Jasmine Joseph started a customer service job at Apple right after high school. “Even then, I was thinking about entering health care, but I was intimidated by the required biology and chemistry courses,” says the 28-year-old from Toronto. She worked on the job for a decade before taking maternity leave near the start of the pandemic. Then she heard about a free and free accelerated personal support worker (PSW) program in the news.
“I thought, this is my chance to get on the field,” says Joseph. “Also, I had heard of the PSW shortage in Canada and with the ongoing pandemic, I thought I could help myself in my career and help others at the same time.” He enrolled in a 24-week program at Centennial College and says it is one of the best decisions he has ever made.
In Canada, PSWs, also known as Health Care Assistants (HCAs), or Ordinances in Quebec, work in settings ranging from private homes to hospitals and long-term care facilities. Generally speaking, they help disabled, sick, or elderly people with daily life (bathing, eating, etc.), light housework, and sometimes with medical procedures delegated by or under the supervision of a doctor or nurse. .
They are also critically rare. During the pandemic, that problem became apparent when long-term care facilities, where a large portion of the country’s public health workers work, regularly made headlines as they struggled to keep enough staff to care for their residents. The staff shortage got so bad during the summer of 2020 that the federal government deployed the military to nursing homes in Ontario and Quebec, where some older people were reported to have died from dehydration and neglect.
MORE: COVID-19 in Long-Term Care: A Report from the Inside Out
In response, free, condensed PSW programs have appeared across the country. On average, full-length PSW programs take about eight months to complete; these newer and shorter programs range from three to six months. The provincial governments of Ontario and Quebec have funded programs to train 6,000 and 10,000 PSW, respectively; The federal government also recently partnered with Colleges and Institutes Canada (CICan) to train 4,000 new PSWs in various provinces and territories. Graduates of that program, which is not yet available, will not work as a PSW, but in a supportive capacity that precludes participation in health care.
“The number of Canadians over the age of 85 is expected to triple in the next 30 years,” says Denise Amyot, president and CEO of CICan. “We know there is a shortage of PSW. Meanwhile, we know that many workers have been displaced from their industries during the pandemic, especially in areas such as hospitality and tourism. Our program allows participants who are unsure whether PSW’s work is suitable for them to dip their feet in the field and, at the same time, contribute to the well-being of their community while earning a salary. ” (The CICan program consists of a 10-week online course followed by a four-month paid placement.)
“What we have done with the accelerated program is to focus solely on vocational learning outcomes; for example, we have eliminated the English and general education credits, ”says Natashia Deer, president of nursing programs at Centennial. “And instead of taking eight courses at the same time, students only take four, so they can really focus on the subject.
Centennial student Jasmine Joseph in a clinical laboratory at the PSW School for Workers. (Photograph by Carmen Cheung)
Midway through his program, Joseph describes it as hands-on, collaborative, and well-designed. “We are in labs once a week, so we have access to hands-on learning,” he says. “In our skills lab, we practice feeding clients, checking their vital signs, handling equipment like wheelchairs and crutches, and what to do in an emergency.”
Still, Joseph is concerned about job issues commonly cited by public health workers. “I think they are really undervalued. Some people see PSWs as glorified babysitters, ”he says. “But it takes a lot of work to ensure that clients are treated with compassion, dignity and respect. I am also concerned about workplace injuries and overwork as there is a huge shortage. “
Burnout is a notorious problem for workers in the field and a major contributing factor to their often-cited turnover problem. According to Health Force Ontario, 50 percent of PSWs in the health care sector stay less than five years, and 43 percent cite burnout due to staff shortages as their main factor in leaving. Turnover is highest for part-time and casual positions, which represent 48% and approximately 11% of public service workers in the province, respectively.
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Is accelerated training the solution to this problem? Some experts argue that while programs like the ones described above have their place, they are only one part of a much larger picture. “If we need to create PSW and do it quickly, then an accelerated program makes sense. But the most fundamental reasons we have a national shortage is that this work is largely unregulated and not well paid, ”says Dr. Samir Sinha, director of geriatrics at Sinai Health in Toronto and an advocate for the elderly. for a long time. (Sinha is also the director of health policy research at Ryerson University’s National Institute on Aging and chair of Canada’s National Standard for Long-Term Care Services, a federal technical committee that will oversee the development of standards for long-term care).
He believes that the lack of regulation, and in turn, the lack of standardized training protocols, means that PSWs may end up ill-prepared for the jobs for which they are hired.
“In particular, I think there is not enough focus on [caring for] people living with dementia, which is a problem given that most of the people in our long-term care homes have some form of cognitive impairment, ”he says. “Bathing someone is one thing, bathing a person with significant cognitive impairment is another, especially when you are not able to do it well. The truth is, this job is incredibly highly skilled, but we don’t treat it that way. “
MORE: How the pandemic would have been different if PSWs were regulated
An Ontario study of 2020 long-term care staffing highlighted a gap between the educational experience and work environment of PSWs. The biggest complaint among new graduates of PSW programs in the long-term care sector is “preparation for the speed at which tasks must be completed,” according to the report. He also noted that staff may “feel insufficiently prepared or supported” to care for residents with cognitive impairments, who represent 81% of long-term care residents.
Sinha believes there are two main keys to solving the national PSW shortage: national, or at least provincial regulation, and pay parity in different care settings. “Pay parity is important so that there are not people jumping off the boat all the time,” he says. “A doctor earns the same salary wherever he works in Ontario. But that’s certainly not the case for the PSWs. “
Deer believes that addressing the shortage is in part a matter of convincing potential students that being a PSW can be a first step toward other careers in the healthcare sector. “We need to rethink the paths for these workers. We are in a time when it is rare for people to stay in a job for 30 years. So instead of thinking that ‘people don’t stay,’ it’s about allowing fluidity within healthcare, ”he says. “I think we should have standardized PSW roles across the country, because that would allow people to move more fluidly through the system.”
She also says educators should work to expand the public’s perception of what a PSW can do. “High school students or others who are considering entering these programs should know that while you can work with an aging population, you can also work with children or adolescents, with the appropriate training.”
RELATED: Fear and Burnout: Working as a PSW in Long-Term Care During Coronavirus
PSW’s work is also a racial and gender issue: 90 percent of the workforce is female and 41 percent is racial. “This space tends to attract racialized women and new Canadians who don’t necessarily have a ton of money in the bank to do a training program, so tuition can be a big barrier,” says Sinha, who says she supports the enrollment. -Free appearance of the new accelerated programs.
“Historically, female-dominated professions have also not paid off,” says Deer. “I think there should be a base salary, but I also believe that those who have advanced and received additional training to support the care they provide should be paid accordingly.”
In April, Ontario introduced a bill that attempts to register PSW in the province (along with medical assistants and behavior analysts). Bill 283, the Ontario Health System Advanced Planning and Supervision Act, seeks to introduce a new corporation called the Healthcare and Support Provider Supervisory Authority. It received royal approval in June, which means it will go into effect soon.
Sinha is hopeful that the bill will make a dent in the problem, but it points out what she sees as major oversights. “The bill does not mandate becoming a registered PSW and it is unclear where registration will be required,” he says. “It is difficult to force regulation on a group of people where there is no educational standard, a standard exam, etc. And in a profession where it is difficult to attract people, this could create more barriers for some. Furthermore, it is not clear how difficult it is to lose their registration when a highly vulnerable population receiving care reports so few abuses ”.
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Sinha points out that some provinces like BC, which require PSWs (known as HCAs there) to register with the province if they want to work with publicly funded health authorities, performed better in terms of organizing their workforce during the pandemic. . “I think the jury is still out on whether this new measure will make a significant difference. I certainly hope so. “
At the time of writing, Ontario had not yet graduated its first cohort. Meanwhile, more than a third of Quebec’s 10,000 student cohort did not finish the training program last year. (The province is currently training another 3,000 students to make up the difference.)
It’s unclear what impact these programs will have on the national shortage, and the problems PSWs face don’t seem to be going away anytime soon, but the enthusiasm of novice trainees looking to make a difference in the health of their communities seems as strong as ever. “I decided to take a chance and see where it ended,” says Joseph. “I love the program and am very excited to get out on the field, do my placement, and help people in my community.”
Reference-www.macleans.ca