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Registered nurses in Ontario feeling pressure of hospital cuts

Posted: October 23, 2017

(October 19, 2017)

By: Heidi Westfield, Ottawa Citizen

As a registered nurse, Angela Spiler has seen first-hand the impact of hospital staffing cuts in Ontario. Over the past few years, there has been a significant drop in the number of RNs in her workplace – a large, municipal hospital outside of Toronto.

The number of registered nurses on her acute medical ward has fallen, while the hospital operates at over-capacity, with patients waiting for a hospital bed. The RN staffing cuts, she says, have made it more difficult to care for her patients. She has less time to monitor their needs, prepare medications, and assess their health.

A recent national study brings into focus just how much Ontario has fallen behind when it comes to staffing of registered nurses in hospitals. The Canadian Institute for Health Information (CIHI), an independent health research body, has gathered some startling data on health care in the province. The CIHI report, released in June, identifies Ontario as having the lowest ratio of registered nurses per capita in Canada.

The CIHI report, Regulated Nurses, 2016, found Ontario had 703 RNs per 100,000 people, down from 711 in 2015. The Canadian average for 2016 was 839 RNs per 100,000 – 19.5 percent higher than in Ontario.

“Because of funding freezes, and hospitals trying to balance tighter budgets, they have basically either deleted the RN nurse, or they have replaced that nurse with a less-skilled provider,” says Linda Haslam-Stroud, President of the Ontario Nurses’ Association (ONA).

Registered nurses in Ontario are university-educated, Haslam-Stroud points out, and often have another post-secondary degree before they come to the nursing program. They require advanced training to work in a number of hospital settings such as operating rooms, nephrology floors, or neonatal wards. They are highly specialized professionals who, she stresses, should not be replaced with workers with less education and fewer clinical skills.

The CIHI report, released in June, identifies Ontario as having the lowest ratio of registered nurses per capita in Canada.

“We have so much research both in Canada and in hospitals in the United States, which shows that our patients’ health is positively impacted when there is a higher number of RNs who are able to care for our patients,” says Haslam-Stroud, adding that readmission rates to hospitals are reduced when RNs are taking care of patients.

As hospitals across the province work to balance their budgets, registered nurses are feeling the crunch of fewer staff, and a more challenging workload. The Ontario Nurses’ Association would like to see the province better recognize the vital role registered nurses play, and bolster their staffing levels to be more in line with other provinces.

Natalie Mehra, executive director of the non-partisan Ontario Health Coalition, has for years called for Ontario to invest in more nurses and hospital care. She is travelling across the province, holding consultations on the impact of hospital cutbacks.

“The Ontario government has cut nursing care to a point that is unheard of in the rest of Canada,” Mehra says, who has worked as a public health advocate for nearly two decades. “The gap with other provinces is growing every year. What it means is that a person’s health cannot be monitored properly. Patients are going without proper tracking of their medications or health status.”

Mehra calculates that hospitals have lost 20 percent of their budget in real dollar terms in the past decade. Cracks in the system are widening as hospitals feel pressure to cut staff and patient beds. She notes Ontario has cut more hospital beds per capita than any jurisdiction in the developed world; “only Turkey and Chile have fewer hospitals beds per capita than Ontario does.”

The Coalition has heard dozens of unsettling stories of overcrowded hospitals, and sick patients facing long wait times due to a shortage of hospital beds and nurses.

Once admitted into hospital, though, health care workers point out that staffing cuts can lead to another set of potential risks. Recent data shows that one in 18 hospital stays in Canada involves at least one “avoidable harmful event”. These errors put patients in jeopardy, frustrate health providers, and are also very expensive. One calculation found that hospital costs across Canada for related additional care due to these hospital errors, in the year 2014-2015, totalled $685 million dollars.

The ONA is calling on the province to invest in more registered nurses as a way to provide better care, and help reduce costly harmful events. A growing body of research suggests cutting back on RNs has long-term consequences for patients, and the quality of hospital care.

“In the last few years budgets have been tight,” notes Haslam-Stroud, “Our patients are suffering because of this. We want them to know there is a better way. And we, as nurses in Ontario, we have solutions on how to help patients get better, and live a happy and healthy life.”

This article was created by Content Works, Postmedia’s commercial content division, on behalf of Ontario Nurses’ Association

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