The Ontario government’s plan to invest $260 million and hire 4,000 staff within a year in the long-term care sector is, simply put, misguided.
The reason given for this financial injection is to meet the goal of providing long-term care residents with an average of four hours direct care per day. Long-Term Care Minister Rod Phillips, in his Oct. 6 announcement, also stated, “This investment will allow all homes to hire and retain the staff they need.”
This is simply not true. What this announcement and funding scheme reflect is yet another ineffective attempt to solve the crisis of the worker shortage without addressing the bigger issue – retaining the folks in these positions.
Retaining personal support workers (PSWs) – a persistent and steadily growing issue – matters. Educating and training them is costly but government spending in the past year and more has focused mainly on recruitment, leaving retention planning and strategizing lower on the list of priorities.
Health-care providers at all levels are burned out as the pandemic continues and are taking medical leave or quitting their jobs. Despite cries of help from industry stakeholders, politicians and decision-makers are ignoring the data. Why?
Critics and advocates like myself are dumbfounded by the indecision and political banter that skirts the issues.
Frankly, it’s exasperating. Since this is my area of specialty, I am going to focus on PSWs – the workers who provide personal care (bathing, feeding, dressing, positioning and toileting) of patients. Without them, residents and patients would suffer desperately as their dignity and independence often depend mainly on PSWs.
The shortage of this level of unregulated worker was documented even before the pandemic, and COVID-19 has exacerbated the situation.
In Ontario, government initiatives to “solve” this included temporary pay increases, a voluntary registry to regulate PSWs and, worst of all, more educational programs to accelerate learning or water the programs down for new levels of worker.
Temporary pay increases, with extensions given every few months, are like dangling a carrot and saying thanks for your hard work dear “unsung heroes and front-line angels,” but please keep working. And when the pandemic is over, we will end the pay increase. How insulting.
It is because most of this workforce is made up of women and minorities that this kind of political nonsense flies. Marginalized groups know this all too well.
This is yet another ineffective attempt to solve the crisis without addressing the bigger issue – retaining the folks in these positions.
Instead of providing a higher level of regulation similar to that afforded to nurses and doctors, Bill 283, which became law in the spring, creates an oversight authority with questionable disciplinary frameworks for PSWs and is based on voluntary registration. This will not protect the public; the lack of clarity on regulations is an example of flimsy planning.
Accelerated PSW programs, Supportive Care Assistant programs, online learning options for weekend courses and the creation of even more names to add to the list of 50+ titles used for this class of worker has created the need for a national organization for unregulated care providers (UCPs), a designation used in College of Nurses of Ontario documents that covers all titles and levels of unregulated workers who provide care. That would be a worthwhile investment.
National initiatives like the Employment and Social Development Canada-funded project to create a framework of occupational standards for this level of worker are a start, but they are under constant pressure to get deliverables out there. I sit on the working group and can tell you first hand that there is a lot of hard work being put into this, but the work often feels incomplete. I mean no disrespect to my peers, but this is an opinion piece and here is an example of a rushed outcome – the title used for PSWs in this national document is currently “personal care provider” (PCP). Yep, the commonly used acronym for angel dust, not a great one to knowingly assign. And the title is not even representative of what this worker does (which is more than personal care).
There is a need for a national association of unregulated care providers in Canada – a professional, national voice like the Canadian Nurses Association in which the focus is to advance the profession with the public interest in mind. Having this type of organization would promote the profession and positively impact recruitment and retention challenges since it would encourage formal UCP leadership. Organizations like OLTCA and AdvantAge Ontario and unions like SEIU, CUPE and OPSEU/SEFPO have spoken up on the need for working conditions to be improved. Having a national, professional organization along with one protected title would be an investment that helps keep the PSW workforce strong.
Retaining employees is critical to the success of the health-care team and to patient outcomes. It’s now time to focus more on retention … Who is listening?