the government does moves towards a Registry, however, the union strongly urges the government to consider the following:
• the PSW Registry should remain a list of names with strict privacy rules supported by Ontario’s Privacy Commissioner;
• the union be involved in governance; • the list involves grandparenting; • the list involves a fair exclusion process; • the list be free for PSWs to join; • the list be non‐mandatory; and that • a province‐wide certified PSW educational program be created which will include information
on workplace rights and responsibilities and which involves Unions as contributors.
Canadian Union of Public Employees (CUPE) Ontario / Ontario Council of Hospital Workers Union OCHU)
Response Submitted to the Ministry of Health and Long Term Care (MOHLTC) Ontario
Finally the union is eager to discuss with the Government: • Effective ways to ensure Ontarians get the public health care that they require; • Appropriate and effective financial incentives for current employees in this sector to upgrade
their qualifications and; • Standardized training and education measures that need to be developed to ensure that PSW
work is an attractive career choice. Educational changes also require the province to address the issues of wages and working conditions of a predominately female work sector to ensure that there is an adequate supply of workers to provide this care.
sl/cope491
August 15, 2011 CUPE Research
T:\HC‐RA\Ontario\PSW\2011\Brief\MOHLTC PSW Registry\Brief MOHLTC PSW Registry August 15 2011.doc
Canadian Union of Public Employees (CUPE) Ontario / Ontario Council of Hospital Workers Union OCHU)

Letters to the editor:

RPNs important part of system

The Cornwall Standard-Freeholder
Sat May 15 2010
Section: Editorial/Opinion
Column: Letters to the Editor
Canadian Union of Public Employees (CUPE) Registered Practical Nurses (RPN) are professional, practical and caring nurses who have probably cared for you or your family. CUPE RPNs work in all health care facilities, from hospital maternity units to working with seniors in nursing homes, to surgery units and emergency wards. Among other skills, CUPE RPNs are professionals who perform assessments, initiate treatments and therapy, dispense medications and provide health care teaching. CUPE RPNs are registered with the College Nurses of Ontario (CNO) and obtain nursing competencies through a two-year college diploma program.
The CUPE employees and their bargaining group the Ontario Council of Hospital Unions (OCHU) have proudly represented RPNs since 1963. CUPE/OCHU argue for full RPN staffing complements so that RPNs are not overworked.
Fully utilizing RPNs means that valuable health care resources are not wasted and RPNs are respected and treated as professionals.
Do you feel like you know more about CUPE RPNs? We hope so.
Our public health care system depends on it.
Diane Morin,president CUPE 7811, Cornwall Community Hospital

Nurses told to expect changing roles

Northumberland Today.Com
Fri May 14 2010
Section: News
Byline: VALERIE MACDONALD NORTHUMBERLAND TODAY;
Dateline: COBOURG
Health care in the future will involve more robots and fewer registered nurses providing bedside care in hospitals, June MacDonald-Jenkins, an educator with the office of research and innovation at Durham College, told nurses at Northumberland Hills Hospital on Thursday.
The role of nurses will be that of patient care facilitators, not care providers, while the scope of practice by registered practical nurses will be expanded even more and personal support workers will be providing direct patient care. "Unregulated" professions will increasingly become part of the health-care team, she predicted, and hospitals will set the "care criteria".
The system will become a "shared care model" and nurses are going to be the "coordinators of care," MacDonald-Jenkins stressed.
These predictions come, in part, from the Canadian Nurses Association's vision for nursing study entitled Toward 2020, published in 2006. The other factor is cost. The largest expense in the hospital setting is people and the second is equipment, she said.
Taxpayers can't afford the existing health-care system and if it isn't changed, "we'll go bankrupt," the Cobourg woman said.
Instead of remaining in a facility such as a hospital, patients will be "empowered to go home" as the acute care environment changes and more care takes place in the community.
In fewer instances will doctors be the primary health-care provider, MacDonald-Jenkins said. The role will be handled by nurses, nurse practitioners, social workers or other health-care practitioners,
Nurses will be shepherding patients and helping them navigate through the experts, she said. And nurses, themselves, will be moving out of the hospital setting.
Overall, health-care providers will stop fulfilling roles that can be completed by patients and non-human personnel and with unregulated health-care providers, Mac-Donald-Jenkins predicted.
One of those non-humans is the Fanuc Robot that can work in care situations where nurses would prefer not to be, such as in isolation units where the robots can be decontaminated easily, or in dealing with a violent, armed patient.
The expanded use of robots in health-care applications, currently used in some surgical units and more widely in some U.S. hospitals, is underway now, said MacDonald-Jenkins, who is part of that investigation. In an interview following her presentation she said she was unable to talk publicly in detail at this time.
Seeing robots in hospitals will become more common over the next 15 years, Mac-Donald-Jenkins predicted.
vmacdonald@northumber landtoday.com

Remember to say thanks to a nurse this week

With National Nursing Week taking place this week, CUPE Local 5666 members are urging the community to join them in recognizing the commitment, skills and dedication of registered practical nurses (RPNs).
Every day and in almost every clinical setting, RPNs are bringing their skills and compassion to patients in our community, ensuring people have the care they need.
In spite of huge challenges around provincial underfunding, the threat of increasing privatization of our public health-care system, RPNs across the province, and right here in Brockville, bring their professionalism and caring to patients.
National Nursing Week is May 10-16, so please, if you know a nurse, say a few kind words.
Martha Peters-Godin, President, CUPE, Local 5666

Nurses recognized during time of change

Northumberland Today.Com
Wed May 12 2010
Page: 1
Section: News
Byline: VALERIE MACDONALD NORTHUMBERLAND TODAY;
Dateline: NORTHUMBERLAND
-Nurses in the community do everything from investigating communicable diseases and visit mothers with new babies to working in operating rooms, dispensing medication, teaching people how to take better care of themselves and their loved ones, cleaning wounds, emptying bedpans, ordering x-rays and diagnostic tests, providing baths, monitoring and documenting patient care and offering words of support.
This is National Nursing Week, and many organizations are taking the time to recognize the importance of nurses in our communities. The celebrations come as more nurses are being graduated than before -yet cost-cutting measures at various health care facilities, including Northumberland Hills Hospital, means layoffs to these same professionals.
According to a media release from Ontario Premier Dalton McGuinty's office 2,910 nurses graduated last year, "up from just 1,647 in 2005". The release states that it is inviting applications across Ontario to create 14 more nurse practitioner-led clinics.
Even as nurses are being recognized this week for their importance in the health care system, the Ontario Nurses' Association (ONA) has launched a public campaign that stresses its "skilled, professional RNs have been 'recognized' far too often as a target for cost-cutting exercises and lost their positions to balance the bottom line."
Cutting nursing care hours for patients affects health-care outcomes, the Cutting Nurses, Cutting Care campaign stresses.
In the past year alone, 2,000 registered nurse cuts have been tracked by ONA, the release states. ONA represents 55,000 front-line registered nurses and about 12,000 nursing student affiliates.
Pending cutbacks at Northumberland Hills Hospital will see that number rise later this year with more than 10 positions to be hit, according to initial estimates.
In addition, of the 76 registered practical nurses at Northumberland Hills Hospital, about 30 will be affected by the cuts, says CUPE Local 2618 president Peggy Smith who has been lobbying for more government funding to reverse the local service and staffing cuts.
Despite this uncertain situation, nurses at the local hospital have a full week of events and educational activities celebrating nursing week. Other organizations are also officially recognizing the importance of nurses, among them the Haliburton, Kawartha, Pine Ridge (HKPR) District Health Unit, Northumberland Hills Hospital, the Ontario Nurses Association and the Canadian Union of Public Employees representing Registered Practical Nurses.
"Public health is all about promoting and protecting the health of the public and nurses play an essential role in this," says HKPR District Health Unit Medical Officer of Health Lynn Noseworthy.
"Every day our nurses show care, compassion and commitment to the public's health -your health -in so many ways."
During last fall's response to the H1N1 influenza virus situation, nurses put in long hours to distribute vaccine and provide information to the public, she noted in a media release.
Durham College and the University of Ontario Institute of Technology (UOIT), along with Trent University, are teaching the next generation of nurses and on Thursday at Northumberland Hills Hospital (NHH) a speaker from UOIT, June MacDonald-Jenkins, will address the future of nursing, says Sandy Ward, one of the registered nurses at the local hospital who helped organize nursing week there.
A display in the hospital's cafeteria provides an historical perspective of nursing in pictures and words that includes the influences of Florence Nightingale, who was born 100 years ago and the earliest records about wound care dating back to cave drawings discovered in Spain.
Partners in the overall display and events, including educational luncheons and pizza nights for nurses, include hospital suppliers, NHH, local retailers, nursing unions and physicians, Ward said.
There are also pampering sessions -from massages and reflexology to manicures and pedicures -being provided complimentary of various area businesses.
Nursing units at NHH will also be competing for the Physicians Challenge Cup by creating the best display portraying "Nursing Now and Then."
vmacdonald@northumber landtoday.com

College of Nurses of Ontario (CNO): Argues for the appropriate utilization of RPNs in their Nursing in Temporary Locations paper (August 2009)

Hospital emergency departments (EDs) are often overcrowded in Ontario. Longer ED wait times and lengths of stay and decreased availability of inpatient beds means patients can be treated in temporary locations, or “hallway nursing”. OCHU has argued for increased hospital funding to end hallway nursing as well as full utilization of trained staff in the ED. The CNO also recognizes that trained health care staff, such as RPNs, must be treated with “appropriate utilization…CNO’s practice guideline entitled Utilization of RNs and RPNs was developed to support nurses, employers and others in making effective decisions regarding the utilization of all nurses.” (Nursing in Temporary Locations. Page 20)

To read the paper, click here.

For CNO’s Utilization of RNs and RPNs, click here.

Media Release

Nursing Researchers join forces to strategize for more full-time nursing jobs

HAMILTON, ON (February 4, 2010) – McMaster researchers have teamed up with four Local Health Integration Networks (LHINs) to design a toolkit for creating strategies to increase full- time positions for nurses.

The Nursing Health Services Research Unit (NHSRU) at McMaster University and Central West, Hamilton-Niagara-Haldimand-Brant, South East, and South West LHINs have created a made-in-LHIN solution, identifying local needs toward 70 per cent full-time nurse employment. Health Human Resource Series Number 18. Strategies to Advance 70% Full-Time Nurse Employment Toolkit, can be found at www.nhsru.com.

This NHSRU/LHIN partnership was formed to address the Ontario Ministry of Health and Long-Term Care’s (MOHLTC) priority theme of a 70 per cent full-time commitment to nurse employment (RN, RPN and NP) in the province of Ontario.

“This toolkit was created by and for organizations working toward the MOHLTC’s 70 per cent full-time commitment for all nurses. It is a hands-on guide to improving and stabilizing the current state of the nursing workforce in the province of Ontario,” says Andrea Baumann, lead author and Scientific Director to the NHSRU.

These following strategies are identified as successful tools for increasing full-time nursing positions: innovative scheduling, cross-training, collaborating across sectors, creating full-time positions from available hours, creating specialty lines across sites, using RPNs to full scope of practice, participating in government initiatives, building relationships with academic partners.

A Made-in-LHIN Solution: Identifying Local Needs in 70% Full Time Nurse Employment, report describes the results of the research study conducted by the NHSRU that examined nurse employment across the four LHINs. It provides evidence of the fluctuating stability of nursing employment over the last two decades and identifies a series of strategies to achieve 70% full- time nurse employment.

Baumann says over the past two decades, the dramatic effects of a casualized nursing workforce have resulted in a greater commitment by the Ontario government to increase full- time employment for all nurses. “The strategies identified in this toolkit provide practical solutions to challenges facing organizations in increasing full-time employment for nurses.”

Following the publication of the report, the LHINs and the NHSRU McMaster site hosted a workshop for the participating LHINs, entitled: 70% Full-time Nursing LHIN Engagement Initiative Workshop. Participants were asked to share their experiences in using the different strategies based on enablers and barriers to implementation. This toolkit reflects the results of these discussions and presents the eight strategies in a format that can be used to assist organizations in increasing full-time employment of their nurses.

Please visit our website www.nhsru.com for the most up to date nursing research.

For more information, contact:
Theresa Noonan
Nursing Health Services Research Unit
McMaster University
905-525-9140 ext. 22698
www.nhsru.com
noonant@mcmaster.ca

or

Laurie Kennedy
Nursing Health Services Research Unit
McMaster University
905-525-9140 ext. 22206
www.nhsru.com
kennedyl@mcmaster.ca

April 30, 2010

Dear CUPE/OCHU Registered Practical Nurse:

We are writing to you today to thank you for your valuable contribution as RPNs to our health care system. RPNs warrant congratulations and admiration for the compassion and care you bring to Ontario’s health care team.
CUPE and OCHU are proud to have been representing RPNs in negotiations for professional practice development, appropriate compensation, and safe working conditions for RPNs, as an independent voice, since 1963.
Registered Practical Nurses keep the pulse of Canada’s health care system strong! Every day, RPNs professionally and skillfully perform assessments, initiate treatments and therapy, and provide health care teaching in numerous challenging settings such as operating and emergency rooms, acute and complex continuing care, clinics, Alzheimer’s units, and palliative care, just to name a few.
Your clinical skills and professionalism are matched only by the empathy, compassion, and commitment to quality care that you bring to your patients every day.
Together, CUPE and OCHU are proud to represent thousands of RPNs. We look forward to working together with you to advance the profession of RPNs for a long time to come.
Once again, thank you for all of your great work, and Happy Nursing/Long Term Care Week!

In solidarity,

PAUL MOIST CUPE National President

MICHAEL HURLEY OCHU President

College of Nurses of Ontario (CNO): New Quality Assurance (QA) Program

All RPNs in Ontario should know that starting in 2010, nurses are required to develop and maintain a Learning Plan form as part of the new Quality Assurance program of the College of Nurses of Ontario. The Learning Plan lists strengths and areas for improvement and needs to be kept for two years. Every nurse needs to be ready to show the College this plan if randomly selected. Information about the QA Program was mailed to members by the College of Nurses of Ontario in October 2009.
For Q&As from the CNO’s “Quality Assurance: Self-Assessment and Your Obligations” teleconference 2009, click here. For a more detailed presentation and a blank form to fill out for a CNO Learning Plan, click here.

You can reach the CNO by calling Practice Inquiries (Practice Support Line) 1-800-387-5526 (ext. 6397) or in Toronto (416) 928-0900 (ext. 6397) or email ppd@cnomail.org

BRIEFING NOTE (for information)

For: OCHU RPN Committee, OCHU and CUPE Ontario RPN’s, OCHU Executive,
Gwen Hewitt, Margaret Evans, Doug Allan

C.C Anthony Pizzino, Irene Jansen

TOPIC
College of Nurses of Ontario (CNO), RPN Research & News Stories: Spring 2007 Update
College of Nurses of Ontario (CNO)

BACKGROUND:
Through the Regulated Health Professions Act, the College of Nurses of Ontario (CNO) sets competency requirements for registration purposes. Every Ontario RPN must be registered with the CNO in order to use the title “registered practical nurse”. Competency is tested through two means: (A) self-test or self-assessment, and by
(B) the College itself.

(A) The College issues information on self-assessment, “quality assurance” or reflective practice. In summary all these terms mean:

1. Complete a self-assessment.
2. Obtain peer feedback.
3. Create a learning plan.
4. Implement the learning plan.
5. Evaluate the learning and application of knowledge in practice.

As part of the Annual Membership Renewal each year, each RPN must sign the Reflective Practice Declaration, which means that all five steps have been completed.

(B) The College reviews 400 nurses randomly each year. This is called a Practice Review and includes a written test. If the test is not passed, nurses go through an interview process and possible steps to address any issues identified in the test or interview. Employers are not able to refer nurses for this review. Practice review results are not available outside of the CNO. For more information:

Click on
http://www.cno.org/docs/qa/44026_fsPracRev.pdf.

UPDATE:

New Competency Review Tool (2007)

This new document helps RPNs do a written self-test or self-assessment. This is particularly important in case of a College audit or Practice Review. It is comprised of five areas: professional behaviour/ethics; critical thinking, research and leadership; client and nurse safety/illness and injury prevention; relationships/caring; and clinical skills. There is also an evaluation of the document that you can return to the College anonymously. The document replaces the 1996 Self-Assessment Tool.

Click on
www.cno.org/docs/qa/44028_CRT.pdf for an electronic copy.

The CNO is also developing a web-based program for assessment purposes. The College suspended the Practice Review in 2007 while their new assessment is being developed. For more information,

Click on page 22 of December 2006’s The Standard at http://www.cno.org/pubs/mag/TSMvol31no4.pdf.


“Delegation” for Ontario Nurses: CNO Proposed Regulation Revision (January 2007)

The CNO has proposed that the regulation on “delegation” be changed. It is soliciting feedback to its proposed changes until May 23, 2007. The CNO explains that the reasons for their proposed changes are due to the “rapid evolution of health care environments and the enactment of regulations allowing RPNs to initiate controlled acts”.

The proposed changes are mainly about nurses’ delegation record-keeping. They propose that nurses now place a copy of the delegation in the client record or ensure that a written copy of the delegation exists within the organization. Previously, the regulation read that the delegation could be in the client record only. The CNO proposal seems a welcome change for CUPE/OCHU RPNs.

Click on
http://www.cno.org/for/rnec/pdf/PoropDelegationRegsR1284CD.pdf for an electronic copy of the CNO proposal.


Nursing Utilization CNO Teleconference (February 14, 2007)

There may be a new trend regarding the importance of RPN work at the CNO. There was a teleconference on the utilization of RNs and RPNs earlier this year. The documents discussed were not new.

For a copy of the slides used for the teleconference:

Click on
http://www.cno.org/prac/learn/teleconferences/utilization/pdf/02_14-Slides.pdf.

Click on
http://www.cno.org/prac/learn/teleconferences/utilization/index.htm for an outline of the teleconference itself.

For more updates from the College of Nurses, click on www.cno.org.

Selected RPN Research

BACKGROUND:

The Nursing Health Services Research Unit (NHSRU) is based at both the University
of Toronto and Hamilton’s McMaster University. The unit is funded through the Ontario government. Formed in 1990, the unit conducts research about the effectiveness, quality, equity, utilization and efficiency of health care and health care services in Ontario with a focus on nursing. For more information, click on www.nhsru.com.

The Canadian Institute for Health Information (CIHI) is an “arms-length” government institute formed in 1994 by Canada’s health ministers. It reports on health care services, health spending, health human resources and population health. It has a 16-member board comprised of federal, provincial and territorial government representatives, and university and hospital administrators. It is entirely funded by government funding through the institutions and departments that are represented on the board.

For more information:
Click on www.cihi.ca.

UPDATE:

Nursing Health Services Research Unit’s (NHSRU) Rural Ontario Nursing Workforce Study (November 2006)

In November 2006, the NHSRU released a research report about nursing in rural Ontario. It focused on the Ontario rural area of Local Health Integrated Network (LHIN) 2 (South West LHIN) and was commissioned by the Ontario Ministry of Health and Long-term Care. The entire name of the study is The New Healthcare Worker: Implications of Changing Employment Patterns in Rural and Community Hospitals.

The timing of the study, the title of their fact sheet – “Rural Nursing Workforce: How sustainable is it?” and the overall tone of the report, may beg the question `why the focus on rural hospital nursing now?’ This is particularly important as it relates to our possible future and current struggles against hospital closures and downsizing especially in rural areas.

The relevant main results of the report about rural LHIN 2 are:

• there are a high number of part-time nurses;
• nurses experience stress due to fluctuation in the number of patients;
• stress is caused by an unpredictable call-in system; being sent home if there are not enough patients; working more than one part-time job; some part-time nurses working full-time hours without full-time benefits;
• some full-time nurses work overtime (since some part-time staff don’t want more hours);
• and “Among nurses who left the system 2002-2004, 70% resigned while 30% retired”.

Recommendations include:

• more nurse training (to work with different patient groups);
• hospitals using a better system to predict patient numbers;
• more full-time nurses to work in more than one site;
• co-op programs and bursaries for rural high school students to attract them into nursing;
• properly funded, standardized rural education/training;
• longer orientation and mentoring programs;
• standardized security measures;
• and, evaluation and action on nurses’ security concerns.

Click on http://www.nhsru.com/factsheets/Rural%20Nursing%20Workforce%202%20of%202.pdf for an electronic copy.


Canadian Institute for Health Information’s (CIHI) Regulated Nursing Workforce in Canada 2005 study (October 2006)

In October 2006, CIHI released its “Regulated Nursing Workforce in Canada,
2005” study. The study includes RNs, RPNs (listed as LPNs in this study) and Registered Psychiatric Nurses. A specific study on each classification was also released. The “Workforce Trends of Licensed Practical Nurses in Canada,
2005” is useful. Main points include:

• casual rates of RPNs in Ontario are the lowest in the country;
• fewer Ontario RPNs work in hospitals (45.9%) than the Canadian average
of 46.4%;
• more Ontario RPNs worked for a single employer (89.3%) compared to the Canadian average of 84.3% (10.7% of Ontario RPNs worked for multiple employers);
• part-time and casual rates in the country have increased since 2003;
• most practical nurses in Canada work in geriatrics/long-term care.

Click on
http://secure.cihi.ca/cihiweb/products/ndb_workforce_trends_licensed_practical_nurses_canada_2005_e.pdf for the full report.


Selected RPN News Stories

New relevant Ontario RPN news stories are as follows:

*”Hospital approves cutbacks” by Carol Martin, SooToday.com, February 17, 2007: This story quotes the CEO of the Sault Area Hospital (SAH) (Ron Gagnon) who argues that there is a trend in Ontario of RPNs replacing RNs in palliative care and that SAH would be vulnerable to the pending RN shortage if it didn’t follow this trend. Sharon Kirkpatrick, SAH senior vice president and chief nursing officer, agrees.

Click on
http://www.sootoday.com/content/news/full_story.asp?StoryNumber=22741
for the full story.

*”Nurse project in hospital ER”, Chatham Daily News, June 14, 2006: This story reports on the Chatham campus emergency department who has implemented a six-month pilot project with a triage-support RPN. The RPN will provide a “visual assessment, triage patients using provincial guidelines and perform reassessments for those awaiting care”. To buy the archived story:

Click on
http://www.chathamdailynews.ca, or contact hfarrow@cupe.ca.


TRANSMITTAL INFORMATION

Heather Farrow
Research Assistant
613-237-1590, ext. 320
hfarrow@cupe.ca

March 28, 2007




sb/cope 491
S:\Research\WPTEXT\HCRA\OCHU\RPN\Briefing CNO & RPN Research Spring 2007.doc
April 5, 2007

Malpractice Insurance for RPNs

New Ontario legislation makes it even more important for RPNs to get malpractice insurance – your hospital’s insurance is not enough. Here is some information from the College of Nurses of Ontario (CNO):

From http://cno.org (College of Nurses of Ontario) downloaded January 15, 2010 <http://www.cno.org/new/notices/bill179_update.htm>”

“On December 15, Ontario passed Bill 179. The new Act amends 26 health-related statutes including the Nursing Act. Although the bill has passed, the changes will not take effect until regulations are amended.”
“8. Will all nurses be required to carry professional liability protection?
Yes. All nurses who are registered with the College, and are practising nursing in Ontario, must have professional liability coverage.
This requirement will not take effect until after the College has developed regulations and by-laws pertaining to professional liability protection that will specify the requirements for nurses.(highlights added)
The College will provide more information on this issue on its website and in The Standard.”
For a detailed review of the amendments to the bill, please click on:
http://www.ontla.on.ca/web/bills/bills_detail.do?locale=en&Intranet=&BillID=2189

A Review and Evaluation of Workplace Violence Prevention Programs in the Health Sector

(completed July 2008)
Nursing Health Services Research Unit (University of Toronto Site), www.nhsru.com
“Risk of violence is high for Registered Practical Nurses (RPNs) due to the sectors in which they work. 75% of RPNs in Long Term Care and hospitals report verbal aggression and 40% in hospital reported emotional abuse.”
“A national survey revealed 58% of nurses had experienced some form of violence in their last 10 shifts.”
“Nurses are at the highest risk of workplace violence in comparison to other health professionals.” ...download full report