Difficulties in recruiting and retaining enough nurses and personal support workers for long-term care homes could mean the Ontario government misses its target for the amount of hands-on care residents receive, the minister responsible for the sector has warned.
There is a “systemic shortage of nurses” across all sectors, according to a briefing document prepared for Long-Term Care Minister Stan Cho when he took over the file in September.
Starting this year, 13,200 additional nurses and 37,700 PSWs are needed in Ontario, according to the document, obtained by The Canadian Press through a freedom of information request.
The long-term care shortage will worsen amid the government’s push to vastly increase the number of homes and as it tries to increase the amount of direct care residents receive, according to the document.
“Expected growth in long-term care services, i.e. increases in the system’s average daily direct care time and 30,000 new beds, will create the need for thousands more new positions for nurses and personal support workers (as well as other long-term care staff) over the next decade,” the report said.
“This goes beyond the existing shortage.”
The Progressive Conservative government in 2021 set a goal for long-term care residents to receive an average of four hours of direct care from nurses and PSWs per day by 2025, up from less than three hours in 2018. It included that objective in the legislation.
The government met its first and second interim targets, documents show, with residents receiving an average of three hours and 15 minutes of hands-on care as of March 31, 2023.
Cho’s office could not yet say whether the three-hour, 42-minute goal by March 31, 2024, was met, but reports it received after taking over the file in September paint a difficult picture.
“Ongoing staffing challenges (e.g., supply shortages, cross-sector competition, etc.), as well as the ongoing impact of the pandemic and increased occupancy… present risks to achieving goals,” it said The document.
The warning does not surprise many long-term care workers, including the president of SEIU Healthcare, the largest union representing long-term care workers.
“Every time the government announces they’re going to have thousands of new beds, we sit on the sidelines and say, ‘Who’s going to staff those homes?'” Sharleen Stewart said.
The shortage is impacting care, Stewart said, as staff, such as personal support workers, take on increasingly unmanageable workloads — caring for more residents at a time than they should and completing tasks they should be doing alone in pairs) and then they run out.
“Some of them don’t last six weeks,” he said.
“A lot of them come in and say the workloads are too heavy, the conditions are unsafe, and they move on. So we’ve reported that about 50 percent of new hires leave within the first six months and definitely leave.” then a year. So it’s a continuous revolving door.”
A spokesperson for Cho said the government is working with the long-term care sector to ensure funds go toward quality care for residents, but acknowledged the staffing situation is difficult.
“Our government recognizes the current pressures facing Canada, such as inflation and global health and human resource shortages, that are impacting our ability to continue making progress on our ambitious goals,” Daniel Strauss wrote in a statement.
“That’s why our government continues to make historic investments in Ontario’s long-term care sector.”
The government is funding several programs to address these issues, including a $3 per hour pay increase for PSWs in long-term care, stipends during clinical placements, $10,000 for newly graduated PSWs in exchange for a 12-month commitment to work in a long-term job. nursing home, and even more so if it is in a rural or northern area.
Still, according to Cho’s transition portfolio, PSW attrition is as high as 25 percent, meaning up to a quarter of the profession leaves annually. Low wages and working conditions are cited as key issues.
Lisa Levin, executive director of AdvantAge Ontario, which represents non-profit homes, said that after the government enacted the pay boost during the COVID-19 pandemic for PSWs, it left registered practical nurses, who supervise PSWs, earning the same or less.
“What we have been saying to the government is that we appreciate the efforts they have made, which is quite a bit, to provide funding and implement health human resources programs, but it must be done in a comprehensive manner, and not piecemeal. little because, otherwise, situations will occur such as the salary compression of the RPN, in which things could be improved for one group, but worse for another group,” he stated.
There is also pay disparity between nurses in different parts of the health-care system, said Erin Ariss, president of the Ontario Nurses Association. The union is heading to bargain on behalf of 3,000 members in for-profit homes and wants staffing ratios to improve care for residents and salaries to be equal to those of nurses in hospitals.
“These nurses who work in long-term care have the same grocery bills, the same gas bills, the same mortgage rates as the rest of Canadians… and their salaries haven’t changed significantly in almost a decade” . she said.
“What compounds this is the fact that they are caring for, in some cases, hundreds of residents for each nurse.”
Donna Duncan, executive director of the Ontario Long-Term Care Association, said staffing shortages in health care are a global problem and the province has done a lot of work on the issue, although there is still more to do.
“We are beginning to see that these initiatives are beginning to bear fruit,” he said.
“It’s getting a lot easier to recruit PSWs… We still continue to have challenges with nurses and RNs, probably more so with RNs than RNs at this point.”
In 2022-23, long-term care homes spent about $418 million on nurses from outside agencies to temporarily fill vacancies, a 46 percent increase from the previous year. Households spent hundreds of millions more hiring PSW agency workers, government documents suggest.
Other “allied health professionals” working in long-term care homes, such as physical therapists, dietitians and recreation staff, are also in short supply, Levin and Stewart said, although the briefing document shows the government has met its 36-minute goal. per resident. of daily direct care by these professionals.
This report by The Canadian Press was first published April 16, 2024.