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Report shines light on personal support worker shortage

Posted: February 14, 2020

(February 13, 2020)

By: Taylor Campbell, Windsor Star

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 — announced Wednesday at media events in Windsor, Chatham and London — 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 provincewide since May 2018.

“In Windsor and the surrounding regions, our long-term care homes are working short-staffed in virtually every home, every day, every shift,” said Shelley Smith, second vice-president of Unifor Local 2458 during a presentation to about 50 people at the union’s office Thursday.

Smith worked as a personal support worker in Windsor for 33 years. She said workers are getting injured because they don’t have the support they need. Many of them leave the field soon after entering it.

“Our personal support workers are passionate about their jobs and want to do everything they can to help our seniors in long-term care,” she said “But they are forced out of the sector because wages have remained too low for too long and working conditions are becoming increasingly difficult.”

The first “eye-opening” meeting to contribute to the report, 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, beginning in London last February, with stops in Chatham, Windsor, Kitchener-Waterloo, Hamilton, Sault Ste. Marie, Sudbury and Hamilton.

“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 that 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 reports of inadequate staffing, the impact of negative media, the extreme level of PSW shortages, and the pressure of meeting high expectations of care without enough staff, the report states.

“The situation in Windsor is critical,” said Patrick Hannon, co-chair of the Windsor Health Coalition.

“Action needs to be taken by our provincial government to solve this problem,” he said. “We’re calling for increased funding directed to improve PSW staffing levels, wages and working conditions. We’re calling for a minimum care standard, and for support for violent and aggressive residents’ care.”

In an emailed statement to the Star, ministry of long-term care spokesperson Rebecca Bozzato said the ministry is “working to improve working conditions to promote recruitment and retention in order to meet current and future staffing needs.”

A long-term care staffing strategy is in the development stage now, she said, and the ministry is committed to implementing it by the end of the year.

With files from Ellwood Shreve

THE KEY ISSUES

-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-hour period. 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 means 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.

RECOMMENDATIONS

-Provide enhanced funding to improve wages and working conditions.
-Levels of care in long-term care homes need to be increased, including more funding to improve care, which also needs to be mandated and enforceable.
-A provincial human resource recruitment and retention plan must be developed with clear, publicly reported timelines and targets, along with accountability to meet these targets.
-Provincial standards for PSW courses are needed to ensure students are prepared for the real work environment.
-Tuition costs must be substantially reduced with access to grants, daycare and other subsidies to support students.
-Staffing shortages must be reported to the Ministry of Health and posted in each home.
-A publicity campaign to share a positive image of PSWs must be developed to increase retention and attract students to the sector.
-Management should make a priority of improving the culture within long-term care to respect and value the vital work of PSWs.
-Capacity in public hospitals must be 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 be stopped.

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