Ontario’s plan for personal support workers


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21 comments

  1. Catherine Richards

    Thank you Andreas Laupacis and Karen Born for covering this topic – it’s worthy of a Healthy Debate! The article is well researched and provides a balanced perspective on the current role of PSWs as understood, or more aptly, misunderstood by the public at large. Education is required all around.

    I tend to agree with Gail Donner’s comment: “a registry is a mechanism of counting and it doesn’t ensure anything about quality, preparation or standards.” I remain unconvinced of the benefits of this PSW Registry but look forward to seeing how it affects the PSW workforce and if it will improve over time the quality of the care they provide.

    In my opinion, what we need most is a ministry (MOHLTC) that will demonstrate leadership by clarifying the role of the PSW in long-term care, nursing homes, hospitals and yes, home care, and to consistently enforce high standards of care for the patients and residents receiving their care.

    We also need the government and long-term care companies and hospitals to ensure that PSWs are trained well in terms of caring appropriately for people with dementia and Alzheimer’s for instance, as these patients/residents need specialized attention. The best PSWs I have met did not always have a lot of formal education, but they possessed a lot of common sense, compassion and an adaptable nature, yet these qualities unfortunately cannot be taught though they should be celebrated. PSWs should feel able to rely on consistent supervision and clear guidance from registered nursing staff and management, yet from my observation there is a lack of communication between PSWs and RPNs/RNs in a long term care home setting, and rarely in my experience is honest communication encouraged to include patients/residents and families. In home care, PSWs have even less support or supervision which should concern people.

    Having said all that, PSWs are rarely afforded the time to properly perform the necessary tasks assigned to them and they often bear the brunt of complaints, sometimes unfairly, when care is compromised. They are not to my knowledge paid for their travel time or expense when visiting from home to home and in rural settings this reduces their income dramatically.

    In my view, it is the leadership that must accept the bulk of responsibility when PSW care standards are low because those in command cannot help but be aware that it is next to impossible for PSWs to provide the kind of quality care for vulnerable people in stressful and demanding environments if and when they are overworked, under-compensated and too often unappreciated. A PSW registry will not address these realities.

    There is also a lack of independent oversight of the entire healthcare system including long term care homes and hospitals where many PSWs work. Currently, the public is prevented from having the benefit of accountability via independent oversight by the Ontario Ombudsman although he and his team are ready and willing to provide it. I assert that a PSW Registry will do little to improve the standard of care in hospitals and long-term care homes or home care, but Ombudsman oversight would provide an immediate and direct incentive to elevate care standards. Only the government can make these decisions, but it is in both the PSWs and the public’s interest to have an independent oversight body in place when complaints arise. Are governments and long-term care companies willing to invest in accountable, quality care for the most helpless in our province or will they remain focused mainly on excuses that involve budgets or profits at the expense of our most vulnerable citizens?

    I would suggest families whose loved ones depend upon the care of PSWs to make an effort to support the PSWs in their work, physically where possible, and emotionally too, as PSWs struggle to meet the complex needs of those relying upon them in less than ideal circumstances and with limited resources. Open communication between PSW and patient/resident and family can do so much to improve conditions for all concerned. I think PSW, Maureen Hylton makes an excellent point and I know many people who share her view. A good PSW can make a great difference, but Ontario Ombudsman oversight of long term care homes and hospitals has the potential to make the greatest difference of all.

    Catherine Richards,
    Cause for Concern: Ontario’s Long Term Care Homes (Facebook group)

  2. Irene Jansen

    Thank you for calling attention to the important work of PSWs and the need for better working conditions, which are also better caring conditions. CUPE addresses these issues in Our Vision For Better Seniors’ Care:

    http://cupe.ca/privatization-watch-february-2010/our-vision-research-paper

    Irene Jansen
    Researcher, Canadian Union of Public Employees

  3. dorothy Klein R.N.

    Start with registry of PSWs. It will be mere counting but will tell where most PSWs received their education/training, how long ago, length of course, in Onario/Canada/other, etc. From this statistical information – decisions can be made on how to providetraing/education courses to upgrade those already in the field.
    Meanwhile set standards for entry to the PSW program. Entry should be a secondary school diploma with reading and writing literacy competency in either French or English. Education programs for PSWs need to be certified
    This will lead to a governing body for PSWs – the ultimate goal. PSWs should become registered as well as their education bodies to protect the public

  4. Linda Wilhelm

    As a patient who has spent far too much time in hospital I can tell you that having someone help you bathe, dress, eat and even wash your hair is as important as the medical care one receives. These are the things that help you get back on your feet and back home to finish the healing process.

  5. alex

    Im just curious to know how much of the governments budget is allocated for the funsing of psw?

  6. Mary

    I totally agree with Catherine. I have worked in a Long-Term Care Facility for four years and have many concerns myself. With my career as a PSW, I feel that we don’t have adequate time to do our jobs much better than is being done. With the high patient/staff ratio, it is totally impossible to do the task properly. Just do the math and it doesn’t take a rocket scientist to figure out that some point of care is being neglected, not saying that I am doing this, but you wonder why we have responsive behaviours??? To do our jobs better and safer we really need to have more PSW staff on the front line, and how are we going to obtain this. Our voices need to be heard. Our registered staff and administration really need to hear our voices as well. Instead of saying ” more staff is not in the nursing budget, yet they hire another RPN, they don’t help us on the floor”… Our residents are feeling rushed and I have heard some residents say “it is like an assembly line here in the morning”. For heaven’s sake, these people we are waking up at 6am are someone’s loved one’s, mother, father, brother sister, etc, with a past and have paid into society to be treated with dignity and respect. Sometimes, I don’t think these people are getting the dignity and respect they deserve. Who are our resident’s and what was their past. How do we find this out? Have more time and appropriate staff to help obtain this information so we can treat these people as individuals.

    We want to stop responsive behaviours, we need to know what triggers are. what is the root cause for the behaviours. We need the time to be able to find out this information either from the resident or the family. We can’t do this with having less than 15 mins per resident for care.

    We need to have our Provincial Government and the MOHLTC hear our PSW’s concerns as front line workers and provide us with adequate staff to do more than adequate care. Just think about it for a minute, ask yourselves “how would you like your parent or spouse treated”? let me guess, with alot of attention and care. We lets give it to all of our seniors and vulnerable people who need our compassionate care!!!!

    I also believe that registering PSW’s will eliminate those who are in the career for just the money. We need to have individual men and women who have taken on this career as a profession and treat the PSW certificate with all seriousness. We as PSW’s should be regulated and be responsible for participating in continued education. Education is what makes us a better PSW. When we are dealing with residents of Responsive Behaviours we need to have individual care givers who have been trained to support the behaviours in a positive manner. We are the front line staff and who are responsible for advocating for our seniors. It is time for us to make a difference. There has been to much abuse and resident abuse in one manner or another. Register and Regulation is the future for PSW’s.

  7. Anonymous

    Ah yes the infinite wisdom of the puppet masters in charge of determining what useless practices need to be implemented in order to keep them having projects to work on in order to justify their over paid government jobs.

    I have been a PSW for 8 years and work for a government ran Long Term Care home. Every year they talk more and more about residents rights, dignity ect ect … and yet every year, residents have been given less one on one time, poorer quality of meals, cut backs on activities and more than anything else, a lessened quality of care provided by over worked PSW’s. Everything is about legal accountability these days, not about actual quality of care. If it looks good on paper, that’s all that matters. Our floors are overwhelmed with “safety devices” which sound high pitched alarms constantly. Residents have floor mat sensors, wheelchair sensors, wander guard door alarm sensors, bed alarm sensors and add that to the endless stream of call bells and psw’s pagers sounding, it sounding like you are living inside a firestation with non-stop fire to attend to. It’s insane, and not a comfortable environment which the government chooses now to call these people’s “Home”. In regards to the sensors, when a resident is a risk for falling, these devices are implemented to alert staff when the resident falls, but they do not provide the staff to PREVENT the resident from falling. As long as they show on paper they installed a safety device, they can’t be sued so its all good for them. What usually happens however, is a resident may have a fluke fall and so they immediately install a sensor alarm, the result is anytime the resident readjusts themselves in bed or ion their chair, the alarm sounds. These devices sound anywhere from 20-50 times during an 8hr shift causing psw’s to run and answer false alarms. We get bell fatigue, and like the boy who cried wolf, eventually we stop feeling urgency to answer them. Not to mention the poor resident who feels like they are in a high security prison. So this is dignity and their “home”??

    This registry is just another cash grab and another way to make PSW’s more accountable. Since we are the front line workers and the lowest end of the healthcare scale, we are ALWAYS the fall guys. Now, it will be that much easier to put the blame on us. They add more and more to our work load, knowing full well we can’t fulfill the demands. When we do our 1.5hrs worth of charting every night they tell us to lie and say we have done restorative care and other tasks which had no time to do so they can provide funding which never seems to result in more staff. Then, when something goes wrong, the PSW takes the fall because we didn’t have the time or were to busy to properly take care of a situation which results in a resident falling or injuring themselves.

    Oh, and as for the Cupe reps reading this. You make me sick. Your union doesn’t back us up in the slightest and you have allowed for MANY additional tasks to be put onto psw’s without any increase in pay. In the past year alone our charting has become computerized and went from 25mins to 1.5hrs. We now provide restorative care like rehab workers and now are officially responsible for applying and charting for medicated creams, not to mention the additional time spent now that prn behavior meds were discontinued and restraints removed created chaos on our floors which we not only have to try to control, but are also responsible for. Whats more, when your union reps come into meeting with us to “support” us, they side with our managers and don’t assist us in any way at all. Why? Because you don’t care! At the end of the day you get your pay cheque, provided by us!

    One last thought about this registry. If you get reported within your home.. whether it be by a family member, fellow staff or even a resident who doesn’t even know their own name. You get suspended immediately until there is an investigation. If you are “innocent” of the allegations, you will still receive a “coaching letter”. This is the organizations way of covering their asses. Now, you will have a information being public on a psw registry. So even though you may have done NOTHING wrong and were “cleared” of it, they still record it in your record.

    Look Out Fellow PSW’s, they are finding new and clever ways get rid of us before we can claim our pensions! Don’t be fooled by all the ‘Better Health Care” mumble jumble, it’s all politics and money. They talk about caring for our elderly but we are the ones who are actually doing it, the conditions we have to attempt it in, are horrendous.

    You make me sick.

    Just remember, one day it could be you in the homes you are in charge of right now. Ontario government officials need to ask themselves, “Would this be how and where I would want to spend the last years of my life?”

  8. dorothy Klein R.N.

    The role of the PSW is invaluable to patient/resident/client well being. I agree with Catherine Richards’ comments expecially the need for better communication between the registered staff and the PSW. Everyone is part of the team – working TOGETHER to provide quality care for the patient/resident/client. We must ALWAYS give cieint centered care. Anything less is unacceptable

  9. Shirl

    I could have never said it this good. You are so right. You have my vote!!

  10. Rose

    What is the diferent between regulated and not regulated by minister of health ?
    my sister works for 12 dollars H in Retirenment home.very soon it will be regulated by the government,she has over 40 Residents by herself,She has to do laundry, bedding,serving tables and some shower and cleaning the facility if necessary..why the pay is too low?regulated by the minister of health will be different?

  11. Shirl

    Rose,
    I work in a retirement home as well and make the same wage as your sister. I do all the same kind of work as she does and I have 30 residents to care and I also work alone on my shifts. What is the diferent between regulated and not regulated by minister of health, nothing its all bull. As long as retirement homes are privily own they will always be run under the landlord and tenant act. That’s why they can work you like a dog and get away with it.

    • Anonymous

      Perhaps you should work in Long Term Care then, you will make a few buck more, still have 30-40 residents but at least you have a partner. On the other hand though, unlike retirement homes, for those 30-40 people, you will be dealing with aggressive behaviors, resistive residents, dementia, 75% of your residents will require a mechanical lift, you will have 1-2hrs worth of charting to do on top of your already hectic work load which they will not provide you more time to complete it, so only expect to get one 15min break in an 8 hr shift and often stay late to finish your charting.

      Retirement home workers are extremely underpaid, you are better off working at tim hortons… at least your hours will be better and you will most likely have a better benefit program. Also, you won’t have to pay for college, pay for a registration (soon) or be legally responsible and able to be sued if a resident gets injured and the company you work for pins it on you.

      With that being said, I have worked retirement living.. it’s not exactly heavy nursing care, you are more so a housekeeper and a general ADL assistant.

  12. Denyse Lynch

    My 95 year old Dad is in LTC. I see what the PSW’s do “daily” as I provide him with the care “daily” that the PSW’s would like to – but due to insufficient staff, the amount of computer reporting per shift, (1.5 hours) the heavier more care required by residents now coming in to LTC, PSW’s simply do NOT have time to maintain, let alone enhance seniors’ quality of life. The government regulations force PSW’s to be task-oriented; government load them with so many residents per staff and there are NO rules or regulations about what the ratio of PSW staff to residents “should be”, that would constitute “resident-centered, quality care.”

    The things that make “anyone’s” life meaningful – companionship, socialization, engaged in living, enabling seniors to use their existing skills, knowledge to the best of their abilities and desires are not compatible nor, possible with the current government approach.

    Until those responsible & accountable for designing and implementing “care” for seniors understand that quality is more than assistance with daily hygene, feeding, dressing, providing meds, getting people up in the morning, putting them to bed in the evening, the current problems will only be compounded with the large boomer population aging.

  13. anonymous

    I have read all of the comments and in agreement with a lot of them! however it was never mentioned that psw’s are not only caregivers/ nurses we r also sometimes ONLY friend! some patients clients have no one in their life’s (family or friends) we r their only communication to the world! we bend over backwards and we don’t even get noticed! we do more work, harder work, stressful work then those (above) us … management , nurses, and they get all the praise…. but WE are the ones that do all the w irk! and way less pay! which makes us over worked and burnt out….

  14. Anon

    As a PSW myself, I do not believe that registering us is going to be helpful to us in the least.
    First and foremost, our problems begin with the education system. The way in which a PSW course is run is disgraceful to say the least, I say this even though I had a fantastic teacher when I was in school. A 6 month crash course is more than a little underwhelming.

    Maybe other people wont agree with me and that’s fine, but I believe that if our program was constructed differently there would be many more workers in it for the love of the career and not for the money. For instance, there is very little taught about the Ethics of Health Care, Mental Health, Illnesses and Impairments these areas in particular need to be well illustrated for future PSW’s to understand why a certain client acts the way they do, why a PSW should not be doing certain things. I have found that the more newly graduated PSW’s (actually even older ones as well) I have met, the less and less educated they seem to be.

    To be a Personal Support Worker takes a lot of patience, caring and love. It is not an easy career to be in, and with that being said the education a PSW recieves should not be easy either. Yes, I understand that most of it is common sense but I am sure that if any of you other PSW’s here are like me you will agree that the quality of a PSW’s work is much more important than the quantity of PSW’s they are farming out of these schools.

    If the Ministry of Health wants to take is a step up and regulate us, they should be taking an even farther step and begin with the education they recieve. If it was up to me, the entire way they are educated would be re-considered.

    The solution to our problem begins at the top, and this all seems very backwards to me.

  15. bacon bits

    Personal support workers are one of the back bones of the health care system. We protect, care, and encourage independance. Home care workers have much more responsibility than facility workers i find. The one on one interpersonal relationships can have a more emotional exhausting effect than those of facitilty.

    Straight up, we worker more than nurses, etc. Yes they’re more educated .. yet personal support workers have the expierence! We perform routine tasks that prn do.

    Home care- not paid travel time in most cases, no benifits etc, personal support worker may be the only career job that you can do that doesn’t insure financial stability.

    As a psw, we have enough stress in taking care of others. While trying to take care of our families aswell. Psw is more recognized as a temporary stepping stone towards a career other than a full time career. Yes, we have to struggle to make money, when we paid the government to educate us to put money back into the economy and assist health care and clear up the frustration with ccac not having places to assist these people…

    We should be more appreciated and better paiid.

    How many health care professionals end up needing urgent health care in the terms of their careers. This needs to be addressed.

    I personally am retraining for a new career. As are many others i know, its not worth risking our health over.

    My opinion, a personal support worker

  16. Rose

    I do not unserstand why the PSW have to do insulin narcotic.and meds I think this is RPN job.is a RET IN Waterdown,and the PSW is doing Rpn jobs it is not right,and also they have to do all the HSKP job how the Residents can get the properly care if the PSW are too busy?

  17. Tanya Mariotti

    I am starting the PSW program in 2 weeks. I have a Health Care Aide certificate (1995), and have 6 years of experience working in Long Term Care, and private home care. In 2001, I decided to “take a break,” as I was burnt out, staff shortages, resulting in my being overworked on a regular basis. After reading the comments here, I see nothing has changed in regard to staffing, which is really disappointing! Eleven years later, and nothing has changed? Something’s wrong here! I agree with most of the PSW’s who have expressed their opinions here, as I have seen it for myself, working in similar conditions. It’s the patient who suffers in the end, staff shortages cause inadequate time to provide the necessary care, “to meet these increasingly complex needs.”

    But I will not let this discourage me from taking the course, because no other job I’ve had has even come close to being as rewarding or fulfilling:) I love working with the elderly and to see that I can make a difference in their lives is the best reward!

  18. Rose

    Tanya
    is to many P.S.W in Ontario,and is not respect for them,My sister went to the interview with Chartwell.they own Retirement and the administration told her to work voluntary she did and the work was housekeeping job,they have to clean 11 apartments per day and it is not light cleaning ,plus the laundry of 11 residents .she said why they ask for p.s.w.when they can hiring H.S.K.P The P.S.W.is every thing is the cleaning lady,the dishwasher in the facility,the laundry lady,every thing.How p.s.w. can do properly care when they have to do all this duties.in 8 hours shift L.T.C and retirement Residences are not cheap, family paid a lot of money for their parent to be in good care and the trust is not staff the sad is to pay the school and now many places are paying minimum wage ,if you work for agency doing home care you have to drive more than 5 hours to make 40 visiting 5 clients per day ,1 hour each 40 dollars!! it is not worthy.I feel really bad for the people who pay this course.kijijiji has a lot of ad ,from p.s.w looking for work.the goverment should be to stop the school,unti’ll the one who is graduated find work to support their family.

  19. Don

    I am a male PSW and lets just say that job security and guaranteed hours are a big issue. Too many PSW’s are working as a Casual Employee, this is unacceptable long term, for the short term I understand. Home Care agencies have to start paying a little better then 14.00 hr. There is going to come a time very soon where there’s not going to be enough PSW’s because of the influx in people needing care, then the agencies will be raise the hourly rate considerably. Long Term Care homes are working PSW’s to the bone, they need more staff on a day to day shift. The pay is better in Long Term care as we know but PSW’s work for that extra few dollars more an hour so it’s all relevant. Most of us enjoy the field but more work has to be done to take care of your PSW’s and a pat on the back is just not going to do it. Together we can make a difference but administration has to stop being greedy with their big wages and start finding more money to invest in your front line, the PSW.

  20. Nadia Wolfe

    Im a PSW for nine years and I think for the amount of work we do we should get more recognition for it. PSW spend more hands on time with the residents, clients then any other healthcare team members. PSW are suppose to spend quality time with the residents without rush, its pretty hard to give quality care with such little time and so many residents to care for. PSWs should get recognized just like every healthcare members, we should be registered and entitled to benifits to as part timers i think its just not fair. most PSWs feel like were worth nothing in the healthcare field when we do so much.

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