Inquiry Highlights LTC Issues

By Vicki McKenna, RN,

As ONA believed would happen, the testimony coming from the Long-Term Care Homes public inquiry is shedding light on working conditions in long-term care, particularly in for-profit long-term care, that is illustrating just how underfunded and understaffed this sector is.

While the beginning of this inquiry focused on ONA’s role in representing Ms. Wettlaufer, a thinly veiled attempt by the employers involved to deflect the blame in anticipation of possible lawsuits against them in the future, the evidence that is emerging now is absolutely shocking.

When reading each day’s testimony you will see that a witness from Telfer Place, a small, for-profit home in Paris, ON, has an RN-to-patient ratio of 99:1. The home employs just one RN per shift and relies often on a nursing agency to staff the home with an RN.

This week, a Telfer Place administrator, who is not a regulated health-care professional, testified that during an enteric outbreak, she personally administered medication to a resident.

It seems that the for-profit nursing agency, which Telfer Place relied on to supply RNs, failed her. And, when the best it could do was supply an RPN, with no time for orientation or training, the administrator herself helped the RPN on a med pass. She then self-reported to the Ministry of Health and Long-Term Care.

There was also a moment in the inquiry that struck me this week when an RN was testifying about completing her paperwork three hours after she had finished her shift. She was not actually testifying about the unpaid overtime, but even the Commissioner stopped her to confirm that she had heard her correctly, because it is so shocking.

Also, the inquiry heard the final confirmation that the letters of reference for Ms Wettlaufer, one from Geraldton Hospital and one from Caressant Care, did not play a role in the nurse ever getting another job. And I want to add that the onus is on employers to do their due diligence when hiring workers.

The fact is that the difficulty in recruiting long-term care nurses has much to do with inferior pay and benefits, heavy workloads, and the onerous paperwork.

I for one am grateful that there are registered nurses who have that passion for geriatric nursing, who do this work even though they are paid less and forego the benefits that nurses enjoy in other sectors, in order to provide that care for our frail elderly.

Thousands of residents, their families, and friends are grateful to you as well.

As the inquiry has proceeded, I am seeing letters to the editor and newspaper columns calling for nurses to be given medals for the loving, caring, and imaginative care they give to their residents.

We know that many RNs who begin their careers in for-profit long-term care leave their jobs for employment with non-profit municipal homes. The municipal homes provide superior working conditions, more RNs, more RPNs, more PSWs, and pay hospital-sector wages and benefits.

The most important consideration for RNs in these facilities is that they have the working conditions that enable them to provide high-quality care to residents.

The Inquiry is taking a two-week break after the long Canada Day weekend, but will resume in mid-July. ONA will be there and we will use the information emerging from testimony to develop and submit thoughtful recommendations with the hope that we can and will improve long-term care.

The irony is that we have known all along how to improve long-term care. The difference this time is that perhaps the will is there to do so.

Vicki McKenna, RN, is the president of the Ontario Nurses’ Association.