‘Extreme’ PSW shortage burning out long-term care workers: Study
Posted: February 8, 2020
Personal support workers caring for some 80,000 long-term care home residents in Ontario feel anger, frustration and burnout as they struggle to meet expectations while routinely working in understaffed facilities, a new report says.
According to Caring in Crisis: Ontario’s Long-Term Care PSW Shortage, commissioned for the Ontario Health Coalition by Unifor, the situation has become an epidemic.
The report is based on accounts from the more than 350 people, including PSWs, nurses, family members, union members and long-term care home managers who took part in meetings held province-wide since May 2018.
The first “eye-opening” meeting, along with stories of “crisis-level PSW shortages” at facilities in southwestern Ontario, prompted the health coalition and Unifor to document the problems and propose solutions. Seven more roundtable meetings were held, including a stop in Sudbury.
(A meeting to talk about the report will be held in Sudbury on Feb. 20, 10 a.m. at the Sudbury Indie Cinema Co-op, 162 Mackenzie St.)
“There was total consensus that PSW shortages across Ontario in long-term care are epidemic and severe,” the report states. “Long-term care homes are short-staffed every day; in fact, virtually every shift, and in every area of Ontario.”
The report notes PSWs who shared their stories gave vivid descriptions of their difficult work conditions and the quality of care and life for residents.
“In many cases, workers are angry and upset,” the report states. “This mostly female, often racialized workforce feels they themselves are being abused and neglected.”
The report states this is due, in part, to negative media coverage about long-term care that doesn’t reflect the care, generosity and compassion given to residents every day.
“At the same time, they are frightened of the levels of aggressive behaviours and violence that they face,” the report adds. “They feel they are being held accountable for a level of care that is impossible to provide with the resources that they have been given.”
Accounts from managers supported the concerns have been expressed.
“This is not a local problem. The situation that was described to us is pressing and it requires urgent systemic action by policy-makers,” the report says.
Long-term care homes report working short one to two PSWs on nearly all shifts, which means homes can be short five to 10 PSWs in every 24 hours. Some are short 20 to 50 PSWs.
Weekends, summertime and less-appealing shifts can sometimes leave homes operating with double the shortage of PSWs.
Pay that is barely above minimum wage, with considerably heavier workloads than jobs with comparable wages, is driving PSWs to quit to work in retail or restaurants. Some PSWs opt to work in less onerous housekeeping positions at the same home.
PSW jobs in hospitals and school boards, with better pay and working conditions, also take away from the already too-small pool of available workers.
Staff shortages mean vacation time is often denied, resulting in PSWs working double shifts to cover for staff calling in sick, which has increased their own sick time and injuries.
Long-term care injury rates are high as is the turnover, particularly with young PSWs.
Burnout is a major issue, which is compounded by “compassion fatigue” frequently described as a problem among staff having to cope with grief as residents die, high expectations from families, management and government, stressful workloads and inadequate (or nonexistent) emotional support.
Compounding PSW shortages is the increase in care for many residents who are medically complex and frail.
Many residents require peritoneal dialysis, wound treatments, palliative care, post-operative care, pain management and suctioning, among other types of care.
Complex care is being provided in environments not physically designed to provide it with insufficient numbers of nursing and PSW staff.
The report recommends:
- Enhanced funding to improve wages and working conditions.
- Levels of care in long-term care homes be increased, including more funding to improve care.
- A provincial human resource recruitment and retention plan.
- Provincial standards for PSW courses to ensure students are prepared.
- Tuition costs be substantially reduced with access to grants, daycare and other subsidies to support students.
- Staffing shortages reported to the Ministry of Health and posted in each home.
- Capacity in public hospitals restored, including psychogeriatric and complex continuing care beds. The offloading of patients whose care needs are too complex to be appropriate for long-term care must stop.