{"id":24175,"date":"2023-01-06T18:47:28","date_gmt":"2023-01-06T23:47:28","guid":{"rendered":"https:\/\/www.ontariohealthcoalition.ca\/?p=24175"},"modified":"2023-03-01T01:10:58","modified_gmt":"2023-03-01T06:10:58","slug":"personal-support-worker-and-paramedic-groups-alarmed-as-psws-tapped-to-monitor-patients-awaiting-hospital-care","status":"publish","type":"post","link":"https:\/\/www.ontariohealthcoalition.ca\/index.php\/personal-support-worker-and-paramedic-groups-alarmed-as-psws-tapped-to-monitor-patients-awaiting-hospital-care\/","title":{"rendered":"Personal support worker and paramedic groups alarmed as PSWs tapped to monitor patients awaiting hospital care"},"content":{"rendered":"

(January 6, 2023)<\/p>\n

By: Alan Hale, Politics Today<\/p>\n

At least two Toronto hospitals are resorting to using personal support workers (PSWs) to watch patients who were dropped off by an ambulance so paramedics can get back on the road,\u00a0Queen\u2019s Park Today\u00a0<\/em>has learned \u2014 despite the fact that PSWs cannot provide medical care.<\/p>\n

The move has alarmed both paramedics and PSWs.<\/p>\n

\u201cI work in the east end of the city and I can tell you there are at least two hospitals (Scarborough General and Scarborough Centenary) deploying PSWs there, which can be problematic because they are not able to take complete vital signs. They\u2019re just there to keep an eye on the patient,\u201d paramedic\u00a0Charles Labelle<\/strong>, who is also a steward of the Toronto Civic Employees Union Local 416, told\u00a0Queen\u2019s Park Today<\/em>.<\/p>\n

(Labelle noted that \u201cnot all hospitals are deploying PSWs.\u201d)<\/p>\n

Even when PSWs do have some medical training, they are generally forbidden from providing medical attention in hospitals because it is outside their scope of practice.<\/p>\n

Because of this, Labelle said only \u201cvery low-acuity\u201d patients are being attended to by PSWs at the facilities in question.<\/p>\n

Another Toronto paramedic who spoke to\u00a0Queen\u2019s Park Today<\/em>\u00a0on the condition of anonymity said they are comfortable handing off patients to PSWs when their condition is stable and they are able to communicate their needs.<\/p>\n

However, in some instances patients who needed cardiac monitoring or other vital signs observed had been offloaded to PSWs, when they should have been placed in the care of a nurse or a doctor.<\/p>\n

\u201cThey are trying to shove people into care when there is no one to properly care for them,\u201d they said.<\/p>\n

When asked about the decision, a spokesperson for Scarborough Health Network confirmed that PSWs are being used as \u201cadditional supplement support for our patients\u201d and that \u201can EMS nurse is still used,\u201d but did not provide any more details.<\/p>\n

\u201cAt Scarborough Health Network quality, safe patient care is our top priority,\u201d said the hospital in a statement to\u00a0Queen\u2019s Park Today<\/em>. \u201cThis allows paramedics to offload faster, while still maintaining the safest patient care.\u201d<\/p>\n

But sources also expressed concern to\u00a0Queen\u2019s Park Today\u00a0<\/em>about what qualifications these PSWs might have.<\/p>\n

Personal support work is an unregulated profession, and while many have training from specialized post-secondary training programs, some hospitals have significantly lowered the bar for who can be hired to work as a PSW during the staffing crunch caused by the pandemic.<\/p>\n

While a patient may seem to be low-acuity when they arrive, they may not always stay that way. A blood clot could migrate and quickly turn into a stroke, or a patient\u2019s heart rate could rapidly decline, which can be deadly if it\u2019s not being monitored.<\/p>\n

Ontario Health Coalition director\u00a0Natalie Mehra\u00a0<\/strong>said PSWs should not be asked to do things that are outside their scope of practice.<\/p>\n

\u201cIt\u2019s not safe. Neither for the patient or the PSW,\u201d she said. \u201cLow acuity may sound like they don\u2019t really have a medical need, but they are arriving by ambulance at an emergency department. So there\u2019s a medical need there, obviously.\u201d<\/p>\n

There are also questions about liability and insurance surrounding the practice.<\/p>\n

The Ontario Personal Support Worker Association (OPSWA) was surprised to hear this is happening in Scarborough, telling\u00a0Queen\u2019s Park Today<\/em>\u00a0that the Scarborough Health Network had not discussed adding more responsibilities to PSWs\u2019 scope of practice with them.<\/p>\n

CEO\u00a0Miranda Ferrier<\/strong>\u00a0said the OPSWA is deeply \u201cconcerned\u201d to hear that PSWs are being utilized in the admitting process at hospitals in this way.<\/p>\n

\u201cWhile on the surface this practice is understandable, it is very concerning as the PSW scope of practice does not fully extend to the hospital setting,\u201d said Ferrier in a statement.<\/p>\n

\u201cFurthermore, the OPSWA has not been consulted by any hospitals in Ontario as to this practice therefore putting the PSW and patients at risk. The OPSWA welcomes the opportunity to work with any hospital to ensure public safety.\u201d<\/p>\n

Ontario Ministry of Health denies involvement in decision<\/h2>\n

The practice of using PSWs as a stopgap during the staffing crisis does not appear limited to these two hospitals, however, as other hospitals in Cambridge, Bradford and Ottawa have apparently spoken to the OPSWA about altering their PSWs\u2019 scope of practice.<\/p>\n

The Ministry of Health told\u00a0Queen\u2019s Park Today\u00a0<\/em>it does not control hospital staffing decisions.<\/p>\n

\u201cAlthough the Ministry of Health funds and regulates public hospitals, the ministry does not play a direct role in the governance or management of hospitals,\u201d said spokesperson\u00a0Bill Campbell\u00a0<\/strong>in an emailed statement.<\/p>\n

By tapping PSWs to monitor low-acuity patients, the hospitals are trying to reduce \u201cambulance offload delays,\u201d which can require paramedics to wait with their patients for many hours \u2014 in some extreme cases, their entire shift \u2014- until they are admitted and the first responders can get back on the road to take more 911 calls.<\/p>\n

It\u2019s a problem that has plagued ambulance services for years but has only gotten worse with the pandemic, hospital staffing shortages and the recent wave of respiratory illnesses.<\/p>\n

According to internal government\u00a0health data<\/a><\/span>\u00a0leaked to Liberal Health critic\u00a0Adil Shamji<\/strong>\u00a0in November, offloading an ambulance patient at Ontario hospitals took 90 minutes in September 2022, up from 59 minutes in 2021, and roughly 40 minutes in 2020.<\/p>\n

In Toronto, the impact of these longer delays, combined with increasing call volumes, has been profound.<\/p>\n

\u201cIt\u2019s dire right now. In 2021, we had over 1,136 incidents of having zero ambulances available in Toronto. Those are times when there is nobody available to respond to any kind of emergency. Sometimes these zero ambulance availability [periods] have lasted close to an hour in length,\u201d said Labelle, who noted that 30 per cent of Toronto paramedics are working overtime in attempt to keep up.<\/p>\n

\u201cYou can imagine how bad that is, and it\u2019s not getting any better. If anything, it\u2019s getting worse.\u201d<\/p>\n

Ultimately, said Mehra, the province \u201cbears the lion\u2019s share of the responsibility\u201d for what is happening because its management of the health-care system has led to the staffing shortage in hospitals.<\/p>\n

\u201cIt sounds like it was those particular hospitals who made this decision, and they should be liable for it \u2026 but there are things that have happened in Ontario that are the responsibility of government,\u201d said Mehra. \u201cWe have more of a staffing crisis than anyone has ever seen, there still remains very, very little happening to address it. No light at the end of the tunnel. Hospitals are in a very difficult situation.\u201d<\/p>\n

The province has tried to address the issue through the Dedicated Offload Nursing Program, which provides funds to allow nurses to take over from paramedics when they bring patients to hospital. The PCs expanded the program last January to also allow respiratory therapists and physician assistants to look after patients as well \u2014 but not PSWs.<\/p>\n

\u201cPersonal support workers are not eligible for funding through the Dedicated Offload Nursing Program,\u201d said the Ministry of Health.<\/p>\n

The Scarborough Health Network said it is using funds from the program for an EMS nurse who is being supplemented by PSWs.<\/p>\n

The government said it is providing $23 million through that program, $4.7 million of which went to help relieve Toronto Paramedic Services.<\/p>\n

The province said this is just one piece of a four-part strategy to tackle ambulance offload times, which also includes more non-ambulance patient transfers, community care and increased health-care worker capacity.<\/p>\n

CUPE Ontario spokesperson\u00a0Stella Yeadon<\/strong>\u00a0told\u00a0Queen\u2019s<\/em>\u00a0Park Today<\/em>\u00a0the union has been asking for months to meet with Premier\u00a0Doug Ford<\/strong>\u00a0about ambulance offload times, but has not received any response.<\/p>\n

Click here for original article<\/a><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

(January 6, 2023) By: Alan Hale, Politics Today At least two Toronto hospitals are resorting to using personal support workers (PSWs) to watch patients who were dropped off by an ambulance so paramedics can get back on the road,\u00a0Queen\u2019s Park Today\u00a0has learned \u2014 despite the fact that PSWs cannot provide medical care. The move has […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[21],"tags":[],"class_list":["post-24175","post","type-post","status-publish","format-standard","hentry","category-ohc-in-the-news"],"yoast_head":"\nPersonal support worker and paramedic groups alarmed as PSWs tapped to monitor patients awaiting hospital care - Ontario Health Coalition<\/title>\n<meta name=\"description\" content=\"(January 6, 2023) By: Alan Hale, Politics Today At least two Toronto hospitals are resorting to using personal support workers (PSWs) to watch patients\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ontariohealthcoalition.ca\/index.php\/personal-support-worker-and-paramedic-groups-alarmed-as-psws-tapped-to-monitor-patients-awaiting-hospital-care\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Personal support worker and paramedic groups alarmed as PSWs tapped to monitor patients awaiting hospital care - 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